2025 全球烟草流行报告

worldHealth

rganization

WHOreporton

theglobaltobaccoepidemic,2025

Warningaboutthedangersoftobacco

Executivesummary

freshandalive

mpowur

©WorldHealthOrganization2025.

Somerightsreserved.ThisworkisavailableundertheHYPERLINK“

/licenses/by-nc-sa/3.0/

igo

”CCBY-NC-SA3.0IGOlicence.

Suggestedcitation.WHOreportontheglobaltobaccoepidemic,2025:warningaboutthedangersoftobacco.Executivesummary.Geneva:WorldHealthOrganization;2025.

/10.2471/B09466

mpowur

m

Monitortobaccouseandpreventionpolicies

p

Protectpeoplefromtobaccosmoke

o

Offerhelptoquittobaccouse

w

Warnaboutthedangersoftobacco

e

Enforcebansontobaccoadvertising,promotionandsponsorship

r

Raisetaxesontobacco

“MPOWERprovidescountrieswithproven,

cost–effectivestrategiestoreducetobaccouse.

Theresultsspeakforthemselves:millionsoflives

saved,smokingratesdeclining,andashiftin

publicattitudestowardtobaccocontrol.”

DrTedrosAdhanomGhebreyesus,

DirectorGeneral,WorldHealthOrganization

Acknowledgements

Thispublicationwasproducedby

WHODepartmentofHealthPromotionincollaborationwithWHOtechnical

programmes,WHOregionaloffices,

WHOcountryofficesandWHO

FrameworkConventiononTobacco

ControlSecretariat.WHOwouldliketothankthemanyrepresentativesoftheMinistriesofHealthandMinistriesof

Financegloballywhohavetakenthetimetosupportourdatacollection,validationandanalysesprocesses.WHOisgratefulforthecontributionsmadebyseveralexternalexperts

andpartnersincludingCampaignfor

Tobacco-FreeKids,theUnitedStates

ofAmerica(theUnitedStates),Vital

Strategies,theUnitedStates,Johns

HopkinsBloombergSchoolofPublic

Health,theUnitedStates,theUniversityofBath,theUnitedKingdomofGreat

BritainandNorthernIreland(theUnitedKingdom)SouthEastAsiaTobacco

ControlAlliance,Thailand,CanadianCancerSociety,Canada;NCDAlliance,India.

AllexternalexpertssubmittedtoWHOadeclarationofinterestdisclosing

potentialconflictsofinterestthatmightaffect,orbereasonablybe

perceivedtoaffect,theirobjectivityandindependenceinrelationtothesubjectmatterofthisreport.WHOreviewed

eachofthedeclarationsandconcludedthatnonecouldgiverisetoapotentialorreasonablyperceivedconflict

ofinterestrelatedtothesubjectsdiscussedinthisreport.

ProductionofthisWHOdocument

hasbeensupportedbyagrantfrom

BloombergPhilanthropies.The

contentsofthisdocumentarethesole

responsibilityofWHOandshouldnotberegardedasreflectingthepositionofBloombergPhilanthropies.

WHOREPORTONTHEGLOBALTOBACCOEPIDEMIC,2025/EXECUTIVESUMMARY|5

6|WORLDHEALTHORGANIZATION

Overview

Tobaccouseremainsasignificant

globalhealthchallenge,responsibleforover7milliondeathsannuallyaswellasdisabilityandlong-termsuffering

fromtobacco-relateddiseases.To

tackleoneofthegreatestthreatsto

publichealth,tobaccocontrolremainsaworldwidepriority.ThisreportisthetenthWHOreportontheglobaltobaccoepidemicandmarks20yearssincetheentryintoforceoftheWHOFrameworkConventiononTobaccoControl.The

reporthighlightsthat,in2024,over6.1billionpeople,representingover75%of

theworld’spopulation,wereprotectedbyatleastoneMPOWERmeasure

adoptedatthehighestlevel(

Fig.1

).Thisisaremarkableachievement,though

moreworkisneededtoclosethegapforthepopulationsnotcurrentlyprotected.

