Tobacco consumption is the largest avoidable behavioural risk factor to health in the EU and the most significant cause of premature death across EU countries, accounting for about 780 000 deaths in 2019 (IHME, 2021[1]). Tobacco use is a major risk factor for severe chronic respiratory diseases, circulatory diseases and cancer, causing over 80% of lung cancer in Europe.
Despite some progress in reducing smoking rates over the last decade, close to one in five adults (19%) still smoked daily in 2020 on average across EU countries. The proportion of adults who smoke daily is lowest in Nordic countries (Sweden, Finland, as well as Iceland and Norway) (12% or less) and at least two times higher in Greece, Hungary, France and Bulgaria (25% or above) (Figure 4.3). Estonia, Ireland, Finland, Denmark and Greece have achieved the largest reductions since 2010, with reductions of 7 or more percentage points.
During the COVID‑19 pandemic, the proportion of people who smoked increased in some countries while it decreased in others. A study gathering data from 24 countries suggests that the proportion of smokers was lower during the COVID‑19 pandemic than before. Among people who smoked, the majority did not change smoking behaviours, while similar proportions reported smoking more or smoking less (Sarich et al., 2022[2]).
Smoking remains more common among men than women in all EU countries (Figure 4.4). Nearly one in four men (24%) and one in seven women (15%) smoke daily on average in EU countries. This gender gap is particularly large in Latvia, Lithuania and Romania, as well as Moldova, Türkiye and Ukraine.
Across European countries, 3.6% of people used e‑cigarettes or similar electronic devices daily or occasionally in 2019. The proportion is higher (5.1%) among those aged 15‑24 (Figure 4.5). Regular use of e‑cigarettes is more common among men than women in virtually all EU countries. On average, 4.5% of men aged 15 and over regularly used e‑cigarettes compared with 2.6% of women in 2019. Among younger people, 6.4% of 15‑24‑years-old men regularly used e‑cigarettes compared with 3.7% of women of the same age.
The European Commission calls for stronger actions to achieve the “Smoke‑Free Generation” goal of the Europe’s Beating Cancer Plan, especially with regards to labelling, assessment of ingredients, cross-border sales, novel tobacco products such as heated tobacco products, and smoke‑free environments including outdoor spaces (European Commission, 2021[3]; 2022[4]).
