Tobacco Use and Trends
- In 2022, an estimated 287.5 thousand people (173.3 thousand males and 114.8 thousand females) aged 15 years and older were tobacco product users in Estonia. This positions the country as the 127th globally and the 43rd in the WHO European Region in terms of number of tobacco users.1,2
For comparison, according to the Attitudes of Europeans Towards Tobacco and Electronic Cigarettes survey in 2020, 18% of respondents (22% males and 16% females) were currently smoking tobacco products (cigarettes, cigars, cigarillos or pipe). Tobacco smoking was more prevalent in the 25-39 age group (26%) followed by the 40-54 age group with 21% and the oldest age group 55 years and over with 13%. Among these age groups, the lowest prevalence of smoking was observed in the youngest 15-24 age group with 12%.
Among those tobacco smokers, 70% were daily cigarette and 4% were daily hand-rolled cigarettes smokers.
In 2019, 20% of youths (19% boys and 21% girls) aged 15-16 years were current cigarette smokers.
Demand for cigarettes per capita reduced by 33% in Estonia from 83 packs in 2002 to 56 packs in 2021. The demand for per capita fine-cut tobacco (e.g. roll your own) was not significant until it reached its peak to 4.3 packs of 20gr weight in 2010, and then continuously declined, a notable 32% to 2.9 packs of 20gr weight in 2021 (Figure 1).
Figure 1 Cigarette and Fine Cut Tobacco Consumption in Estonia 2002-2021
Source: European Commission, Releases for consumption of cigarettes and fine cut tobacco (2002-2022)
Nicotine Alternatives
In 2020, 25% of respondents in Estonia (30% males and 21% females) have used or at least tried e-cigarettes.
The “at least tried out” category, the prevalent was the highest (46%) among the youngest 15-24 age group, followed by the 25-39 age group with 42%, the 40-54 age group with 21% and the oldest 55 years and over age group with 9%.
2% adults were current e-cigarette users.
In 2020, 8% of respondents (9% males and 7% females) have used or at least tried heated tobacco products (HTPs).
The “at least tried out” category, the prevalent was the highest in the 25-39 age group with 16%, followed by the 15-24 age group with 11%. Notably lower rate 7% was recorded for the 40-54 age groups. The lowest rate, 3% was identified in the oldest age group of 55 years and over.
1% adults were current HTP user.
In 2020, 84% of respondents who tried stopping and ex-smokers said they either quit or attempted to quit without assistance.
Approximately 13% utilized Nicotine Replacement Therapy (NRT), 3% sought medical support and 7% utilized e-cigarettes. About 1% of smokers opted for HTPs, and 2% for oral, chewing, nasal tobacco products in their quitting journey.
In 2019, 15% of youths (12% girls and 17% boys) aged 15-16 years were current e-cigarette smokers.
Health and Economic Burden From Tobacco Use
In 2021, it was estimated that tobacco was the 4th highest risk factor driving the most deaths and disability combined in Estonia.
Tobacco was responsible for an estimated 1.3 thousand deaths, which is about 14.0% of total deaths.
Of tobacco-related deaths, 1.2 thousand or 90.2% were due to smoking, and 164.2 or 12.3% were due to secondhand smoke.
In 2021, the top 10 causes of the most deaths in Estonia included Ischemic Heart Disease (IHD) ranking 1th, Stroke ranking 4th, and Lung Cancer ranking 6th.
Tobacco was responsible for an estimated 367.7 or 13.4% of all IHD deaths, 107.3 or 11.1% of all Stroke deaths, 396.9 or 86.9% of all Lung Cancer deaths, and 71.1 or 68.3% of all COPD deaths.
In 2021, tobacco use caused an estimated loss of 37.5 thousand disability-adjusted life years (DALYs), which was about 17.2% of total DALYs. Tobacco accounts for 8.0 thousand DALYs for IHD, 2.9 thousand DALYs for Stroke, 9.2 thousand DALYs for Lung Cancer, and 1.8 thousand DALYs for COPD.
Regulatory Environment and Economics
Public Health Commitment
- Estonia ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2005.
Diverse Tobacco Market
HTPs and e-cigarettes with and without nicotine are available and all are classified as other tobacco products. Consequently, they are subject to the same regulations as combustible cigarettes (CCs).
Flavor restrictions are in place, allowing only menthol and tobacco flavors for e-cigs and tobacco flavors for HTPs.
Product restrictions for e-cigarettes include a maximum nicotine concentration to 20mg/ml, the tank capacity not exceeding 2ml, and refill containers limited to a maximum 10ml.
Text health warnings, covering 30% of both inner and outer surface packaging, are mandatory for both e-cigarettes and HTPs.
Taxation Policy
In 2022, total tax rate on retail prices of a pack of cigarette was 88.2%.
HTPs in Estonia are subject to a specific excise tax of EUR 107/kg in 2023 with rates progressively increasing each year until 2026. E-cigarettes are subject to specific excise of EUR 0.20/ml regardless of nicotine content.
Estonia applies a differential excise tax policy between CCs and HTPs. Excise value of EUR 0.65/pack with the excise share 13.89% of the retail price (EUR 4.70/pack) of HTPs in 2023, while excise value of EUR 3.53/pack being lower than CCs (66.00%). The retail price for HTPs is relatively lower than the price (EUR 5.35/pack) of CCs.
Smoking and Advertising Bans3
- Weak smoking bans with moderate level of compliance, and moderate advertising bans with complete level of compliance were enforced in Estonia in 2022.
Age Restrictions
- Tobacco products and e-cigarettes cannot be sold to individuals younger than 18 years of age.
Illicit Cigarette Trade
Estimated figures indicate that illicit cigarette trade was significant in between 2010 with 28.4% and 2013 with 21.8%, and then it consistently reduced and reached its lowest level in 2022 with 2.8%.
In 2021, 0.1 billion counterfeit & contraband (C&C) cigarettes were consumed in Estonia. The market share of C&C was 10.3% of the total cigarette market, costing the government an estimated EUR 24 million total tax revenue.
Tobacco Production and Diversification
- Detailed data is not readily available from the Food and Agriculture Organization for Estonia. (FAOSTAT [accessed January 2024])