Data sourced:
2025.
Page updated:
2025-10-30
Efforts to control smoking in Macedonia are enforced through several regulatory measures. There is a complete ban on all forms of tobacco advertising. The sale and use of cigarettes are allowed including online purchase. However, purchasing through vending machines is prohibited. Import of cigarettes is allowed with a license. Moreover, health warnings on packaging are mandatory, and the minimum legal age for purchasing or selling cigarettes is 18 years. Also, there are legal restrictions on smoking in public places and the total taxation rate of 76.99%, with a specific excise tax component of 52.73% is applied to cigarettes.
Despite these control measures, smoking remains a major public health issue in Macedonia. The country reported an estimated 589,000 current adult smokers in 2024, representing an adult smoking prevalence 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 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. These deaths were 15.9% among males and 8.75% among females.
Prevalence
589,000
1
2024
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| Year | Value | Reference/Comment |
|---|---|---|
| 2017 | 46% | 1A A |
| 2024 | 39.9% | 1B |
References:
- 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.
- 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:
- 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:
- 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.
- 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:
- 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:
- 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.
- 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:
- Adults survey: General population survey on drugs in the Republic of Macedonia, 2017; National, ages 15-64
References:
- 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:
- The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
- Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
- 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:
- The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
- Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
- 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:
- The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
- Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
- 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 A |
References:
- The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
- Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
- 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 A |
References:
- The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
- Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
- 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 A |
References:
- The Tobacco Atlas. Available at: https://tobaccoatlas.org/topic/deaths/ Data source: GBD 2016 Risk Factors Collaborators.
- Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
- 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:
- Global Burden of Disease (GBD) 2021. https://vizhub.healthdata.org/gbd-results/
Comments:
- 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.
- 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:
- 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:
- 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:
- There are certain restrictions to consider.
Availability
Yes
1
A
2023
Yes
1
2023
Yes
1
A
2023
No
1
2023
Yes
2
A
2025
Yes
1
A
2023
References:
- 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.
- 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:
- There are certain restrictions to consider.
- An import license is required.
Regulations and restrictions
YES
1
2023
Yes: 18 years
1
2023
YES
1
2023
References:
- 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
0.77
1
A
2023
References:
- 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:
- Total taxes: 76.99%
The GSTHR database is updated regularly by our team.
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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.
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