Since2007,thenumberofcountries1

thathadatleastoneMPOWERmeasureinplacehasmorethantripled,risingfrom44to155.Meanwhile,thosewithtwoormoremeasuresinplacehave

seenanearlytenfoldincrease(from

11to107countries)nowcoveringa

populationof4.8billion(

Fig.2

).Of

these,40countrieshavethreemeasuresinplace,7countrieshavefourmeasuresandfourcountrieshaveallfiveMPOWERmeasuresinplace.Together,these51countrieswithatleastthreeMPOWER

measuresinplaceprotect1.8billionpeople.

Ofthe40countriesthathavenot

yetreachedthehighestlevelof

achievement(orbest-practicelevel,

meaningtheyhaveachievedthecriteriaasdescribedinTechnicalNoteI)foranyMPOWERmeasure,28arejustonelevelawayfrombest-practiceforoneormoreoftheirMPOWERmeasures.Sixofthemwouldreachbest-practicelevelinWiftheyincreasedtheirhealthwarningsizeto50%ormore.

Countriesthathaveadoptedmeasuresthatarenotatbest-practiceleveloftenhavedonesointhefaceofstrong

industryoppositionandinterference.Inthisreport,wepresentcasestudiesthatdescribewhatcountrieshavedoneontheirwaytoachievingtheirbest-

practiceMPOWERmeasures.

Overall,whileprogresssince2007is

undeniable,thepaceofreachingbest-practicelevelshasslowedinrecent

years.Thecoronavirusdisease2019

(COVID-19)pandemiclikelycontributedtosomedelaysorsuspensionofpolicyadoption;however,countrieshavealsohadtheirattentiondivertedtowards

swiftlyregulatingthemultitudeofnewproductsthatareappearingintheirmarketsandthreatentoundoearlier

progressmadeintobaccocontrol.

Notably,fivecountries(Indonesia,

Oman,Palau,SierraLeoneand

Uzbekistan)thatpreviouslyhadno

best-practicemeasuresinplacehavesincereachedthehighestlevelof

achievementononeormoremeasures.

6.1billionpeople,over75%oftheworldpopulation,

arenowprotectedbyatleastoneMPOWERmeasure

atbest-practicelevel.

Fig.1.AtleastoneMPOWERmeasureathighestlevelofachievement(2007–2024)

Populationprotected(billions)

Numberofcountries

108

2014

5644

20072008

Population(billions)

76

2010

125

2016

93

2012Countries

140

2018

146

2020

155

6.1

2024

152

5.8

2022

200

150

100

50

0

1.91.2

8

7

6

5

4

3

2

1

0

Totalpopulation:8.1billion

Totalnumberofcountries:195

5.2

3.1

2.6

2.4

5.7

5.5

1Forthepurposeofthispublication,theterm“country”shouldbeunderstoodtoreferto“countriesandterritories”,asappropriate.

WHOREPORTONTHEGLOBALTOBACCOEPIDEMIC,2025/EXECUTIVESUMMARY|7

Graphichealthwarningsandplainpackaging

aremakingexceptionalprogress

ThetentheditionoftheWHOreportontheglobaltobaccoepidemicfocuses

onthe“W”componentoftheMPOWERpackage:warningaboutthedangers

oftobaccouse.Thiselementisakey

componentofcomprehensivetobaccocontrolstrategies.Evidenceindicatesthatgraphichealthwarningsareacost–effectiveinterventionthatincreases

awarenessofthehealthrisksassociatedwithtobaccouseanddemonstratesthatwarningscancontributetoincreased

cessationattempts,improvequit

successratesanddiscouragetobaccoinitiation,particularlyamongyoungpeople.

AmongallMPOWERmeasures,graphichealthwarningshaveexperiencedthemostsignificantglobalexpansionsince2007.Asof2024,56%ofcountrieshaveimplementedbest-practicegraphic

healthwarningsoncigarettepackaging.

Intotal,110countrieshaveadopted

thesemeasures,collectivelycovering

approximately5billionpeople,or62%oftheglobalpopulation.Thisrepresentssubstantialprogressrelativeto2007,

whenonlyninecountries,covering

lessthan400millionpeople,hadsuchpoliciesinplace.

In2024,graphichealthwarnings

continuedtoshowthemostprogress

amongMPOWERcomponents.Six

additionalcountriesreachedthehighestlevelofimplementation,expanding

coveragetoanadditional412millionpeoplesince2022.

