A new WHO global report on trends in the prevalence of tobacco use 2000–2024 and projections 2025–2030 shows that while tobacco use continues to fall across the world, the WHO European Region has the highest prevalence of tobacco consumption – and is projected to hold that position for years to come. This means higher rates of noncommunicable disease (NCD) risks, such as cancer and cardiovascular diseases, for people across Europe.
Globally, tobacco use declined from 1.38 billion users in 2000 to 1.20 billion in 2024, with progress driven by strong tobacco-control measures. But the pace of decline is uneven, and the Region is lagging behind with many unaddressed challenges.
Slowest decline among women
In 2000, more than 1 in 3 adults in the Region used tobacco (34.9%). According to the new report, by 2024 that figure dropped to 24.1%, representing 173 million people. Yet this decline falls far short of the global target of a 30% reduction by 2025 under Sustainable Development Goal (SDG) 3.a. Modelling shows that the Region will have a relative reduction in current tobacco use rates of only 19%.
Tobacco use among men has dropped more sharply, from nearly 50% in 2000 to 30.8% in 2024, with further falls expected. Among women, however, progress is slower: prevalence decreased from 22.3% in 2000 to 17.4% today and is expected to remain above 16% by 2030. The Region now has more than 40% of the world’s female smokers. This imbalance goes against the global trend where women are leading the charge to quit tobacco.
E-cigarettes threaten adolescents and children
For the first time, the WHO tobacco report assessed global patterns of e-cigarette use. The findings are striking: over 100 million people worldwide now use e-cigarettes, with the highest rates in the WHO European Region. Adult e-cigarette prevalence in the Region is 4.6% – more than double the global average.
Among adolescents aged 13–15, the picture is even more concerning: 14.3% report using e-cigarettes, the highest rate in the world. Adolescents are 3 times more likely to use e-cigarettes than adults. Among boys, e-cigarettes consumption is 2.7 times higher than among men. Among girls, the rate is 3.6 times higher than among women.
“These figures show that policies protecting children and adolescents from new and emerging nicotine and tobacco products must become a top priority in all countries,” said Kristina Mauer-Stender, WHO/Europe Regional Advisor for Tobacco Control. “Industry marketing tactics – using flavours and snappy package designs to make the deadly products appealing for the youth and exploiting legislative grey zones to promote them on social media – are hooking a new generation on nicotine.”
Overall, 11.6% of young people aged 13–15 in Europe use some form of tobacco. The Region also reports the world’s highest adolescent cigarette smoking prevalence (8.4%), with girls (8.7%) slightly ahead of boys (8.2%).
Progress in countries
Despite the challenges, the report highlights countries in the Region that are on track to achieve SDG 3.a. Eleven have already met or are set to meet the target of a 30% relative reduction in tobacco use by 2025. Eight more are close, with reductions of 25% or more, with 6 countries needing only modest policy strengthening to reach the milestone.
What steps can Europe take?
The Region’s leaders are showing that accelerated progress is achievable when robust and comprehensive measures aligned with the WHO Framework Convention on Tobacco Control (FCTC) are adopted and strong enforcement is ensured. A package of high-impact “quick-win” policies can deliver measurable results within 1 political cycle (1–5 years). Among these measures are high tobacco taxes, full enforcement of smoke-free laws, comprehensive bans on advertising, promotion and sponsorship and widely accessible cessation support.
As of 2024, 28 of 53 countries in the Region taxed tobacco at the recommended level, only 18 countries had comprehensive smoking bans in place, just 13 countries prohibited all forms of tobacco advertising, promotion and sponsorship and 12 countries offered support to quit at the level of best practice.
“The new WHO report’s results illustrate the significant policy gaps that continue to leave people across the Region vulnerable to health threats driven by the tobacco industry,” added Kristina Mauer-Stender. “To ensure a healthier, happier future for the next generations, countries must urgently adopt and enforce evidence-based policies.”