State of Smoking and Health in Czechia

In 2022, 27.4% of Czechia's adult population used tobacco, with men showing a higher prevalence (31.7%) than women (23.3%). Tobacco use contributed to 22.9% of total deaths in 2021, with significant impacts on ischemic heart disease, lung cancer, and chronic obstructive pulmonary disease (COPD). Notably, cigarette demand has declined by 50% since its peak in 2007. E-cigarettes and heated tobacco products (HTPs) are legally available, with 18% of adults having tried e-cigarettes and 15% having tried HTPs.

Tobacco Use and Trends

  • In 2022, an estimated 2.5 million people (1.4 million males and 1.1 million females) aged 15 years and older were tobacco product users in Czechia. This positions the country as the 55th globally and the 15th 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, 30% of respondents (35% males and 26% females) were currently smoking tobacco products (cigarettes, cigars, cigarillos or pipe). Tobacco smoking was more prevalent in the 25-39 age group (42%) followed by the younger 15-24 age group with 30% and the 40-54 age group with 29%. The older 55 years and over age group was the last with 24%.

    • Among those adult tobacco smokers, 79% were daily cigarette and 12% were daily hand-rolled cigarettes smokers.

  • In 2021, 3.3% of adults (5.3% males and 1.4% females) aged 15 years and over were current smokeless tobacco users.

  • In 2019, 23.6% of youths (20.8% boys and 26.5% girls) aged 15-16 years were current cigarette smokers.

  • Demand for cigarettes per capita peaked in 2007 with 149 packs, since then despite some fluctuations, the demand fell by 50% to 75 packs in 2021. The demand for per capita fine-cut tobacco (e.g. roll your own RYO) reached its peak in 2012 with 7.8 packs of 20gr weight and has been slowly falling to 6.8 packs of 20gr weight in 2021. (Figure 1)

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

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

Nicotine Alternatives

  • In 2020, 18% of respondents (18% males and 17% females) have used or at least tried e-cigarettes.

    • The “at least tried out” category, the prevalent was the highest (31%) among 25-39 age group, followed by the youngest 15-24 age group with 25%, the 40-54 age group with 16% and the oldest 55 years and over age group with 8%.

    • 3% adults were current e-cigarette users.

  • For comparison, according to National Research on Tobacco and Alcohol Use in the Czech Republic (NAUTA) in 2021, 7.4% of adults (8.8% males and 6% females) aged 15 years and over were current e-cigarette users. In the same year, 4% of adults (4.5% males and 3.5% females) were daily e-cigarette users.

  • In 2020, 15% of respondents (15% males and 14% females) have used or at least tried heated tobacco products (HTPs).

    • The “at least tried out” category, the prevalent was the highest (25%) in both 15-24 and 25-39 age groups, followed by the 40-54 age group with 14%, and the oldest 55 years and over age group with 6%.

      Current HTP use prevalence was 3%.

  • In 2020, 77% of respondents who tried stopping and ex-smokers said they either quit or attempted to quit without assistance.

    • Approximately 10% utilized Nicotine Replacement Therapy (NRT), 4% sought medical support, while a notable 10% utilized e-cigarettes and 6% utilized HTPs. About 1% smokers opted for oral, chewing, nasal tobacco products in their quitting journey.

  • In 2019, 19.8% of youths (22.5% boys and 16.9% girls) aged 15-16 years were current e-cigarette users. In the same year, 3.1% of youths (1.3% girls and 4.9% boys) were daily e-cigarette users.

Health and Economic Burden From Tobacco Use

  • In 2021, it was estimated that tobacco was the 2nd highest risk factor driving the most deaths and disability combined in Czechia.

  • Tobacco was responsible for an estimated 15.8 thousand deaths, which is about 22.9% of total deaths.

    • Of tobacco-related deaths, 13.8 thousand or 87.7% were due to smoking, and 2.5 thousand or 15.6% were due to secondhand smoke.

  • In 2021, the top 10 causes of the most deaths in Czechia included Ischemic Heart Disease (IHD) ranking 1st, Stroke ranking 3rd, Lung Cancer ranking 4th and Chronic Obstructive Pulmonary Disease (COPD) ranking 8th.

    • Tobacco was responsible for an estimated 4.8 thousand or 17.8% of all IHD deaths, 1.0 thousand or 12.8% of all Stroke deaths, 4.0 thousand or 85.1% of all Lung Cancer deaths, and 1.7 thousand or 66.0% of all COPD deaths.

  • In 2021, tobacco use caused an estimated loss of 420.0 thousand disability-adjusted life years (DALYs), which was about 25.0% of total DALYs. Tobacco accounts for 99.5 thousand DALYs for IHD, 26.7 thousand DALYs for Stroke, 90.3 thousand DALYs for Lung Cancer, and 41.5 thousand DALYs for COPD.

Regulatory Environment and Economics

Public Health Commitment
  • Czechia ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2012 and WHO Illicit Trade Protocol in 2019.

  • Czechia 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 or without nicotine, are legally available.  E-cigarettes are regulated in line with EU Tobacco Directive (TPD) HTPs are not regulated as tobacco products, only general consumer regulation applies.

    • 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 cover 30% of both surfaces for HTPs and e-cigarettes as of 2023.

Taxation Policy
  • In 2022, total tax rate on retail prices of a pack of cigarette was 75.6%.

  • HTPs are subject to a specific excise tax of CZK 3000/kg, while no excise is being levied on e-cigarettes as of 2023.

  • Czechia applies differential excise tax policy between CCs and HTPs. The excise value for HTPs is (CZK 18.30/pack) with its share (16.34%) of the retail selling price CZK 112.00/pack while, the excise tax value for CCs is (CZK 84.10/pack) with its share (56.44%) of the retail selling price CZK 149.00/pack as of 2023.

Smoking and Advertising Bans3
  • Minimal smoking bans with moderate level of compliance, and moderate advertising bans with complete level of compliance were enforced in Czechia 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 remained consistently below or slightly above 6% over the years with 6.1% in 2008, falling to 1.9% in 2020 and then increasing again to 5.8% in 2022. (Euromonitor [accessed November 2023])
  • In 2021, 0.5 billion counterfeit & contraband (C&C) cigarettes were consumed in Czechia. The market share of C&C was 3.5% of the total cigarette market, costing the government an estimated EUR 75 million total tax revenue

Tobacco Production and Diversification

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

Skip to content