Progresshasalsobeenobservedin

theimplementationofplainpackagingpolicies,whichaimtoreducethe

attractivenessoftobaccoproducts

andenhancetheeffectivenessof

healthwarnings.Bytheendof2024,

25countrieshadadoptedlegislation

mandatingplainpackagingand

issuedthenecessaryregulationsfor

implementation–threemorethanin2022.Asmallnumberofadditional

countrieshaveenactedplainpackaginglawsbuthaveyettofinalizeregulatoryframeworks.

Despitethisprogress,challenges

remain.Regardingsmokelesstobacco,119countriesmandatehealthwarningsonpackaging;however,only54oftheseincludepictorialelements.Violationsofwarningmandates,particularlywheresmokelessandirregularpackagingis

concerned,needaddressing.Inadditiontowarningsthemselves,thereare

severalwaysthattobaccopackaging

canberegulatedtostrengthentobaccocontrolincludingtherequirementto

displayaquitlinenumber(asof2024,

only55countrieshaveprovisionsforthismeasure),thebanningofdescriptors

suchasflavours(57countries)andthebanningofthedisplayofquantitativeinformationonemissionyields(67

countries).

Fig.2.AtleasttwoMPOWERmeasuresathighestlevelofachievement(2007–2024)

200

8

Totalpopulation:8.1billionTotalnumberofcountries:195

Populationprotected(billions)

7

150

6

Numberofcountries

5

4.8

4.3

3.7

3.3

4.5

1.0

1.5

1.1

107

102

100

84

71

46

37

26

15

100

4

3

50

2

1

0.50.6

0

0

11

2007200820102012201420162018202020222024

Population(billions)——Countries

8|WORLDHEALTHORGANIZATION

Graphichealthwarningsnowcover56%ofcountries

and62%oftheworldpopulation.Thisisa

12-foldincreasesince2007,whenninecountries

werecovered.

Massmediacampaignsneedmoreinvestmentglobally

Massmediacampaignsareacrucialpartofacomprehensivetobaccocontrol

strategy.Anti-tobaccocampaigns

canreachabroadaudienceandhelp

topreventtheuptakeoftobacco

amongstthosewhohavenotyettriedit.Campaignscanalsohelpsupportothertobaccocontrolmeasuresbyinformingthepublicofnewregulations,buildingcommunitysupportfornewmeasuresandprovidinginformationonhowto

seekhelptoquittobaccouse.

In2024,37countriescoveringa

populationofjustunder3billion

reportedconductinganationalmassmediacampaignthatranforthreeor

moreweeksandmetthefollowing

criteria:(1)airedontelevisionand/orradio;(2)waspartofacomprehensivetobaccocontrolprogramme;

(3)campaignmaterialswerepre-testedwiththetargetaudience;(4)media

planningwasconductedandairtimeand/orplacementwaspurchasedorsecured;(5)earnedmedia/journalistswereleveragedtogainnewscoverage;(6)processevaluationwasundertakenand(7)outcomeevaluationwas

conducted.

Atotalof85countriesreportedrunningcampaignsbetween2023and2024;ofthese,56%didnotmeetbest-practicelevel.Inmostcases,thecriteriathat

weremissingweretheimplementationofpre-testingortheuseofoutcome

evaluationaftertheimplementationofthecampaign.Onlyninecountrieshaveconductedcampaignseverybiennium

since2010whenmassmediadatawerefirstcollected.

SevencountriesareonlyonemeasureawayfromachievingallMPOWERmeasuresatthehighestlevelofachievement

Ofthe107countriesnowcoveredbyatleasttwoMPOWERmeasures,40have

threemeasuresatthehighestlevelofachievement,andsevencountrieshavefourmeasuresatthehighestlevelof

achievement(Ethiopia,Ireland,Jordan,Mexico,NewZealand,Sloveniaand

Spain).WhileSloveniahasmovedtothiscategory,onecountrydroppedoffthelistinthepasttwoyears,Iran(IslamicRepublicof).

