PAHO and WHO present their 2025-2030 tobacco control strategy for the Americas region

A new report from the’The Pan American Health Organization (PAHO) and the World Health Organization (WHO) present a roadmap to 2030 aimed at accelerating the implementation of the most effective tobacco control measures, beyond existing obligations, in order to reduce tobacco use and premature deaths from non-communicable diseases (NCDs) in the Americas.[1]. It incorporates an equity-based approach, targeting vulnerable populations, and covers all tobacco and nicotine products. In the Americas Region, tobacco-related NCDs—cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes—account for 81% of annual deaths, and tobacco use causes approximately one million deaths each year, particularly affecting populations in low- and middle-income countries.

A strategy based on proven global treaties and programs

This report is part of the implementation of the Framework Convention on Tobacco Control (FCTC), adopted in 2003 and entered into force in 2005, to which 183 WHO Member States are Parties, and the recommendations of its MPOWER program: monitoring tobacco use and prevention policies, protecting the population from tobacco smoke, providing support to those who want to quit smoking, warning about the dangers of smoking, enforcing the ban on tobacco advertising, promotion, and sponsorship, and increasing tobacco taxes. It also draws on the Protocol to Eliminate Illicit Trade in Tobacco Products, adopted in 2012 and entered into force in 2018, to which 72 WHO Member States are Parties. Robust evidence shows that their implementation is effective in combating this epidemic, which has high social, economic, and environmental costs.

It is worth noting that smoking remains the leading cause of premature and preventable death worldwide and a major risk factor for non-communicable diseases. According to WHO estimates, approximately 133 million adult smokers aged 15 and over live in the Americas, representing 11.3 million of the global adult smokers. The smoking prevalence among women is 11.4 million, higher than the global average of 7.4 million. Furthermore, it is estimated that at least five million adolescents aged 13 to 15 in the region use some form of tobacco.

The report underlines that, despite a reduction of 16.35 % in the number of smokers between 2000 and 2022 in the region, this decrease remains insufficient to reach the target that had been set of a reduction of 30 % for 2025, particularly in certain social groups and among young people.

He notes that measurable progress has been made in several countries in recent years, while recalling that significant gaps persist between states in terms of capacity, resources and effective implementation.

Thus, the United States and the Dominican Republic, for example, are among the countries where the implementation of anti-smoking measures is most hampered by tobacco companies, which still benefit from privileged access to policymakers and more permissive regulations. In Mexico and Panama, tobacco companies have taken legal action to try to overturn bans on e-cigarettes and heated tobacco, illustrating the "harm reduction" marketing strategy used to delay regulations., in a broader context of a global offensive by the tobacco industry.

It therefore aims to support States in implementing evidence-based tobacco control policies, taking into account the rapid evolution of the market, marked by the emergence of new tobacco and nicotine products.

A regulatory framework that builds on the key measures of the FCTC

The report identifies product regulation as a key lever in the fight against tobacco and related products. It covers all product categories, including tobacco products in the strict sense, such as heated tobacco, but also vaping products, like e-cigarettes with or without nicotine, and other emerging nicotine products.

The WHO has identified five measures from the FCTC that are recognized as particularly cost-effective for preventing and controlling NCDs. These provisions can indeed be easily implemented even in resource-limited settings. Specifically, they include regular and significant tax increases applied to all products (Article 6), the development of smoke-free areas, including outdoors (Article 8), the placement of large combined health warnings – photo and text – on standardized plain packaging (Article 11), the prohibition of all forms of tobacco advertising, promotion, and sponsorship in any medium, including CSR (Corporate Social Responsibility) communications (Article 13), and measures relating to smoking cessation support (Article 14).

These measures must be accompanied by monitoring of the tobacco epidemic. The report emphasizes the need to strengthen surveillance systems, data collection and analysis, research, and regular evaluation of public policies. Progress indicators will be collected every two years through the WHO global report, with a mid-term review planned for 2028 and a final report in 2031.

The report's authors further emphasize that the absence or inadequacy of regulation for certain emerging products creates loopholes that can be exploited by the industry, and they recommend, if these products are authorized on the markets, extending existing regulatory frameworks to all products containing tobacco or nicotine, regardless of their method of consumption.

Reducing demand requires, in particular, taxation, prices, and smoking cessation programs.

The report's authors place particular emphasis on the importance of strong and sustained tax policies. According to them and the findings of international literature, increasing taxes reduces overall demand, prevents initiation of substance abuse, especially among young people, and decreases social inequalities in health. Furthermore, the experience gained from adopting these measures can have a ripple effect on the adoption of taxes on other products harmful to health, such as alcoholic and sugary drinks.

The need for simple tax systems, based on specific and sufficiently high taxes, is essential to limit the tobacco industry's tax avoidance strategies. The recommendations specifically target 10 countries, aiming for a tax burden representing 75% or more of the final retail price by 2030.

Furthermore, the report emphasizes the importance of providing comprehensive smoking cessation and prevention services (national smoking cessation helpline, access to smoking cessation support services, and availability and coverage of nicotine replacement therapies). These services should be fully integrated into healthcare systems. Similarly, the inclusion of smoking cessation in primary healthcare, the training of healthcare professionals, and access to evidence-based treatments should be systematically implemented.

A requirement for international cooperation and independent industry governance

Finally, the report emphasizes the need for countries in the Americas that have not yet ratified the UNFCCC to do so. Similarly, this encouragement applies to countries in the region that have not yet ratified the Protocol to Combat Illicit Trade in Tobacco Products. This recommendation is further reinforced by the need to establish effective governance mechanisms capable of protecting public policies from interference by the tobacco industry and its representatives.

The authors recall the characteristics of the tobacco industry's new strategy, which is trying to improve its image and legitimize its presence in political and economic decision-making spheres through greenwashing and so-called CSR practices.

The fight against parallel markets also poses a health and fiscal challenge for the region, and even a security challenge internationally. The provisions of the Protocol are intended to address these issues and will be all the more effective if a maximum number of countries ratify it, particularly within the Americas.

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[1]PAHO and WHO, Strategy and plan of action to strengthen tobacco control in the Region of the Americas 2025–2030, Published on December 22, 2025, accessed on December 24, 2025

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