Tobacco use is recognized as a global public health problem killing nearly 8 million people annually. Globally, an estimated 8.71 million deaths and 229.77 million disability-adjusted life years (DALYs) were associated with tobacco use in 2019, with cardiovascular disease, neoplasms, and chronic respiratory diseases identified as the leading causes of mortality. Although there has been a historical decline in tobacco-related deaths from 1990 to 2019, mortality rates and the burden of disabilities have consistently remained higher in countries with low to middle incomes.

The WHO South-East Asia Region, which is one of the largest consumers and producers of tobacco products, encounters 1.6 million deaths annually due to tobacco-related health complications. The prevalence of smokeless tobacco is still very high in this Region, and youth tobacco use is a source of deep concern. Consequently, the implementation of strict tobacco control strategies is imperative to accelerate the decline in the overall prevalence of tobacco use.

The illicit trade of tobacco also contributes significantly to the tobacco-related disease burden. The global estimate of the size of the illicit cigarette market is 11.6%. From a trade perspective, this translates to 657 billion sticks a year and approximately USD 40.5 billion in lost revenue globally. For low- and middle-income countries, eliminating the illicit trade would result in approximately USD 18.3 million in revenue, and from a health standpoint, it would save around 132,000 lives annually. While the volume of the illicit market has remained steady over time, overall cigarette consumption is declining. Consequently, the absolute size of the illicit trade market is shrinking as well.

It also notes that the common narrative of the tobacco industry – that higher tax would result in more illicit trade - turns out to be a myth for the Region.

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