Fig.3.Thestateofselectedtobaccocontrolpoliciesintheworld,2024

100%

90%

Proportionofcountries

(Numberofcountriesinsidebars)

80%

70%

60%

50%

40%

30%

20%

10%

0%

64

47

17

67

M

Monitoring

Noknowndata,ornorecentdata

ordatathatare

notbothrecent

Proportionofcountries

(Numberofcountriesinsidebars)

andrepresentative

Recentand

representativedataforeitheradultsoradolescents

Recentand

representativedataforbothadultsandadolescents

Recent,representativeandperiodocdataforbothadultsand

adolescents

RefertoTechnicalNoteIforcategorydefinitions.

32

39

7

17

51

40

29

21

110

63

42

24

88

102

67

79

110

36

68

40

31

37

1

100%

90%

80%

70%

60%

23

50%

12

40%

30%

20%

10%

0%

P

Smoke-free

environments

O

Cessation

programmes

E

Advertising

bans

R

Taxation

W

Massmedia

Pack

warnings

Datanotreported

Nopolicyorweakpolicy

Minimalpolicies

Moderatepolicies

Completepolicies

RefertoTechnicalNoteIforcategorydefinitions.

Note:Brunei

Darussalam

isexcludedfromRbecausenoretail

saleofcigarettesorrenewalofcigaretteimportlicenses

havebeenreportedsinceMay2014.

WHOREPORTONTHEGLOBALTOBACCOEPIDEMIC,2025/EXECUTIVESUMMARY|9

TwobillionpeopleremainunprotectedbyanyoftheMPOWERmeasuresatbest-practicelevel

Allcountriescanadoptandimplementcomprehensivetobaccocontrol

policiestopreventtheimmenseburdenimposedbytobaccouseandexposuretosecond-handsmoke.Yet,in2024,40countrieshadnotyetadoptedasingleMPOWERmeasureatbest-practice

level,leavingalmost2billionpeoplevulnerabletotheharmsoftobacco.Ofthese,28countriesareonlyonestepawayfromachievingtheirfirstbest-practiceMPOWERmeasure.

Progressmustbe

acceleratedglobally

TheMindicator,monitoringtobacco

use,hasnotyetrecoveredfromthe

after-effectsoftheCOVID-19pandemic,whenalargenumberofsurveyswere

delayedorcancelled.In2024,only67

countriesremaininthebest-practice

group,downfrom77in2022,andfromapeakof81in2016.

Completesmoke-freeindoorpublic

places,workplacesandpublictransportnowcover2.6billionpeoplelivingin

79countries,makingitthesecond

mostadoptedMPOWERmeasure,aftergraphichealthwarnings,intermsofcountriescovered.

Only31countriesareproviding

cessationservicesatbest-practicelevel.Since2022,twocountriesweregained(ElSalvadorandLithuania)whilethree

countrieswerelost(CookIslands,Iran(IslamicRepublicof)andPhilippines)

fromthebest-practicegroup.Althoughthismeasureisfullyadoptedbyveryfew

countries,thesecountriesarehometoapproximatelyonethirdoftheworld’spopulation,makingitthesecondmostadoptedMPOWERmeasureintermsofpopulationcovered.

Whiletobaccoadvertising,promotionandsponsorship(TAPS)bansremain

anunder-adoptedmeasure,justover2billionpeoplein68countriesarenowcoveredbythispolicyatbestpracticelevel.High-incomecountriesarelaggingwhenitcomestoreachingbest-practicelevelonTAPSbans,withonly18outof64high-incomecountriesreachingthislevel(28%ofallhigh-incomecountries).Bycontrast,38outof105middle-

incomecountries(36%)and12outof26low-incomecountries(46%)haveachievedbest-practicelevel.

Whileraisingpricesthroughtaxationisthemosteffectivewaytoreduce

tobaccouse,thismeasurehasbeen

slowtoprogress.Alargeincreasein

populationcoveragebythismeasurewasobservedbetween2016and2018(from8%in2016to13%in2018).Sincethen,theproportionoftheworld’s

populationprotectedbytaxesatbest-practicelevelhasrisenonlyslightlyto15%in2024.

MPOWERprogress

continuesbutthepaceisunequalacrossmeasures

MPOWERmeasureshavebeennewlyadoptedatbest-practicelevelby

additionalcountriessince2022.

