Tobacco smoking in Madagascar

In Madagascar, cigarettes are legally allowed for sale and smoke, and are subject to certain regulations. Based on these frameworks, there is a comprehensive ban on all forms of tobacco advertising, promotion, and sponsorship, and specific prohibitions are in place regarding smoking in public settings, including healthcare and educational facilities. The minimum age for sale is set at 18 years, and the country also prohibits specific distribution methods such as online sales and vending machines. Furthermore, cigarettes are subject to a specific excise tax of 31.09%, contributing to a total taxation rate of 87.74% in Madagascar.

As of 2024, the current smoking prevalence among adult males in Madagascar was 15.9%, while among adult females it was only 1.1%. The overall adult current smoking prevalence was 15.9% in 2024. This marks a slight increase from 2020, when the overall current smoking prevalence was 15.8%, and among adult males and females, the prevalence was 30.8% and 1.1%, respectively. The total number of current adult smokers in 2024 was approximately 3 million, showing an increase from 2,523,140 in 2020. The adult daily smoking prevalence in 2017 was 27.7% among males and 1.5% among females.

In terms of health outcomes, tobacco smoking led to 5,485 deaths in 2021, corresponding to 2.65% of all deaths in Madagascar. Smoking-related deaths accounted for 3.77% of all male deaths and 1.34% of all female deaths in the same year, representing 4,210 and 1,274 deaths, respectively. These figures highlight the ongoing public health challenge in Madagascar, emphasising the need for effective public health measures to mitigate the health burdens associated with smoking.