State of Smoking and Health in El Salvador

In El Salvador, 8.2% of adults were tobacco users in 2022, predominantly males (15.6%). Youth smoking rate was reported as 0.9% among 13-15 years age group in 2021, a sharp decline from 13.5% in 2015.

Tobacco Use and Trends

  • In 2022, an estimated 387.5 thousand people (341.4 thousand males and 48.2 thousand females) aged 15 years and older were tobacco product users in El Salvador. This positions the country as the 118th globally and the 18th in the WHO Region of the Americas in terms of number of tobacco users.1,2
  • In 2021, 0.9% of youths (1% boys and 0.9% girls) aged 13-15 years in El Salvador were current tobacco users. This marks a significant improvement compared to 2015 when 13.5% adolescents (15.3% boys and 10.7% girls) were current users of tobacco products.

  • In 2021, 0.1% of youths (0.2% boys and 0% girls) aged 13-15 years were current smokeless tobacco product users, a stark decrease from 2% (2.1% boys and 2% girls) in 2015.

Nicotine Alternatives

  • In 2021, 0.6% of youths (1% boys and 0.2% girls) aged 13-15 were current e-cigarette users in El Salvador. This represents a significant reduction compared to 2015 when 2.7% of youths (3.3% boys and 2.1% girls) aged 13 to 15 years were reported as current e-cigarette users.

Health and Economic Burden From Tobacco Use

  • In 2021, it was estimated that tobacco was the 10th highest risk factor driving the most deaths and disability combined in El Salvador.

  • Tobacco was responsible for an estimated 1.5 thousand deaths, which is about 6.9% of total deaths.

    • Of tobacco-related deaths, 1.2 thousand or 79.1% were due to smoking, and 351.4 or 22.7% were due to secondhand smoke.

  • In 2021, the top 10 causes of the most deaths in El Salvador included Ischemic Heart Disease (IHD) ranking 2nd, Stroke ranking 6th, and Chronic Obstructive Pulmonary Disease (COPD) ranking 10th.

    • Tobacco was responsible for an estimated 534 or 9.4% of all IHD deaths, 130.6 or 7.7% of all Stroke deaths, 166.5 or 58.2% of all Lung Cancer deaths, and 178.8 or 31.4% of all COPD deaths.

  • In 2021, tobacco use caused an estimated loss of 48.9 thousand disability-adjusted life years (DALYs), which was about 6.6% of total DALYs. Tobacco accounts for 14.8 thousand DALYs for IHD, 4.0 thousand DALYs for Stroke, 4.2 thousand DALYs for Lung Cancer, and 4.0 thousand DALYs for COPD.

Regulatory Environment and Economics

Public Health Commitment
  • El Salvador ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2014.

  • El Salvador adopted graphical health warnings (GHWs) on combustible cigarettes (CCs) in 2012, covering 50% of the front and 50% of the back of the packages.

Diverse Tobacco Market
  • Heated Tobacco Products (HTPs) are classified as “smokeless tobacco” while e-cigarettes with nicotine content are regulated under the tobacco framework.
Taxation Policy
  • In 2022, total tax rate on retail prices of a pack of cigarette was 45.7%.
Smoking and Advertising Bans3
  • Complete smoking bans with moderate level of compliance, and moderate advertising bans with moderate level of compliance were enforced in El Salvador in 2022.
Age Restrictions
  • Tobacco products cannot be sold to individuals younger than 18 years of age.

Tobacco Production and Diversification

  • In 2022, El Salvador produced about 1.8 thousand tons of unmanufactured tobacco. This positioned El Salvador as the 75th largest tobacco producer in the world.

    • When compared to 2010, when El Salvador produced about 1.5 thousand tons of unmanufactured tobacco, there was a 15% increase by 2022.

  • In 2022, El Salvador utilized approximately 890 hectares of land for tobacco cultivation, reflecting a 15% increase compared 2010. (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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