Tobacco & Nicotine
Policymakers & government officials
Tobacco remains one of the largest preventable causes of disease and death in Europe. It is strongly linked to cancer, cardiovascular disease, chronic respiratory disease and other serious health conditions.
The challenge is also changing. New nicotine products, including e-cigarettes and nicotine pouches, are creating new risks for prevention, especially among children and young people.
For policymakers, tobacco and nicotine prevention is a major opportunity to save lives, reduce inequalities, protect young people and reduce pressure on health systems.
1.1 million
deaths caused by tobacco
each year in the WHO European Region
153,000
deaths linked to second-hand smoke
each year in the WHO European Region
71%
of male lung cancer deaths
linked to tobacco use in the WHO European Region
46%
of female lung cancer deaths
linked to tobacco use in the WHO European Region
Tobacco and nicotine are not ordinary consumer products
Tobacco and nicotine products are highly addictive and cause major harm to health. This means prevention is not only about information or personal choice. It is also about protecting people from products and environments designed to create and maintain dependence.
Prevention becomes harder when tobacco and nicotine products are affordable, visible, easy to access or promoted in ways that appeal to young people.
Flavours, packaging, product design, social media, sponsorship and digital marketing can all shape attitudes, behaviour and social norms.
What makes prevention harder?
Tobacco and nicotine use is shaped by addiction, availability, marketing, social norms and industry influence. This makes comprehensive policy action essential.
Prevention becomes harder when:
- Tobacco and nicotine products are cheap or easily available
- Products are promoted through flavours, packaging or attractive design
- Marketing reaches children and young people
- New nicotine products are presented as modern, discreet or harmless
- Smoke-free and nicotine-free rules are incomplete or poorly enforced
- People who want to quit cannot access support
- Industry narratives create confusion or delay effective regulation
- Policymaking is exposed to commercial influence
Protecting people from tobacco and nicotine harm requires action on the environments that shape use, exposure and addiction.
What policy can do
Policy can reduce tobacco and nicotine-related harm by changing the environments that shape use, exposure and addiction.
Important policy levers include:
Tobacco taxation and pricing policies
Smoke-free and nicotine-free environments
Marketing, advertising and sponsorship restrictions
Plain packaging and strong health warnings
Age protections and restrictions on youth access
Regulation of flavours, product design and packaging
Support for quitting tobacco and nicotine
Protection from second-hand smoke and aerosols
Safeguards against industry interference
Effective actions for tobacco and nicotine prevention
Evidence-based tobacco and nicotine prevention combines population-wide measures with support for people who want to quit.
Make tobacco less affordable
Taxation and pricing policies are among the most effective ways to reduce tobacco use, especially among young people and price-sensitive groups.
Create smoke-free and nicotine-free environments
Smoke-free environments protect people from second-hand smoke, reduce the normalisation of smoking and support people who want to quit.
Restrict marketing and promotion
Strong restrictions help protect children and young people from messages that make tobacco or nicotine products appear attractive, normal or harmless.
Regulate new nicotine products
E-cigarettes, nicotine pouches and other products require clear regulation to prevent youth uptake and avoid creating new pathways into nicotine addiction.
Reduce availability and appeal
Policies can limit flavours, attractive designs, points of sale and other features that increase appeal, especially among young people.
Support people to quit
Quitting tobacco and nicotine brings major health benefits. Policies should be combined with accessible advice, services and treatment for people who want support.
Protecting children and young people must be a priority
Children and young people are especially vulnerable to tobacco and nicotine marketing, attractive product design and social norms that make use appear normal.
New nicotine products can be promoted as modern, discreet or less harmful. Flavours, packaging and digital promotion can make these products more appealing and harder to regulate.
Prevention should protect young people from nicotine addiction before it starts, while avoiding messages that unintentionally normalise experimentation.
Industry influence is central to tobacco and nicotine prevention
Tobacco and nicotine use is strongly shaped by commercial determinants of health. Product design, pricing, marketing, packaging, lobbying, sponsorship, digital promotion and retail availability all influence behaviour and policy environments.
The WHO Framework Convention on Tobacco Control is the main international tool for guiding effective tobacco control policy. Article 5.3 is especially important because it calls for public health policies to be protected from the commercial and vested interests of the tobacco industry.
Strong governance, transparency and monitoring can help ensure that public health policy remains independent and focused on preventing harm.
Tobacco-related harm is not distributed equally
People in more disadvantaged circumstances often experience higher exposure, higher dependence and greater barriers to quitting.
This means tobacco and nicotine prevention should be designed with equity in mind. Strong population-wide measures are important, but some groups may also need targeted support to quit, protection from exposure and better access to services.
A fair approach reduces harm without blaming or stigmatising people who use tobacco or nicotine.
Questions for policymakers
Equity-focused tobacco and nicotine prevention means looking beyond overall population averages. Policymakers need to consider who is most exposed, who is most affected, and who may need additional support to benefit from prevention measures.
A strong prevention approach asks:
- Who is most exposed to tobacco and nicotine marketing?
- Who has access to cessation support?
- Are children and young people being protected from nicotine addiction?
- Are smoke-free policies protecting workers and vulnerable groups?
- Are new nicotine products being regulated quickly enough?
- Are policies reducing harm without increasing stigma?
- Is policymaking protected from industry influence?
Prevention should support people, protect health and make tobacco-free and nicotine-free environments easier, fairer and more realistic.
Practical starting points for policymakers
Public institutions and decision-makers can begin by reviewing how tobacco and nicotine products are priced, promoted, sold, regulated and used in shared environments.
Examples include:
- Strengthen tobacco taxation and reduce affordability
- Expand smoke-free and nicotine-free environments
- Restrict marketing, sponsorship and digital promotion
- Regulate flavours, packaging and product designs that appeal to young people
- Strengthen age protections and enforcement
- Reduce retail availability and points of sale
- Ensure accessible quitting support in health and community services
- Communicate clearly about nicotine addiction and health risks
- Monitor and respond to new nicotine products
- Protect policymaking from industry interference
Tobacco and nicotine prevention saves lives. Strong policy can protect young people, support people who want to quit, reduce inequalities and create healthier environments for everyone.
Explore the prevention areas
