Prevention / Policymakers / Tobacco & Nicotine

Tobacco & Nicotine

Policymakers & government officials

Protecting people from one of Europe’s largest preventable health risks

Tobacco use remains one of Europe’s largest preventable causes of disease and death. It is a major cause of cardiovascular diseases, cancer and other non-communicable diseases, including chronic respiratory diseases.¹

The challenge is also evolving. E-cigarettes, nicotine pouches and other newer products are creating new pathways into nicotine dependence, particularly among children and young people. Product innovation, attractive designs, flavours and digital promotion can make these products easier to start using and harder for regulation to keep pace with.²

For policymakers, comprehensive tobacco and nicotine control is a major opportunity to save lives, protect future generations, reduce inequalities and ease pressure on health systems.

1.1 million

deaths caused by tobacco

each year in the WHO European Region¹

153,000

deaths caused by second-hand smoke

each year in the WHO European Region¹

71%

of male lung cancer deaths

attributable to tobacco use¹

46%

of female lung cancer deaths

attributable to tobacco use¹

public health

Tobacco and nicotine are not ordinary consumer products

Tobacco products cause major harm to health, while nicotine is highly addictive and newer nicotine products can create and maintain dependence. These are not ordinary consumer goods. Prevention therefore cannot rely only on information or personal choice. It must also address how products are designed, marketed, priced and made available.¹,²,³

Flavours, packaging, discreet product design, sponsorship, social media and digital marketing can make products more appealing and shape attitudes, behaviour and social norms, particularly among children and young people.²,³

For policymakers, this means acting on the commercial and regulatory environments that shape use, exposure and addiction.

PREVENTION CHALLENGES

What makes prevention harder?

Tobacco and nicotine use is shaped by addiction and by the environments in which products are designed, priced, promoted and sold. Information alone cannot counter these influences, which makes comprehensive policy action essential.²,³

Prevention becomes harder when:

Tobacco and nicotine products are affordable or easy to access
Flavours, packaging and discreet product designs increase their appeal
Advertising, sponsorship and digital promotion reach children and young people
New nicotine products are presented as modern, clean or less harmful
Smoke-free and aerosol-free protections are incomplete or poorly enforced
People who want to quit cannot access affordable, evidence-based support
Misleading industry narratives create confusion or delay effective regulation
Policymaking is exposed to commercial influence

Protecting people from tobacco and nicotine harm requires action on affordability, availability, marketing, product design, harmful exposure and access to quitting support.

POLICY LEVERS

What policy can do

Policy can reduce tobacco- and nicotine-related harm by changing the conditions that shape use, exposure and dependence. The WHO Framework Convention on Tobacco Control provides the foundation for comprehensive tobacco control, while newer nicotine products require timely regulation of their design, marketing and availability.³,⁴

Important policy levers include:

Tobacco taxation and pricing policies

Smoke-free and aerosol-free environments

Comprehensive restrictions on advertising, promotion and sponsorship, including in digital media

Plain or standardised packaging and strong health warnings

Age protections and stronger enforcement of youth-access restrictions

Regulation of flavours, product design and packaging

Reduced retail availability and fewer points of sale

Accessible, evidence-based quitting support and treatment

Safeguards against industry interference

What works

Effective actions for tobacco and nicotine prevention

Effective tobacco and nicotine prevention combines strong population-wide policies with accessible support for people who want to quit. The WHO Framework Convention on Tobacco Control and WHO Best Buys provide the foundation for evidence-based and cost-effective action.⁴,⁵

Some of these measures can produce measurable effects within months or a few years, showing that tobacco prevention can deliver results within a political cycle.⁶

Make tobacco and nicotine products less affordable

Higher taxes and prices are among the most effective ways to prevent initiation and reduce tobacco use, particularly among young people and price-sensitive groups.

Create smoke-free and aerosol-free environments

Comprehensive protections reduce exposure to second-hand smoke and harmful aerosols, support healthier social norms and help people who are trying to quit.

Ban marketing, promotion and sponsorship

Comprehensive restrictions, including in digital and entertainment media, protect children and young people from messages that make tobacco and nicotine products appear attractive, normal or harmless.

Regulate new nicotine products

E-cigarettes, nicotine pouches and other newer products require timely regulation of flavours, design, packaging, marketing and availability to prevent youth uptake and nicotine dependence.³

Reduce availability and appeal

Policies can reduce points of sale, restrict flavours and attractive designs, require plain packaging and prominent health warnings, and strengthen enforcement of youth-access rules.

Support people to quit

Quitting brings major health benefits. Policies should ensure that affordable, evidence-based advice, services and treatment are accessible to everyone who wants support.

