Tobacco and nicotine

26 June 2026

Key facts

Tobacco damages nearly every organ in the body, causing cancer, heart disease, stroke, lung disease, reduced fertility, weakened immunity and premature death.
Tobacco kills more than 7 million people each year, including over 1.6 million non-smokers who are exposed to second-hand smoke.
All forms of tobacco use are harmful, and there is no safe level of exposure.
Around 80% of the world's 1.2 billion tobacco users live in low- and middle-income countries
Nicotine is highly addictive and harmful, particularly for children, adolescents and young adults whose brains are still developing.

Overview

The tobacco epidemic is one of the biggest public health threats the world has ever faced, responsible for over 7 million deaths annually as well as disability and long-term suffering from tobacco-related diseases (1).

Tobacco use is a major risk factor for cardiovascular and respiratory diseases, over 20 different types or subtypes of cancer, and many other debilitating health conditions.

All forms of tobacco use are harmful, and there is no safe level of exposure to tobacco. Cigarette smoking is the most common form of tobacco use worldwide. Other tobacco products include waterpipe tobacco, cigars, cigarillos, heated tobacco, roll-your-own tobacco, pipe tobacco, bidis and kreteks, and smokeless tobacco products.

Nicotine is highly addictive and harmful, particularly for children, adolescents and young adults whose brains are still developing. Nicotine exposure during adolescence can affect brain development, including impacts on attention and learning. Early nicotine use can increase the likelihood of long-term dependence and future use of other nicotine and tobacco products. Nicotine use also increases cardiovascular risk.

Around 80% of the 1.2 billion tobacco users worldwide live in low- and middle-income countries (2), where the burden of tobacco-related illness and death is heaviest. Tobacco use contributes to poverty by diverting household spending from basic needs such as food and shelter to tobacco. This spending behaviour is difficult to curb because tobacco is very addictive.

The economic costs of tobacco use are substantial and include significant health care costs for treating the diseases caused by tobacco use, as well as the lost human capital that results from tobacco-attributable morbidity and mortality (3).

Key measures to reduce the demand for tobacco

In 2007, WHO introduced a practical, cost-effective initiative to scale up implementation of the demand reduction provisions of the WHO FCTC, called MPOWER.

The MPOWER measures are:

Monitor tobacco use and prevention policies.
Protect people from tobacco use.
Offer help to quit tobacco use.
Warn about the dangers of tobacco.
Enforce bans on tobacco advertising, promotion and sponsorship.
Raise taxes on tobacco.

WHO has been monitoring MPOWER measures since 2007 and issues annual reports with details on progress made in implementing them, at global, regional and country levels.

Surveillance is key

Good monitoring tracks the extent and character of the tobacco epidemic and indicates how best to tailor policies. Almost half of the world's population are regularly asked about their tobacco use in nationally representative surveys among adults and adolescents (4). Less frequent surveys cover another 51% of adults, making a total of 97% of adults covered by surveys worldwide (2).

Second-hand smoke kills

There is no safe level of exposure to second-hand tobacco smoke. Second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer, and kills more than 1.6 million people prematurely every year (1).

Over a third of the world's population living in 79 countries are protected from second hand smoke by comprehensive national smoke-free laws (4).

Tobacco users need help to quit

Among smokers who are aware of the dangers of tobacco, most want to quit. On average, across countries where the Global Adult Tobacco Survey has been conducted, over 60% of smokers indicated that they intend to quit (5). Counselling and medication can more than double a tobacco user’s chance of successful quitting.

National comprehensive cessation services with full or partial cost-coverage are available to assist tobacco users to quit in only 31 countries, representing a third of the world's population (4).

Health warnings work

Hard-hitting anti-tobacco mass media campaigns and pictorial health warnings prevent children and other vulnerable groups from taking up tobacco use and increase the number of tobacco users who quit.

Today 62% of the world’s population live in the 110 countries that meet best practices for graphic health warnings, which includes, among other criteria, large (50% or more of the main areas of the package showing graphic health warnings) pictorial health warnings displayed in the national language and rotating regularly (4).

Over 2.9 billion people live in the 36 countries that have aired at least one strong anti-tobacco mass media campaign within the last two years (4).

Bans on tobacco advertising lower consumption

Tobacco advertising promotion and sponsorship (TAPS) increases and sustains tobacco use by effectively recruiting new tobacco users and discouraging tobacco users from quitting.

More than one third of countries (68), representing over a quarter of the world’s population, have completely banned all forms of TAPS (4).

Taxes are effective in reducing tobacco use

Tobacco taxes are the most cost-effective way to reduce tobacco use, especially among youth and low-income groups. Implementing strong tobacco taxes is proven to lower tobacco use.

Unfortunately, only 41 countries, covering 12% of the world's population, have introduced taxes on tobacco products to the WHO recommended amount, so that at least 75% of the retail price is tax (4).

Illicit trade of tobacco products must be stopped

The illicit trade in tobacco products poses major health, economic and security concerns around the world. It is estimated that 1 in every 10 cigarettes and tobacco products consumed globally is illicit.

Experience from many countries demonstrates that illicit trade can be successfully addressed even when tobacco taxes and prices are raised, resulting in increased tax revenues and reduced tobacco use.

The WHO FCTC Protocol to Eliminate the Illicit Trade of Tobacco Products (ITP) is the key supply side policy to reduce tobacco use and its health and economic consequences.

Newer tobacco and nicotine products

Heated tobacco products (HTPs) are tobacco products that produce aerosols containing nicotine and toxic chemicals upon heating of the tobacco, or activation of a device containing the tobacco. HTPs contain tobacco and emit toxic emissions that are similar to those found in cigarettes smoke, many of which can cause cancer. HTPs are tobacco products, do not help smokers to end tobacco use and should be regulated as tobacco products.

WHO response

To address the tobacco epidemic, WHO Member States adopted the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2003 (6). Currently 182 countries and the European Union are Parties to this treaty. The WHO MPOWER measures are in line with the WHO FCTC and have been shown to save lives and reduce costs from averted health-care expenditure. Over 6 billion people are covered by at least one MPOWER measure at best practice level (4).

There is a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health interests. The tobacco industry produces and promotes products that have been proven scientifically to be addictive, to cause disease and death and to give rise to a variety of social ills, including increased poverty.

The scale of the human and economic tragedy that tobacco imposes is shocking, and also preventable. WHO is working to promote public health and save lives. The industry is working for profit.

The WHO FCTC is a milestone in the promotion of public health. It is an evidence-based treaty that reaffirms the right of people to the highest standard of health, provides legal dimensions for international health cooperation and sets high standards for compliance. Since its entry into force in 2005, the WHO FCTC has 183 Parties covering more than 90% of the world’s population.

WHO monitors adoption of MPOWER measures in Member States and publishes the WHO report on the global tobacco epidemic every two years. Detailed comparable data for all WHO Member States are available on the Global Health Observatory and country profiles are published on the MPOWER portal.