■Oneadditionalcountryachieved

monitoringbest-practicelevelin

2024(MarshallIslands);however,

10countriesdroppedbackbynotmaintainingaregularprogrammeofsurveys.

■Sixcountries(CookIslands,

Indonesia,Malaysia,SierraLeone,SloveniaandUzbekistan)newly

adoptedcompletesmoke-freelawscoveringallindoorpublicplaces,workplacesandpublictransport.Twocountriesweakenedtheir

smoke-freelaws(KyrgyzstanandTajikistan).

■Twocountries(ElSalvadorand

Lithuania)advancedtobest-practicelevelbystrengtheningtheirtobaccousecessationservices.Three

countriesweakenedtheircessationservices(CookIslands,Iran(IslamicRepublicof)andPhilippines).

■Sixcountries(Côted’Ivoire,

Indonesia,Iraq,Oman,SierraLeoneandUzbekistan)adoptedlarge

graphichealthwarningsoncigarettepackaging.Threecountries(Côte

d’Ivoire,LaoPeople’sDemocraticRepublicandOman)adoptedplainpackaging.

■Fourteencountries(Algeria,

Australia,BruneiDarussalam,China,Côted’Ivoire,DemocraticPeople’sRepublicofKorea,ElSalvador,

Eswatini,Germany,Malta,Qatar,

Samoa,SaudiArabiaandUnited

RepublicofTanzania)thatrannocampaignin2022(oracampaignthatwasnotbestpractice),

implementedabest-practicemassmediacampaignin2023or2024.

■Twocountries(CookIslandsand

Morocco)introducedcomprehensivebansontobaccoadvertising,

promotionandsponsorship,includingatpoint-of-sale.

■Threecountries(Belarus,IndonesiaandPalau)movedtothebest-

practiceRgroupbylevyingtaxesthatcompriseatleast75%ofretailprice.

While40countrieshavenotyetreachedthehighestlevel

ofachievementforanyMPOWERmeasure,sevencountries

areonlyonemeasureawayfromachievingthefull

MPOWERpackage.

10|WORLDHEALTHORGANIZATION

Thenumberofcountries

applyingregulatory

restrictionsonelectronic

nicotinedeliverysystemshasbeenincreasingrapidly

Asof2024,133countriesregulate

electronicnicotinedeliverysystems

(ENDS)insomeway.Forty-twoofthesecountries(covering2.7billionpeople)banthesaleofENDS,andtheother

91countrieshaveadopted(partially

orcompletely)oneormorelegislativemeasurestoregulateENDS,covering3.7billionpeople.However,theregulationsadoptedbythesecountriesincludea

widerangeofmeasures,includingthosethatarepartoftheMPOWERpackage,withnoglobalcommonapproachto

addresstheseproducts.Atthesame

time,62countriesstillhavenoENDS

banorregulationsinplace,leaving1.7billionpeopleparticularlyvulnerableto

theactivitiesofthetobaccoandrelatedindustries.

Healthwarningsarerequiredonbothdevicesande-liquidsin56countries,ondevicesonlyinthreecountriesandone-liquidsonlyinninecountries.ENDS

arecoveredbythesameadvertisingandpromotionbansastobaccoproducts

in63countries,while47countrieshavespecificregulationsgoverningENDS

advertisingandpromotion.UseofENDSisbannedorrestrictedinpublicplacesin99countries.

ENDSmarketingtargetschildrenand

youngpeoplethroughseveraltactics,includingmakingENDSavailablewithmanyenticingflavours.Astonishingly,veryfewcountrieshavemeasuresin

placetoprotectchildrenfromENDS.

Onlysevencountriesnowbanall

flavourswhile15othersrestrictorallowspecificflavours,and74countries,

coveringapopulationof1.9billion

people,havenominimumageatwhichENDSmaybepurchased.

Since2007,MPOWERhasmadeamajorimpactonglobaltobaccocontrol

Since2007andthelaunchofthe

MPOWERtechnicalpackage,all

MPOWERmeasureshavemadenotableprogress.

Fig.4

illustrateshowgraphichealthwarningshavemadethemost

progresscomparedwiththeother

measures,protectinganadditional57%oftheworld’spopulationsince2007.

