1 IN 5 ADULTS STILL ADDICTED: Global tobacco use drops, but e-cigarette rise sparks new concerns

By Francis Allan L. Angelo

The number of global tobacco users has dropped significantly over the past two decades — from 1.38 billion in 2000 to 1.2 billion in 2024 — marking a 27% relative decline, according to a new report from the World Health Organization (WHO).

Despite this progress, health officials warn the tobacco epidemic is far from over, with e-cigarette use surging and one in five adults still addicted to nicotine.

The WHO Global Report on Trends in Prevalence of Tobacco Use 2000–2024, released in tandem with updated findings from the global tobacco control effort, shows uneven progress across regions and genders, and highlights the growing influence of the tobacco industry’s new nicotine products, particularly among youth.

TRENDS

From 2000 to 2024, tobacco use fell from 33.1% to 19.5% among people aged 15 and older. The reduction was largely driven by women, who achieved the WHO’s 2025 target of a 30% relative reduction five years early. Female tobacco use dropped from 11% in 2010 to just 6.6% in 2024 — representing 206 million users, down from 277 million.

In contrast, tobacco use among men remains alarmingly high. Though prevalence among men fell from 41.4% in 2010 to 32.5% in 2024, the pace has been sluggish. The male population still accounts for more than 83% of global tobacco users — nearly 1 billion men — and the 2025 target will not likely be met until 2031.

WHO officials warn that while some countries are experiencing sustained declines, others are stalling or reversing. Twelve countries are now seeing increases in tobacco use prevalence, putting millions more at risk of preventable disease and early death.

E-CIGARETTES, NICOTINE PRODUCTS

The WHO report also highlights an alarming new development: the rapid expansion of electronic nicotine delivery systems (ENDS) and other novel nicotine products, particularly among young people.

For the first time, WHO estimated that more than 100 million people globally now use e-cigarettes, including 86 million adults and at least 15 million adolescents aged 13 to 15. In countries with data, children are nine times more likely than adults to vape.

“This is a new wave of nicotine addiction,” said Etienne Krug, WHO Director of Health Determinants. “E-cigarettes are marketed as harm reduction, but in reality, they’re hooking kids on nicotine earlier and risk undermining decades of progress.”

Industry tactics have evolved with the times, WHO says, now pushing heated tobacco, nicotine pouches, and vaping devices as alternatives to traditional cigarettes. These products are frequently marketed with flavors, sleek packaging, and youth-centric branding — tactics that public health advocates compare to earlier cigarette campaigns.

REGIONAL DISPARITIES

WHO data show significant variation in tobacco trends across regions:

• South-East Asia has made the most dramatic progress. Once home to the highest prevalence globally, the region reduced male tobacco use from 70% in 2000 to 37% in 2024. It alone accounts for over half of the global reduction in users.
• Africa has the lowest current prevalence at 9.5%. However, due to rapid population growth, the absolute number of users is still increasing, posing long-term challenges.
• The Region of the Americas saw a 36% relative reduction, reaching 14% prevalence by 2024, though data gaps remain in some countries.
• In stark contrast, Europe now holds the highest tobacco prevalence globally at 24.1%, with women in the region showing the highest global rate among females at 17.4%.
• The Eastern Mediterranean Region reports 18% prevalence, with tobacco use rising in several countries.
• The Western Pacific Region shows the slowest progress, with tobacco use dropping from 25.8% in 2010 to just 22.9% in 2024. Male prevalence remains the highest globally at 43.3%.

MPOWER STRATEGY

To counter tobacco and nicotine use — especially among youth — WHO is calling for governments to fully implement the MPOWER package, a six-part policy strategy launched in 2008. The framework includes:

• Monitoring tobacco use and prevention policies.
• Protecting people from tobacco smoke.
• Offering help to quit tobacco use.
• Warning about the dangers of tobacco.
• Enforcing bans on tobacco advertising, promotion, and sponsorship.
• Raising taxes on tobacco products.

Additionally, the organization urges countries to tighten regulation of new nicotine products, close marketing loopholes, and ban flavored e-cigarettes that appeal to young users.

“Nearly 20% of adults still use tobacco or nicotine products. We cannot let up now,” said Dr. Jeremy Farrar, WHO Assistant Director-General. “Stronger, faster action is the only way to beat the tobacco epidemic”.

GLOBAL GOALS, FUTURE PROJECTIONS

WHO’s 2025 target — a 30% relative reduction in tobacco use from 2010 levels — will fall short by 50 million users if current trends continue. As of 2024, the world has achieved only a 27% reduction.

While the total number of tobacco users is projected to decline further, WHO estimates that over 1.15 billion people will still be using tobacco by 2030, unless stronger action is taken.

More than 60 countries are currently on track to meet the 2025 goal. But in 12 countries, tobacco use is increasing, and in 11 others, prior progress has reversed.

This trend has dire implications, WHO warns, particularly in countries where surveillance and policy enforcement remain weak.

(2018 Andrey Popov/Shutterstock Photo)