WHO Says 15 Years of Tobacco Tax Increases Reduced Smoking

The World Health Organization said Wednesday that 15 years of tobacco tax reforms in a group of emerging economies show that governments can cut smoking and raise public revenue when they push cigarette prices up in a sustained way, and it used that evidence to press for broader tax increases on alcohol and sugary drinks.

The agency pointed to a new independent analysis of 15 countries that found all of them improved cigarette taxation between 2009 and 2025, though with uneven results. According to WHO, the strongest outcomes came where governments raised taxes sharply, simplified tax systems and made sure cigarettes did not become easier to buy as incomes increased.

“The evidence is clear: when governments make harmful products significantly more expensive, people consume less, lives are saved and public revenues rise,” Dr. Etienne Krug, director of WHO’s Department of Health Determinants, Promotion and Prevention, said in the statement. He said small and irregular tax changes are often erased by inflation or weakened by industry tactics, and argued for predictable increases that make tobacco, alcohol and sugary drinks progressively less affordable.

WHO tied the findings to its “3 by 35” initiative, which calls on countries to use health taxes to increase the real prices of tobacco, alcohol and sugary drinks by 2035. The agency says the policy is meant both to reduce consumption of products linked to noncommunicable diseases and injuries and to generate money that governments can invest in health and development.

The clearest example in the new analysis was the Philippines. WHO said that after a major tobacco tax reform in 2013, the inflation-adjusted price of the country’s top-selling cigarette brand rose steeply. Over the full 2008-2024 period, the analysis estimated a 638% real price increase, while cigarette smoking prevalence fell by about one-third between 2010 and 2025.

WHO also highlighted how the Philippines used part of the added revenue. It said proceeds from higher tobacco taxes were earmarked to help expand universal health coverage, a model the agency says shows how health taxes can both discourage use and fund public programs.

Ukraine recorded an estimated 659% real increase in the price of its most-sold cigarette brand between 2008 and 2024, according to the analysis. Mexico, the Philippines and Ukraine all saw significant declines in smoking after major tax and price increases, WHO said, although it noted that taxation worked alongside other tobacco control measures.

Across the 15 countries, adult tobacco use also dropped sharply in several cases. WHO cited relative declines of about 43% in India, 37% in Pakistan, 34% in Brazil and 29% in both Bangladesh and the Philippines between 2010 and 2025. Even so, the agency said progress was uneven because in many places income growth or inflation outpaced price increases, allowing cigarettes to become more affordable over time.

WHO said the stronger tobacco tax systems in the study had several common features: sizable and regular increases, simpler tax structures, greater reliance on specific excise taxes and automatic adjustments that take account of inflation and income growth.

The agency used the tobacco findings to make a wider case for taxes on other products, saying governments are still far from using beverage taxes to their full public health potential. That message could feed into tax debates across the drinks industry, especially for beer and spirits, and could also increase scrutiny of long-standing exemptions for wine in some markets if governments move to align tax treatment across alcohol categories.

WHO said at least 116 countries impose a national excise tax on one or more types of sugar-sweetened beverage, but the global median excise tax share on a comparable carbonated sugary drink is only 2.4% of the retail price. It said sugary drinks became less affordable between 2022 and 2024 in just 34 countries, while they became more affordable in 62 countries.

The agency also said design matters. Only around one quarter of countries with the relevant tax systems base their beverage taxes on sugar content, WHO said, even though that approach can steer consumers toward lower-sugar products and push manufacturers to reformulate. Just 14% automatically adjust specific taxes, the agency added, leaving most systems exposed to erosion from inflation.

WHO pointed to several countries that direct part of sugary drink tax revenue to health spending. It cited Azerbaijan, France, Hungary, the Philippines and Tanzania as examples where some proceeds support expanded health coverage. It said Panama, Russia and Zimbabwe use revenue for programs focused on cancer, diabetes or other noncommunicable diseases, while Poland and Portugal direct funds to broader health purposes.

The highest total tax share on a comparable sugary drink was reported in Timor-Leste at about 53% of the retail price, WHO said. Globally, however, the total tax share averages only about 22%, which the agency said is roughly two-thirds lower than the total tax share imposed on cigarettes.

On alcohol, WHO said taxes are more common but still too low to meet the goals it is promoting. At least 167 countries apply national alcohol excise taxes, according to the agency. On a population-weighted basis, it said excise represents about 21% of the retail price of beer and 28% of spirits.

WHO also said affordability moved in the wrong direction in many places. Between 2022 and 2024, beer became less affordable in only 31% of countries and spirits in only 22%, the agency said. Fewer than one in four countries with specific alcohol taxes require regular automatic increases, and at least 25 countries continue to exempt wine from excise taxation.

Those figures matter for brewers, distillers and wine producers because they suggest future reform efforts may focus less on whether alcohol is taxed at all and more on how often rates rise, whether taxes keep pace with inflation and whether different types of drinks are treated equally. In countries where beer and spirits already face excise taxes but wine remains exempt, that gap could become a clearer target for policymakers if health tax plans advance.

WHO said the “3 by 35” initiative calls for a 50% real price increase by 2035. To do that, nominal prices would need to roughly double globally on average, the agency said. It gave benchmark figures showing cigarettes rising from $4.70 to $9.60 per pack, beer from $1.30 to $3.10 per 330-milliliter serving and sugar-sweetened beverages from $0.90 to $1.90 per 330-milliliter serving. In low-income countries, WHO said, the increases needed would be larger, with prices needing to more than triple.

The organization is urging governments to create long-term tax road maps, automatically adjust taxes for inflation and income growth, close loopholes, remove favorable treatment for cheaper products and make sure comparable tobacco, alcohol and sugary drink products are covered by the rules.

The paper behind the tobacco analysis, “Excise Taxes in Emerging Economies: Progress on Cigarette Taxation in the Bloomberg Initiative, 2009-2025,” was written by Rajeev Cherukupalli of the Johns Hopkins Bloomberg School of Public Health and published in Tax Notes International. WHO said the analysis was supported by Bloomberg Philanthropies under the 3 by 35 initiative. The agency also said its 2025 global reports on sugar-sweetened beverage and alcohol taxes rely on country-reported data with a cutoff date of July 31, 2024.

WHO said it has launched a website for the 3 by 35 initiative to support implementation, share information and strengthen country-level advocacy. The agency said it also plans to publish country case studies as governments move ahead with tax reforms.