Macedonia Background
Data sourced: 2025.   Page updated: 2025-10-30

Smoking remains a major public health issue in Macedonia. The country reported an estimated 589,000 current smokers in 2024, with an adult smoking prevalence rate of 39.9%. The adult smoking prevalence was notably higher among males (43.4%) compared to females (36.7%). In 2021, the annual number of deaths attributable to smoking was estimated to be 4,100 including 2,800 deaths among males, and 1,300 deaths among females. Mortality due to smoking was reported to consist 12.66% of all deaths in Macedonia. This was 15.9% among males and 8.75% among females.
Efforts to control smoking in Macedonia are enforced through several regulatory measures. There is a complete ban on all tobacco advertising. The sale and use of cigarettes are allowed including online purcahse. However, purchasing through vending machines is prohibited. In addition, health warnings on packaging are mandatory, and the minimum legal age for purchasing cigarettes is set at 18 years. Also, there are legal restrictions on smoking in public places and the total taxation rate of 0.77 is applied to cigarettes.

Prevalence

589,000
1
2024
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Year Value Reference/Comment
2017 46% 1A A
2024 39.9% 1B
References:
  1. WHO. WHO report on the global tobacco epidemic, 2023. Available at: https://cdn.who.int/media/docs/default-source/country-profiles/tobacco/gtcr-2023/tobacco-2023-mkd.pdf?sfvrsn=5cd39762_3&download=true. Accessed: 10 June 2025.
  2. WHO. (2025). WHO global report on trends in prevalence of tobacco use 2000–2024 and projections 2025–2030 (6th edn). World Health Organization. https://www.who.int/publications/i/item/9789240116276
Comments:
  1. Adults survey: General population survey on drugs in the Republic of Macedonia, 2017; National, ages 15-64
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Year Value Reference/Comment
2017 33.3% 1A A
2024 36.7% 1B
References:
  1. WHO. WHO report on the global tobacco epidemic, 2023. Available at: https://cdn.who.int/media/docs/default-source/country-profiles/tobacco/gtcr-2023/tobacco-2023-mkd.pdf?sfvrsn=5cd39762_3&download=true. Accessed: 10 June 2025.
  2. WHO. (2025). WHO global report on trends in prevalence of tobacco use 2000–2024 and projections 2025–2030 (6th edn). World Health Organization. https://www.who.int/publications/i/item/9789240116276
Comments:
  1. Adults survey: General population survey on drugs in the Republic of Macedonia, 2017; National, ages 15-64
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Year Value Reference/Comment
2017 54.1% 1A A
2024 43.4% 1B
References:
  1. WHO. WHO report on the global tobacco epidemic, 2023. Available at: https://cdn.who.int/media/docs/default-source/country-profiles/tobacco/gtcr-2023/tobacco-2023-mkd.pdf?sfvrsn=5cd39762_3&download=true. Accessed: 10 June 2025.
  2. WHO. (2025). WHO global report on trends in prevalence of tobacco use 2000–2024 and projections 2025–2030 (6th edn). World Health Organization. https://www.who.int/publications/i/item/9789240116276
Comments:
  1. Adults survey: General population survey on drugs in the Republic of Macedonia, 2017; National, ages 15-64
References:
  1. WHO. (2025). WHO global report on trends in prevalence of tobacco use 2000–2024 and projections 2025–2030 (6th edn). World Health Organization. https://www.who.int/publications/i/item/9789240116276

