Eastern Europe and Central Asia - Regional Focus 2024
Estimates of current tobacco use prevalence in the EECA
Currently, tobacco use remains high across the region, though patterns of use differ markedly from country to country. As of 2022, approximately one third of adults in Georgia, Moldova, and Belarus were current tobacco users. In stark contrast, Turkmenistan reported a significantly lower prevalence of 5.6%. This lowers the regional average to 23.3%, equating to around 22.6 million tobacco users across EECA. At 8 million people, Ukraine had the highest number of tobacco users in 2022, followed by Uzbekistan with 4.2 million, and Kazakhstan with 3 million. At the other end of the spectrum, Turkmenistan, Moldova, Armenia, and Georgia each had fewer than one million tobacco users. This is largely attributable to their smaller population sizes.
Estimates of current tobacco use prevalence by gender in EECA (2022)
The region also exhibits significant gender disparities in tobacco use, showing an alarmingly high prevalence among men. An average of 41.2% of men were current tobacco users in 2022, compared to just 5.3% of women. These gender differences are particularly pronounced in some countries, where tobacco use rates among men are exceptionally high. In Georgia, for instance, 55.9% of the male population were current tobacco users in 2022, followed closely by Moldova at 52.4%, Kyrgyzstan at 51.3%, Armenia at 48.2%, and Belarus at 46.3%. All of these countries rank within the top 25 globally for tobacco use among men, with Georgia occupying the 5th position.
Estimates of current tobacco use and tobacco smoking in EECA (2022)
Tobacco smoking is the leading form of tobacco consumption in EECA, albeit with distinct variations across countries. In 2022, the region recorded an average smoking rate of 23.3%, accounting for 20.7 million current smokers. Projections indicate a decrease in these rates, from 28.2% in 2000 to an expected 20.5% by 2030. In countries like Uzbekistan, the prevalence of current smoking (10.7%) is significantly lower than the overall tobacco use rate (16.7%). This underscores the notable impact of smokeless tobacco, especially nasvay, on the region’s patterns of tobacco consumption.
Current use prevalence of SLT in EECA according to the most recent survey
In countries like Uzbekistan, the prevalence of current smoking (10.7%) is significantly lower than the overall tobacco use rate (16.7%). This underscores the notable impact of smokeless tobacco (SLT), especially nasvay, on the region’s patterns of tobacco consumption. According to the most recent international surveys on adult tobacco use, the prevalence of SLT is particularly high in Tajikistan (10.3%) and Uzbekistan (9.9%). This is likely to be rooted in the traditional use of nasvay and its affordability relative to cigarettes. Nasvay is predominantly used by men. About one in five adult men in Tajikistan and Uzbekistan use nasvay - a rate that exceeds male smoking prevalence. With the exception of Kyrgyzstan (5.2%) and Kazakhstan (1.4%), other countries in the EECA region report negligible rates of SLT use.
Deaths attributable to tobacco in EECA
Over the last two decades, most countries in the region have seen a decrease in the percentage of deaths attributable to tobacco. Belarus and Armenia experienced the most notable reductions between 2000 and 2019. Conversely, however, Tajikistan, Uzbekistan, Kyrgyzstan, and Azerbaijan have witnessed an increase in the share of tobacco-attributable deaths. The overall decline in tobacco-attributable death rates in EECA from 2000 to 2019 may indicate advances in tobacco control efforts, or improvements in the diagnosis and treatment of tobacco-related diseases across the region, or a combination of both.
Economic cost of tobacco use in EECA (2019)
The economic consequences of tobacco use, including both direct healthcare expenditure and indirect losses in productivity due to morbidity and mortality, are profound in EECA. Ukraine faces the most severe economic impact, where the estimated costs exceed 4% of its GDP. Tajikistan is the least affected, with tobacco related costs accounting for only 0.8% of its GDP. As well as exacerbating the pressure on these countries’ economies, these costs impact their welfare and development.
Current use prevalence of HTP according to the most recent survey in EECA
The use of heated tobacco products mostly follows the trends observed in vaping in the EECA region. Once again, Belarus (3%), Ukraine (3%) and Georgia (2.3%) show a moderate but noteworthy presence of these products and their use. Moldova deviates from this pattern, with HTP use at 2.6%, while current vaping prevalence stands at only 0.7%. Similar to the low vaping prevalence, Armenia, Azerbaijan, and Uzbekistan exhibit low rates of HTP use.