State of Smoking and Health in Lithuania

In Lithuania, tobacco use in 2022 reached 27.8% (40.1% of men and 17.3% of women), with significant smoking rates among youth; 21% of youths aged 15-16 years smoked cigarettes in 2019, and 31% used e-cigarettes. Despite compliance with WHO FCTC protocols and an 80.5% tax rate on cigarettes, the country still faces challenges with a high illicit cigarette trade, comprising 19% of the market and costing EUR 79 million in lost tax revenue.

Tobacco Use and Trends

  • In 2022, an estimated 666.6 thousand people (444.0 thousand males and 223.3 thousand females) aged 15 years and older were tobacco product users in Lithuania. This positions the country as the 101st globally and the 35th 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, 28% of respondents (45% males and 14% females) were currently smoking tobacco products (cigarettes, cigars, cigarillos or pipe). Tobacco smoking was more prevalent in the 25-39 age group with 39%, followed by the 40-54 age group with 34%. The rate for the youngest 15-24 age group was 25% while for the oldest age group 55 years and over was 18%.

    • Among those tobacco smokers, 83% were daily cigarettes and 2% were daily hand-rolled cigarettes smokers.

  • In 2019, 21% of youths (21% boys and 21% girls) aged 15-16 years were current cigarette smokers in Lithuania.

  • Demand for cigarettes per capita reduced a notable 40% in Lithuania from 72 packs in 2002 to 43 packs in 2021. The demand for per capita fine-cut tobacco (e.g. roll your own) has been consistently increasing in Lithuania by 0.8 packs of 20gr weight in 2003 to 5.3 packs of 20gr weight in 2021. (Figure 1)

Figure 1    Cigarette and Fine Cut Tobacco Consumption in Lithuania 2002-2021

Source:    European Commission, Releases for consumption of cigarettes and fine cut tobacco (2002-2022)

Nicotine Alternatives

  • In 2020, 16% of respondents (23% males and 10% females) said they at least tried e-cigarettes.

    • The “at least tried out” category, the rate was the highest among the youngest 15-24 age group at 37%, followed by the 25-39 age group at 36%, and then the 40-54 age group at 9%, finally, the 55 years old and older age group at 1%.

    • 3% of adults were current e-cigarettes users.

  • In 2020, 10% of respondents (16% males and 6% females) said they at least tried heated tobacco products (HTPs).

    • The “at least tried out” category, the rate was more prevalent among the youngest 15-24 age group and the 25-39 age group at 25%, followed by the 40-54 age group at 4%, and the 55 and over age group at 1%.

    • Current HTP prevalence was 2%.

  • In 2020, 84% of respondents who tried stopping and ex-smokers said they had either quit or attempted to quit without any assistance.

    • Approximately 9% utilized Nicotine Replacement Therapy (NRT), and only 1% sought medical support. 6% utilized e-cigarettes and 6% opted for HTPs. Nearly none of the tobacco users opted for oral, chewing, nasal tobacco products in their quitting journey.

  • In 2019, 31% of youths (34% boys and 29% girls) aged 15-16 years of age in Lithuania were current e-cigarette users.

Health and Economic Burden From Tobacco Use

  • In 2021, it was estimated that tobacco was the 3rd highest risk factor driving the most death and disability combined in Lithuania.

  • Tobacco was responsible for an estimated 4.0 thousand deaths, which is about 16.8% of total deaths.

    • Of tobacco-related deaths, 3.6 thousand or 89.0% were due to smoking, and 529.8 or 13.2% were due to secondhand smoke.

  • In 2021, the top 10 causes of the most deaths in Lithuania included Ischemic Heart Disease (IHD) ranking 1st, Stroke ranking 3rd, and Lung Cancer ranking 5th.

    • Tobacco was responsible for an estimated 1.6 thousand or 12.9% of all IHD deaths, 405.4 or 10.3% of all Stroke deaths, 826.5 or 88.2% of all Lung Cancer deaths, and 233.6 or 70.6% of all Chronic Obstructive Pulmonary Disease (COPD) deaths.

  • In 2021, tobacco use caused an estimated loss of 106.2 thousand disability-adjusted life years (DALYs), which was about 19.7% of total DALYs. Tobacco accounts for 34.2 thousand DALYs for IHD, 10.2 thousand DALYs for Stroke, 19.9 thousand DALYs for Lung Cancer, and 5.7 thousand DALYs for COPD.

Regulatory Environment and Economics

Public Health Commitment
  • Lithuania ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2004, and WHO Illicit Trade Protocol in 2016. 

  • Lithuania adopted graphical health warnings (GHWs) on combustible cigarettes (CCs) in 2016, covering 65% of the front and 65% of the back of the packages.

Diverse Tobacco Market
  • HTPs and e-cigarettes with and without nicotine content are legally available and are regulated under the tobacco framework.
Taxation Policy
  • Total tax rate on retail prices of a pack of cigarette was 80.5% in 2023.

  • HTPs and e-cigarettes are subject to specific excise tax at EUR 0.19ml for e-cigarettes irrespective of nicotine content, and EUR 60.20/1000 sticks for HTPs in 2023. Excise rates will rise to EUR 79.50 per 1000 units for HTPs in 2024.

  • A differential excise tax policy is applied between HTPs and CCs as of 2023. The excise value for HTPs is EUR 1.20/pack with its share (30.10%) of the retail selling price (EUR 4.00/pack), while the excise tax value for CCs is EUR 2.79/pack with its share (58.17%) of the retail selling price (EUR 4.80/pack).

Smoking and Advertising Bans3
  • Minimal smoking bans with unknown level of compliance, and moderate advertising bans with unknown level of compliance were enforced in Lithuania 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 a significant problem for Lithuania starting at 17.8% in 2008, peaking at 47.1% in 2010, consistently declining to 14.3% in 2018, with a slight increase to 23.5% in 2022.

  • In 2021, an estimated 0.5 billion counterfeit & contraband (C&C) cigarettes were consumed in Lithuania. The market share of C&C was approximately 19% of the total cigarette market, costing the government an estimated EUR 79 million in total tax revenue.

Tobacco Production and Diversification

  • Detailed data is not readily available from the Food and Agriculture Organization for Lithuania. (FAOSTAT [accessed January 2024])

[1] Source: World Health Organization: Non-age-standardized estimates of current tobacco use, tobacco smoking and cigarette smoking (Tobacco control: Monitor) [accessed February 2024]

[2] Source: The World Bank’s Population Estimates and Projections [accessed November 2023]
Explanation: The estimated number of tobacco users  is calculated by applying the WHO’s estimated percentage of tobacco smokers for 2023 to the World Bank’s projected population figures of the same year for people aged 15 and older. These figures should be used with caution, as they do not account for the 95% credible interval around the estimate.

[3] The scopes of both the smoking and advertising bans are defined in alignment with the definition of the WHO report on the global tobacco epidemic, 2023 and scored as follows: complete (at least 90% of population covered), moderate, minimal, weak, and unknown (no data available).
The respective compliance level is described on a scale from 0-10 with 3 scoring levels: minimal (0‑2/10), moderate (3-7/10), or complete (8-10/10).

Tobacco and Health Around the World

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