State of Smoking and Health in Cyprus

In Cyprus, 34% of adults used tobacco in 2022, with a significant gender difference: 46% of men compared to 22.1% of women. Tobacco use has been linked to severe health impacts, contributing to 24.5% of total deaths, including a high number of fatalities from ischemic heart disease and lung cancer. While cigarette demand per capita dropped by 65% since 2002, Cyprus still faces challenges with illicit trade, which accounted for 14.4% of the cigarette market in 2021, resulting in an estimated EUR 24 million tax loss.

Tobacco Use and Trends

  • In 2022, an estimated 357.7 thousand people (241.1 thousand males and 116.7 thousand females) aged 15 years and older were tobacco product users in Cyprus. This positions the country as the 121st globally and the 41st 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 (39% 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 (35%) followed by 40-54 with 33%, the younger 15-24 age group with 28% and the older 55 years and over age group with 17%.

    Among those tobacco smokers, 57% were daily cigarette and 32% were daily hand-rolled cigarettes smokers.

    Demand for cigarettes per capita has been consistently reducing in Cyprus, a notable 65% reduction from 103 packs in 2002 to 36 packs in 2021. The demand for per capita fine-cut tobacco (e.g. roll your own) reached its peak in 2012 with 15.1 packs of 20gr weight and has been falling since then with a notable 42% reduction to 8.7 packs of 20gr weight in 2021. (Figure 1)

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

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

Nicotine Alternatives

  • In 2020, 15% of respondents (21% males and 9% females) have used or at least tried e-cigarettes.

    • The “at least tried out” category, the prevalent was the highest (24%) among 25-39 age group, followed by the 40-54 age group with 19%, the younger 15-24 age group with 17% and the oldest 55 years old and over age group with 2%.

    • 2% adults were current e-cigarette users.

  • In 2020, 8% of respondents (12% males and 5% females) have used or at least tried heated tobacco products (HTPs).

    • The “at least tried out” category, the prevalent was the highest (19%) among 25-39 age group, followed by the 40-54 age group with 7%, the younger 15-24 age group with 5% and the oldest 55 years old and over age group with 1%.

    • Current HTPs use prevalence was 3%.

  • In 2020, 73% of respondents who tried stopping and ex-smokers said they either quit or attempted to quit without assistance.

    • Approximately 4% utilized Nicotine Replacement Therapy (NRT), 1% sought medical support, while a notable 15% utilized e-cigarettes and 9% utilized HTPs. Almost none of the smokers opted for oral, chewing, nasal tobacco products in their quitting journey.

  • In 2019, 10% of youths (14% boys and 7.5% girls) aged 13-15 years were current e-cigarette users in Cyprus.

Health and Economic Burden From Tobacco Use

  • In 2021, it was estimated that tobacco was the 1st highest risk factor driving the most deaths and disability combined in Cyprus.

  • Tobacco was responsible for an estimated 1.2 thousand deaths, which is about 24.5% of total deaths.

    • Of tobacco-related deaths, 1.1 thousand or 91.1% were due to smoking, and 141.9 or 12.1% were due to secondhand smoke.

  • In 2021, the top 10 causes of the most deaths in Cyprus included Ischemic Heart Disease (IHD) ranking 1st, Stroke ranking 2nd, Chronic Obstructive Pulmonary Disease (COPD) ranking 5th, and Lung Cancer ranking 7th.

    • Tobacco was responsible for an estimated 315 or 23.4% of all IHD deaths, 81.4 or 12.9% of all Stroke deaths, 290.1 or 87.2% of all Lung Cancer deaths, and 183.2 or 64.3% of all COPD deaths.

  • In 2021, tobacco use caused an estimated loss of 32.4 thousand disability-adjusted life years (DALYs), which was about 26.1% of total DALYs. Tobacco accounts for 7.4 thousand DALYs for IHD, 1.9 thousand DALYs for Stroke, 6.6 thousand DALYs for Lung Cancer, and 3.8 thousand DALYs for COPD.

Regulatory Environment and Economics

Public Health Commitment
  • Cyprus ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2005 and WHO Illicit Trade Protocol in 2017.

  • Cyprus adopted graphical health warnings (GHWs) on combustible cigarettes (CCs) in 2017, covering 65% of the front and 65% of the back of the packages.

Diverse Tobacco Market
  • HTPs and e-cigarettes, with or without nicotine, are legally available in Cyprus.

  • 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 are required for HTPs and e-cigarettes covering 32% of both package surfaces as of 2023.

Taxation Policy
  • In 2022, total tax rate on retail prices of a pack of cigarette was 74.4%.

  • HTPs in Cyprus are subject to a specific excise tax of EUR 150/kg, while e-liquids of e-cigarettes, regardless of nicotine content are subject to excise of EUR 0.12/ml as of 2023.

  • Cyprus applies differential excise tax policy between CCs and HTPs. The excise tax value for HTPs is EUR 0.92/pack with its share (22.88%) of retail selling price EUR 4.00/pack while the excise tax value for CCs is EUR 2.77/pack with its share (56.45%) of the retail selling price EUR 4.90/pack in 2023.

Smoking and Advertising Bans3
  • Moderate smoking bans with moderate level of compliance, and moderate advertising bans with complete level of compliance were enforced in Cyprus in 2022.
Age Restrictions
  • Tobacco products and e-cigarettes cannot be sold to individuals younger than 18 years of age in Cyprus.
Illicit Cigarette Trade
  • In 2021, 0.1 billion counterfeit & contraband (C&C) cigarettes were consumed by Cyprus smokers. The market share of C&C was 14.4% of the total cigarette market, costing Cyprus government an estimated EUR 24 million total tax revenues.

Tobacco Production and Diversification

  • Detailed data is not readily available from the Food and Agriculture Organization for Cyprus. (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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