There is still more we can do to fight the tobacco epidemic

Despite major progress, tobacco remains the world’s leading cause of preventable death and a major driver of heart disease, stroke, cancer, chronic respiratory diseases, and diabetes

AFP_Shutterstock_Al Majalla

There is still more we can do to fight the tobacco epidemic

Tedros Adhanom Ghebreyesus and Adriana Blanco Marquizo

last update on 27 Feb 2025

In the past 20 years, tobacco use has dropped by one-third globally, and there are an estimated 118 million fewer tobacco users today compared with 2005.

This is largely because 20 years ago this week, after years of negotiation, the WHO Framework Convention on Tobacco Control (WHO FCTC) entered into force—one of the most widely embraced United Nations treaties in history. The WHO FCTC was—and remains—a landmark in international law: the first treaty negotiated under the WHO Constitution, incorporating multiple measures to control the demand and supply of tobacco.

Today, the convention has 183 parties, covering 90% of the world's population. More than 5.6 billion people are protected by the comprehensive implementation of at least one tobacco control measure. For example, 138 countries now require large illustrative health warnings on cigarette packages, and dozens of countries have implemented plain packaging rules that prohibit branding on cigarette packages, making them less attractive.

In addition, 66 countries have implemented bans on tobacco advertising, promotion and sponsorship; more than one-quarter of the world’s population is protected by bans on indoor smoking and other smoke-free laws; and increased taxes on tobacco products to reduce their affordability remains the most cost-effective tool to reduce consumption. Tobacco taxes can also raise government revenues for tobacco control and health financing.

There remain around 1.3 billion tobacco users globally, fuelled by a multi-billion dollar industry that peddles addictive and deadly products

Furthermore, in 2018, an additional legal instrument went into force: a protocol to eliminate all forms of illicit trade in tobacco products, which undermines control measures, diminishes tax revenues and fuels criminal activities.

Cost to health

Despite this progress, tobacco remains the world's leading cause of preventable death and a major driver of heart disease, stroke, cancer, chronic respiratory diseases, and diabetes. There remain around 1.3 billion tobacco users globally, fuelled by a multi-billion dollar industry that peddles addictive and deadly products and profits from the suffering of those who use them.

Faced with dwindling sales of cigarettes, the industry is turning to new products such as e-cigarettes, which are falsely advertised as healthier alternatives even though they generate toxic substances—some of which are known to cause cancer and some that increase the risk of heart and lung disorders.

Tobacco manufacturers spare no effort in hooking millions of young people onto their products. Only 56 countries will reach the global goal of a 30% reduction in tobacco use by 2025.

Roughly 4.5 trillion cigarette butts are discarded every year into our environment—the second-highest form of plastic pollution in our world

Economic and environmental costs

Tobacco is not only a health problem—it threatens sustainable development as a whole. The economic cost of smoking, from health expenditures and productivity losses, is estimated at 1.8% of the world's annual gross domestic product.

Our planet also counts among tobacco's victims. Roughly 4.5 trillion cigarette butts are discarded every year into our environment—the second-highest form of plastic pollution in our world. Valuable agricultural land and water are wasted on growing tobacco instead of food. Production and consumption of tobacco also contribute to global warming, releasing 80 million tonnes of carbon dioxide into the air every year.

For all these reasons, the WHO FCTC remains as relevant today as it did when it entered into force 20 years ago, although its implementation remains uneven across countries, and many areas require strengthening.

All countries can do more, including by banning tobacco sponsorship and advertising in traditional media and social media and by protecting public health policies from tobacco industry interference. By fully implementing its provisions, countries can protect their people's health, economies, and environment for decades to come.

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