Protectingpeoplefromtobaccosmokethroughsmoke-freepublicplacesis

second,withanadditional30%oftheglobalpopulationprotectedsince2007.Althoughin2024morecountrieshave

achievedbestpracticetobaccotaxationthancessationservice(40versus31)

intermsofpopulationcoveragethetaxmeasurehasbeentheslowesttoprogress,withonlyanadditional

8%oftheworld’spopulationcoveredinthelast17years.

Fig.4.Increaseintheworldpopulationcoveredbyselectedtobaccocontrolpolicies,2007ato2024

Shareofworldpopulation

30%

16%

M

Monitoring

57%

5%

Pack

warnings

30%

3%

P

Smoke-free

environments

28%

5%

O

Cessation

programmes

70%

60%

50%

40%

30%

20%

10%

0%

23%

3%

E

Advertisingbans

4%

32%

Massmedia

8%

7%

R

Taxation

100%

90%

80%

2024

2007

W

a2010forWmassmedia,2008forRtaxation

WHOREPORTONTHEGLOBALTOBACCOEPIDEMIC,2025/EXECUTIVESUMMARY|11

Conclusion

SincetheintroductionofMPOWER,

thenumberofpeopleprotectedby

itstobaccocontrolmeasureshas

growndramatically.In2007,1.2billionpeoplewerecoveredbyatleastone

measureatbest-practicelevel.Today,morethan6.1billionpeople–over

75%oftheworld’spopulation–are

protectedbyatleastonemeasure,

and1.8billionbenefitfromthreeor

more.Thisrepresentsamorethanfive-foldincrease.

Theimpactofthisprogresshasbeensignificant.Globalsmokingprevalencedroppedfrom22.3%in2007to16.4%in2023.Hadthisdeclinenotoccurred,anestimated300millionmorepeoplewouldhavebeensmokingin2023.

Theseachievementsaretheresultofsustained,coordinatedactionbyaglobalcommunitycommittedtotobaccocontrolandresilientinthefaceofpersistentinterferencefromthetobaccoandrelatedindustries.

Yet,thefightisfarfromover.Morethan7millionpeoplecontinuetodieeachyearfromtobacco-relateddiseases.

Emergingproductslikee-cigarettes

andtheevolvingtacticsofthetobaccoindustryposenewchallenges.

Continuedvigilance,innovation,and

globalsolidarityareessentialtoprotectfuturegenerations.

EstablishingallMPOWERmeasuresatbest-practicelevel,becausethecombinedimpactofthesemeasuresisgreaterthantheirparts,isthe

bestwaytoreducetobaccouseand

improvethehealthofgenerationsto

come.Nonetheless,adoptingMPOWERmeasuresonpaperisnotenough:themeasuresmustbeimplementedand

enforcedtoensuretheinterventionsareexecutedeffectivelyandwhererelevant,legislationcompliedwith.Onlythencanthemeasuresofthepackageprotect

thepopulation.

AlthoughatleastoneMPOWERpolicyalreadyprotectsthreequartersoftheglobalpopulation,2billionpeople

across40countriesremainwithout

coverageunderanyevidence-based

tobaccocontrolmeasures,leaving

themhighlyvulnerabletothehealth

andeconomicconsequencesoftobaccouse.Whilesmokingprevalencehas

decreasedinmostcountries,overall

populationgrowthhasslowedthe

declineinthetotalnumberofsmokers.Tomitigatetheserisks,acceleratingtheadoptionofMPOWERpoliciesiscrucial.ThistenthWHOreportontheglobal

tobaccoepidemicfocusesonmeasurestowarnpeopleabouttheharmsof

tobacco,ameasurethathasoutpacedtheothersoftheMPOWERtechnical

packageintermsofadoption.Graphichealthwarningsareaparticularly

cost–effectivemeasureasthecosts

ofimplementationarebornebythe

industryandadoptionbarriersarefew.Thisreportfindsthat22countrieshavenolegalmeasuresrequiringthedisplayofhealthwarningsoncigarettepacks,potentiallyleavingtheirpopulationsunder-informedaboutthedangersoftobacco.Sixty-threecountrieshave

takenstepstowardsadoptingthe

measurebuthavefallenshortofa

comprehen