Three-quarters of the world’s citizens – 6.1 billion people – are covered by at least one of the six tobacco control measures advocated by the World Health Organization (WHO), according to the global body’s annual Tobacco Epidemic 2025 report launched at the World Conference on Tobacco Control in Dublin on Monday evening.

However, tobacco use still claims over seven million lives a year and the WHO warns that there are still significant global gaps in tobacco control, particularly to counter growing industry interference.  

The report focuses on the six proven WHO MPOWER tobacco control measures to reduce tobacco use, introduced in 2008.

Each of the letters of ‘MPOWER’ stands for an intervention:  Monitoring tobacco use and prevention policies; Protecting people from tobacco smoke with smoke-free air legislation; Offering help to quit tobacco use; Warning about the dangers of tobacco with pack labels and mass media; Enforcing bans on tobacco advertising, promotion and sponsorship; and Raising taxes on tobacco.

Some 155 countries have implemented at least one of the MPOWER measures, and four countries – Brazil, Mauritius, the Netherlands and Türkiye – have implemented all six measures. 

Seven countries have implemented five of the six measures, namely Ethiopia, Ireland, Jordan, Mexico, New Zealand, Slovenia and Spain.

Graphic health warnings

The most striking gains have been in graphic health warnings, with 110 countries enforcing these on cigarette packs. The average size of warnings has also grown from a global average of covering 30% of the pack in 2007 to almost 60% in 2024, with two countries thus far increasing the size of the warning to 92.5% (on the front and back).

The WHO also warns of “major gaps”, as 40 countries that are home to two billion people still have no MPOWER measures, while 22 countries still do not have warning labels on cigarette packs. 

Health warnings should be applied to new and emerging nicotine and tobacco products including e-cigarettes and nicotine pouches, according to the WHO report, which describes e-cigarettes with nicotine as “highly addictive and harmful to health”.

“Twenty years since the adoption of the WHO Framework Convention on Tobacco Control, we have many successes to celebrate, but the tobacco industry continues to evolve and so must we,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told the conference opening.

 “By uniting science, policy and political will, we can create a world where tobacco no longer claims lives, damages economies or steals futures. Together, we can end the tobacco epidemic.”

Tackling e-cigarettes

Dr Rüdiger Krech, the WHO’s director of Health Promotion, told a media briefing on Monday that the WHO report highlights the new threats – the spread of e-cigarettes, heated tobacco products and other nicotine products like nicotine pouches – that are being “aggressively marketed to young people”.

Krech added that the tobacco industry was deliberately flooding the market with “thousands of new products”, which made it very difficult for government regulators to keep up.

“We are calling on governments to act boldly, raise tobacco taxes to best practice levels, give people the support they need to quit tobacco, strengthen health warnings and run sustained media campaigns and protect policies from tobacco industry interference,” said Krech.

He highlighted that “134 countries have failed to make cigarettes less affordable since 2022, just three have increased taxes to the best practice level, over 30 countries allow the sales of cigarettes without health warnings, one third of the world lacks access to basic smoke free environments, and only a third of people have access to cost-covered quit services.

“Tobacco control is one of public health’s greatest success stories, and without our tobacco control efforts, we would have 300 million more smokers today. But it is not a fight we have won. Progress has come through evidence, policy and perseverance to protect future generations. We must stay the course with renewed stamina, robust research and strong partnerships,” said Krech.

Raising taxes

While the global health sector has faced enormous aid cuts over the past few months, primarily from  United States, tobacco control has been relatively sheltered as it is supported by Bloomberg Philanthropies, which over the past 20 years has committed about $1.6 billion to strengthen tobacco control policies in low- and middle-income countries, according to Bloomberg’s Kelly Larson.

Expressing full commitment to the WHO’s urgent work, founder Michael Bloomberg said that, since Bloomberg Philanthropies started supporting global tobacco control efforts in 2007, “there has been a sea change in the way countries prevent tobacco use, but there is still a long way to go.”

However, Andrew Black, from the secretariat of the Framework Convention of Tobacco Control (FCTC), urged countries to raise taxes on cigarettes to compensate for the loss of overseas development assistance.

Image Credits: WHO, Chemist 4 U/Flickr, Filter.