Lighting Up Trouble: Africa’s Smoking Problem
The smoking rate is rising among young Africans, and the continent does not seem to be taking the right actions to tackle it...
CREDIT: INTERNET IMAGE
Imagine a future where tobacco-related illnesses claim millions of lives across Africa. This is where we could be headed as a continent.
First, let me tell you the bad news we already know. Every year, 300,000 people in the African region die from smoking-related causes, according to the WHO.
While smoking rates in Africa have historically been lower than in high-income countries, new research suggests a troubling rise in tobacco use. Sub-Saharan Africa is now at a critical juncture, facing aggressive tobacco industry marketing and weak regulatory enforcement.
A March 2025 systematic review and meta-analysis published in Drug and Alcohol Review highlights this growing public health concern. Particularly disturbing is the increasing smoking rate among young people, urban dwellers, and lower-income groups.
The study found that men are significantly more likely to smoke than women, with some of the highest prevalence rates reported in Sierra Leone, Lesotho, and Madagascar.
Between 2018–2023, the study found that:
9% of people in Sub-Saharan Africa had smoked at least once in their lifetime.
11% had smoked in the past year.
3.5% smoked daily.
Teenagers:
4.5% had tried smoking at some point.
4.1% had smoked in the past year.
Almost 5% smoked daily.
Adults:
13% had smoked at some point in their life.
12% had smoked in the past year.
3.3% were daily smokers.
Teen Smoking and the influence of environment
A study published in Addictive Behaviors Reports found that among school-going adolescents (11-17 years old) in 53 African countries, about 14% had used some form of tobacco:
6.4% smoked cigarettes.
6.7% used other smoked tobacco.
6.4% used smokeless tobacco (like chewing tobacco).
5.2% smoked shisha.
If you smoke at home, it could be influencing teens around you. The study found that young people were more likely to use tobacco if they saw family members, schoolmates, or peers smoking.
The Nicotine and Tobacco Research Journal reported high youth smoking rates:
17.8% in Zimbabwe.
Over 10% in Seychelles, Mauritius, Mauritania, and Madagascar.
Between 6.5% and 9.5% in Algeria, Cameroon, Gabon, and The Gambia.
A 2023 article in Nature reported that Sub-Saharan Africa is experiencing one of the fastest-growing tobacco epidemics in the world. Between 1990 and 2023, the number of smokers increased by nearly 75%, and by the end of 2025, the number of smokers on the continent is expected to reach 84 million.
Weak Taxation
A major driver of increased smoking is aggressive advertising by tobacco companies and weak taxation policies. The Nicotine and Tobacco Research Journal noted:
"African countries have among the lowest excise taxes in the world. This paper provides new evidence on the association between cigarette prices and youth smoking in 16 African countries."
Currently, African countries impose some of the weakest tobacco taxes in the world, according to a WHO report:
Excise taxes make up less than 30% of the price of the most popular cigarette packs—the lowest of the six WHO regional country groupings.
In Europe, excise taxes account for about 56% of the price of a pack.
Raising taxes is one of the most effective ways to curb smoking. A 2022 study published in BMJ Journal found that when cigarette prices increase, fewer people start smoking, and existing smokers tend to smoke less.
It's a big financial burden.
Smoking is not just a health crisis—it’s also an economic burden.
A 2020 study in South Africa estimated that smoking cost the country R42 billion (US$2.88 billion), with R14.48 billion spent on medical care (hospital stays, doctor visits, etc.). Smoking-related costs accounted for 1% of South Africa’s total economy and 4.1% of healthcare spending.
In Kenya, a 2024 study estimated that smoking costs the economy between $544.7 million and $756.2 million.
CHART OF THE WEEK
Reducing smoking rates requires higher cigarette prices. How frequently does your country increase prices and track cigarette pricing data? The map below from the BMJ study provides insights
QUOTE OF THE WEEK
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RESEARCH HIGHLIGHTS
Link between diabetes and HIV in Ethiopia: this study found that 9.9% of HIV patients on treatment (ART) also had diabetes (DM). The main risk factors were being male, having a family history of diabetes, being overweight, and stopping ART at some point. About 4% of patients experienced treatment failure, meaning their HIV was not well controlled. [Reference, Nature]
Forest Loss and CO2 Emissions: as forests shrink, CO2 emissions rise. In 29 years, Africa lost 0.1 million kha of forest, at a rate of 3,500 kha per year. At the same time, CO2 emissions increased significantly. Over 77% of African countries lost more forest than they gained, with the Democratic Republic of Congo (DRC) losing the most—285.71 kha per year from 2000 to 2020. [Reference, ScienceDirect]
Making Africa's transport more eco-friendly: Africa wants to grow in a way that reduces pollution, but transportation is a big problem—it’s the second-largest source of CO2 emissions and costs the economy 6.14% of GDP each year. To understand how efficiently African countries manage transport emissions, this study looked at studies of 40 countries from 2000 to 2020 using a special efficiency analysis.Its results show that transport carbon efficiency (TCE) is low, averaging 0.372 in Africa. Central Africa has the best green transport technology, followed by Southern Africa. There is a huge potential to cut CO2 emissions—74.5% of current transport emissions could be reduced, which equals about 5,584 kt per year. [Reference, ScienceDirect]