YOUTH PROTECTION

Protecting children and young people must be a priority

Children and young people are especially vulnerable to nicotine addiction and to marketing that makes tobacco and nicotine products appear attractive, normal or low risk. Flavours, bright packaging, discreet designs, social media promotion and influencer marketing can all increase their appeal.²,³

The rapid growth of e-cigarettes, nicotine pouches and other products shows why regulation must keep pace with changing markets. Prevention should address the full range of tobacco and nicotine products rather than allowing regulatory gaps to create new pathways into dependence.

Protecting young people means preventing addiction before it starts through strong rules on flavours, product design, marketing, availability and age restrictions, supported by effective monitoring and enforcement. Communications should inform young people without unintentionally normalising curiosity or experimentation.²,³

COMMERCIAL DETERMINANTS OF HEALTH

Protect policymaking from industry interference

Tobacco and nicotine markets are shaped by commercial strategies including product design, pricing, marketing, lobbying, sponsorship, digital promotion and retail expansion. These activities influence patterns of use and can delay, weaken or obstruct effective public health measures.³,⁷,⁸

The WHO Framework Convention on Tobacco Control recognises a fundamental conflict between the interests of the tobacco industry and public health. Article 5.3 requires governments to protect tobacco-control policies from the commercial and other vested interests of the tobacco industry.⁴,⁷

Industry interference is evolving as tobacco and related nicotine industries exploit regulatory differences and gaps around newer products. Protection therefore requires practical implementation, including clear cross-government protocols, codes of conduct, declarations of interest, lobby and contact registers, systematic monitoring, transparency and information exchange. Monitoring can also act as an early-warning system for emerging products, marketing tactics and attempts to circumvent legislation.⁷,⁸

EQUITY

Tobacco-related harm is not distributed equally

Tobacco-related harm is not evenly distributed. People facing socioeconomic disadvantage, difficult living or working conditions, stress or limited access to health services may experience higher exposure, higher levels of tobacco use and greater barriers to quitting.⁹

Strong population-wide policies are essential, but they should be designed and monitored with equity in mind. Measures such as taxation, smoke-free protections, marketing restrictions and reduced availability can lower harm across society, while affordable cessation services and targeted support can help ensure that groups facing greater barriers are not left behind.⁵,⁹

A fair approach addresses the social, commercial and environmental conditions that shape tobacco and nicotine use, while avoiding blame or stigma towards people who use these products.

EQUITY CHECK

Questions for policymakers

Equity-focused tobacco and nicotine prevention looks beyond overall population averages. Policymakers should consider how health risks, exposure, access to support and the effects of regulation differ across population groups and communities.⁸,⁹

A strong prevention approach asks:

Are children and young people protected from nicotine addiction and targeted marketing?
Which groups experience the highest levels of tobacco use, harmful exposure and tobacco-related disease?
Who faces the greatest barriers to affordable, evidence-based quitting support?
Do smoke-free and aerosol-free policies protect people in homes, workplaces and shared public spaces?
Are tobacco and nicotine products becoming less affordable, available and appealing?
Are newer nicotine products being monitored and regulated quickly enough?
Are policies designed and communicated without blaming or stigmatising people who use tobacco or nicotine?
Are the effects of policies monitored across socioeconomic and population groups?
Are all areas of government protected from tobacco and related industry interference?
Are industry activities, lobbying and attempts to influence policy monitored transparently?⁷,⁸

Prevention should protect people, reduce inequalities and make tobacco- and nicotine-free living easier and more realistic for everyone.

WHERE TO START

Practical starting points for policymakers

Public institutions and decision-makers can begin by reviewing how tobacco and nicotine products are priced, designed, promoted and sold, how people are protected from harmful exposure, and whether government procedures adequately safeguard policymaking from industry interference.⁴,⁵,⁷,⁸

Examples include:

Strengthen taxation and ensure tobacco and nicotine products become less affordable over time
Expand comprehensive smoke-free and aerosol-free protections
Ban advertising, promotion and sponsorship, including in digital and entertainment media
Regulate flavours, packaging, product design and health warnings
Strengthen age protections, compliance checks and enforcement
Reduce retail availability and the number of points of sale
Ensure affordable, accessible and evidence-based quitting support and treatment
Communicate clearly about nicotine dependence and health risks
Monitor new products, marketing practices and patterns of use, particularly among young people
Establish clear Article 5.3 protocols, codes of conduct, declarations of interest and transparent records of necessary interactions with industry
Monitor tobacco and related industry interference and exchange information across institutions and countries

Comprehensive tobacco and nicotine prevention saves lives. Strong policy can protect children and young people, support people who want to quit, reduce inequalities and help prevent cardiovascular diseases, cancer and other non-communicable diseases.¹,⁵,⁹

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