Smoking-related mortality

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Year Value Reference/Comment
2016 4,051 1A
2021 4,146 1B A
References:
  1. The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
  2. Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
  1. Number of tobacco-related deaths in the population in 2021 by gender for all age groups. Tobacco-related mortality includes smoking tobacco use, smokeless tobacco use and second-hand smoke.
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Year Value Reference/Comment
2016 1,147 1A
2021 1,297 1B A
References:
  1. The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
  2. Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
  1. Number of tobacco-related deaths in the population in 2021 by gender for all age groups. Tobacco-related mortality includes smoking tobacco use, smokeless tobacco use and second-hand smoke.
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Year Value Reference/Comment
2016 2,904 1A
2021 2,849 1B A
References:
  1. The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
  2. Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
  1. Number of tobacco-related deaths in the population in 2021 by gender for all age groups. Tobacco-related mortality includes smoking tobacco use, smokeless tobacco use and second-hand smoke.
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Year Value Reference/Comment
2016 21.16% 1A
2021 12.66% 1B B
References:
  1. The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
  2. Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
  1. Percentage of tobacco-related deaths to deaths from all causes in 2021 by gender for all age groups. Tobacco-related mortality includes smoking tobacco use, smokeless tobacco use and second-hand smoke.
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Year Value Reference/Comment
2016 11.2% 1A
2021 8.75% 1B B
References:
  1. The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
  2. Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
  1. Percentage of tobacco-related deaths to deaths from all causes in 2021 by gender for all age groups. Tobacco-related mortality includes smoking tobacco use, smokeless tobacco use and second-hand smoke.
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Year Value Reference/Comment
2016 25.1% 1A
2021 15.9% 1B B
References:
  1. The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
  2. Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
  1. Percentage of tobacco-related deaths to deaths from all causes in 2021 by gender for all age groups. Tobacco-related mortality includes smoking tobacco use, smokeless tobacco use and second-hand smoke.
References:
  1. Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
  1. Number of tobacco-related deaths in the population in 2021 by gender for all age groups. Tobacco-related mortality includes smoking tobacco use, smokeless tobacco use and second-hand smoke.
  2. Percentage of tobacco-related deaths to deaths from all causes in 2021 by gender for all age groups. Tobacco-related mortality includes smoking tobacco use, smokeless tobacco use and second-hand smoke.

Product promotion

References:
  1. WHO. WHO report on the global tobacco epidemic, 2023. Available at: https://cdn.who.int/media/docs/default-source/country-profiles/tobacco/gtcr-2023/tobacco-2023-mkd.pdf?sfvrsn=5cd39762_3&download=true. Accessed: 10 June 2025.

Regulation

References:
  1. WHO. WHO report on the global tobacco epidemic, 2023. Available at: https://cdn.who.int/media/docs/default-source/country-profiles/tobacco/gtcr-2023/tobacco-2023-mkd.pdf?sfvrsn=5cd39762_3&download=true. Accessed: 10 June 2025.
Comments:
  1. There are certain restrictions to consider.

Availability

References:
  1. WHO. WHO report on the global tobacco epidemic, 2023. Available at: https://cdn.who.int/media/docs/default-source/country-profiles/tobacco/gtcr-2023/tobacco-2023-mkd.pdf?sfvrsn=5cd39762_3&download=true. Accessed: 10 June 2025.
  2. World Bank. Cigarettes containing tobacco imports by country in 2023. Available at: https://wits.worldbank.org/trade/comtrade/en/country/ALL/year/2023/tradeflow/Imports/partner/WLD/product/240220. Accessed: 2 July 2025.
Comments:
  1. There are certain restrictions to consider.
  2. An import license is required.

Regulations and restrictions

References:
  1. WHO. WHO report on the global tobacco epidemic, 2023. Available at: https://cdn.who.int/media/docs/default-source/country-profiles/tobacco/gtcr-2023/tobacco-2023-mkd.pdf?sfvrsn=5cd39762_3&download=true. Accessed: 10 June 2025.

Tax

References:
  1. WHO. WHO report on the global tobacco epidemic, 2023. Available at: https://cdn.who.int/media/docs/default-source/country-profiles/tobacco/gtcr-2023/tobacco-2023-mkd.pdf?sfvrsn=5cd39762_3&download=true. Accessed: 10 June 2025.
Comments:
  1. Total taxes: 76.99%
The GSTHR database is updated regularly by our team. However, please be aware that the information we provide does not constitute legal advice. We cannot guarantee that the information is up to date or accurate, as the regulatory status of different product categories can change at short notice and with little publicity. If you wish to check the legal status of use or possession of any safer nicotine product in a specific country or region, you should verify the information independently. If you have reason to think that the information supplied on the GSTHR is inaccurate, please contact us with details and any references and we will rectify any errors.