Tobacco use causes 1.1 million deaths in the WHO European Region each year, and over 50 000 premature deaths in the Western Balkans. Mortality and morbidity from tobacco use costs the countries of Western Balkans up to 5% of their gross domestic product as they are losing economically productive individuals and have to pay for treating tobacco-related diseases. This region faces a dual challenge: persistently high tobacco consumption and the presence of illicit tobacco products that pose risks to public health and economic stability. Montenegro hosted a series of high-level events and technical meetings in March 2025, to respond to these pressing issues.
“It’s a simple truth: the tobacco industry remains one of the world’s deadliest and most insidious, its products placing an unbearable burden on families, health systems and economies. Yet every single death it causes is preventable,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.
Policy-makers, health experts, international organizations and civil society groups from the Western Balkans attended the events to strengthen regional political commitment, promote the ratification and implementation of the WHO Protocol to Eliminate Illicit Trade in Tobacco Products, and enhance multisectoral cooperation to protect public health.
A cross-border challenge
On 12–13 March 2025, the Ministry of Finance of Montenegro – in collaboration with the WHO Country Office in Montenegro, the Secretariat of the WHO Framework Convention on Tobacco Control (WHO FCTC), Johns Hopkins University and WHO/Europe – hosted a series of technical and high-level meetings on measures to eliminate the illicit trade in tobacco products.
Finance ministers and deputy finance ministers from Albania, Bosnia and Herzegovina (Republika Srpska), Montenegro, North Macedonia and Serbia joined the event to strengthen efforts to curb the illicit tobacco trade and promote effective tobacco tax policy.
“Our goal is not only to reduce illegal trade, but to build a healthier, safer and more prosperous society,” said Prime Minister of Montenegro, Milojko Spajić, at the event. The illicit tobacco trade circumvents price and tax measures that are among the most effective tools to reduce tobacco use. Smuggled products are cheaper and more accessible to young people and vulnerable populations, while depriving governments of revenue.
“Eliminating the illicit trade in tobacco products is not optional – it is a priority. It undermines the rule of law, weakens the system and endangers youth,” explained Montenegro’s Minister of Finance, Novica Vuković.
Debunking the myth: taxation vs illicit trade
“The tobacco industry frequently argues that higher tobacco taxes drive illicit trade, using this narrative to delay or dilute tobacco tax reform. However, as highlighted by WHO and international researchers, the evidence shows the opposite: countries with strong governance and tax administration can increase tobacco taxes while reducing illicit trade,” said Dr Mina Brajovic, Head of the WHO Country Office in Montenegro.
The Protocol to Eliminate Illicit Trade in Tobacco Products, a treaty under the WHO FCTC, offers countries a roadmap to strengthen tobacco supply chain controls, implement global tracking and tracing systems, and enhance law enforcement and international cooperation.
The events concluded with commitments to accelerate the ratification and implementation of the Protocol. Delegates also voiced concerns over the tobacco industry’s ongoing interference in policy development, calling for greater protections to ensure public health remains a top priority.
Parliamentarians driving tobacco control action
Building on this momentum, on 25–26 March 2025 the Western Balkans Parliamentary Summit on Tobacco Control was held in Budva, Montenegro. Hosted by the country’s parliament and the WHO Country Office, and supported by WHO/Europe and WHO FCTC Secretariat, the summit brought together members of parliament (MPs) from Bosnia and Herzegovina (Republika Srpska), Montenegro, North Macedonia and Serbia to reaffirm their commitment to curbing tobacco use and protecting youth from the harms of nicotine addiction.
MPs discussed how tobacco control is not only a health issue, but also a matter of economic resilience, social equity and environmental sustainability.
Regionally relevant measures to strengthen tobacco control through legislative and policy reform have been recommended across the Western Balkans. Key priorities include:
- banning flavours in all nicotine and tobacco products and mandating plain packaging to reduce appeal, especially among youth;
- raising taxes regularly and significantly to reduce affordability;
- restricting access to emerging nicotine products through strong regulation to protect future generations;
- ensuring 100% smoke- and aerosol-free indoor environments in public places, workplaces and public transport.
“These measures are achievable, evidence-based and cost-effective. Political will and parliamentary leadership are essential to protect health, save lives and secure a tobacco-free future for the next generation,” said Dr Brajovic.
In 2021, the prime ministers of Western Balkan countries endorsed “The roadmap for health and well-being in the Western Balkans, 2021–2025”. It serves as a foundation for elevating health on the political agenda, and collaboratively implementing impactful initiatives. Tobacco use is undeniably a shared concern, and the measures outlined in the FCTC provide means to combat this issue.