State of Smoking and Health in Moldova

In 2022, 28% of the population in the Republic of Moldova used tobacco products, with men (52.7%) having a significantly higher prevalence than women (6.3%). Among youths aged 13-15 years, 16.3% were tobacco users in 2019. Tobacco use remains a major health risk in the country, responsible for 19.2% of all deaths in 2021.

Tobacco Use and Trends

  • In 2022, an estimated 573.6 thousand people (505.4 thousand males and 68.6 thousand females) aged 15 years and older were tobacco product users in Moldova. This positions the country as the 108th globally and the 37th in the WHO European Region in terms of number of tobacco users.1,2
  • In 2021, 0.2% of adults (0.2% males and 0.2% females) aged 18-69 years used smokeless tobacco in Moldova.

  • In 2019, 16.3% of youths (20.4% boys and 11.8% girls) aged 13-15 years in Moldova were current tobacco users.

  • In 2019, 1.7% youth (2.1% boys and 1.4% girls) aged 13-15 years were current smokeless tobacco users in Moldova.

  • In 2019, cigarette-equivalents consumption per capita of 15 years old population was estimated as 111 packs in 2019, that was up 6% from 104.4 packs in 1990.

Nicotine Alternatives

  • In 2021, 0.7% of adults (1.2% males and 0.2% females) aged 18-69 years were current e-cigarette users in Moldova. 0.3% of adults (0.4% of males and 0.2% of females) were daily e-cigarette users.

  • In 2019, 12.7% of youths (16.8% boys and 8.4% girls) aged 13-15 were current e-cigarette users in Moldova.

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 Moldova.

  • Tobacco was responsible for an estimated 5.4 thousand deaths, which is about 19.2% of total deaths.

    • Of tobacco-related deaths, 4.7 thousand or 86.9% were due to smoking, and 863 or 16.1% were due to secondhand smoke.

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

    • Tobacco was responsible for an estimated 2.5 thousand or 19.2% of all IHD deaths, 676.8 or 14.9% of all Stroke deaths, 729.4 or 88.7% of all Lung Cancer deaths, and 279.8 or 62.3% of all COPD deaths.

  • In 2021, tobacco use caused an estimated loss of 159.9 thousand disability-adjusted life years (DALYs), which was about 21.3% of total DALYs. Tobacco accounts for 63.3 thousand DALYs for IHD, 19.4 thousand DALYs for Stroke, 20.2 thousand DALYs for Lung Cancer, and 7.8 thousand DALYs for COPD.

Regulatory Environment and Economics

Public Health Commitment
  • Moldova ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2009, and WHO Illicit Trade Protocol in 2022.

  • Moldova adopted graphical health warnings (GHWs) on combustible cigarettes (CCs) in 2018, covering 65% of the front and 65% of the back of the packages.

Diverse Tobacco Market
  • Heated Tobacco Products (HTPs) and e-cigarettes with and without nicotine content are legally available and regulated under the tobacco framework. E-cigarettes are defined as “other tobacco product” while HTPs as “smokeless and novel tobacco product”. E-cigarettes without nicotine are classified as “consumer product”.

     

    • HTPs and e-cigarettes with nicotine feature text health warnings, covering 30% of the main surfaces.

    • 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 10 ml per package.

Taxation Policy
  • In 2022, total tax rate on retail prices of a pack of cigarette was 65.4%.

  • HTPs are subject to specific excise tax at MLD 1,103/1000 sticks for HTPs in 2023.

  • A differential excise tax policy is applied between HTPs and CCs as of 2023. The excise value for HTPs is MDL 22.06/pack with its share (49.02%) of the retail selling price (MDL 45.00/pack), while the excise tax value for CCs is MDL 22.68/pack with its share (47.25%) of the retail selling price (MDL 48.00/pack).

Smoking and Advertising Bans3
  • Complete smoking bans with complete level of compliance, and complete advertising bans with complete level of compliance were enforced in Moldova in 2022.
Age Restrictions
  • Tobacco products and e-cigarettes with nicotine cannot be sold to individuals younger than 18 years of age.

Tobacco Production and Diversification

  • In 2022, Moldova produced about 100 tons of unmanufactured tobacco. This positioned Moldova as the 112th largest tobacco producer in the world.

    • When compared to 2010, when Moldova produced about 7.6 thousand tons of unmanufactured tobacco, there was a 98.7% decrease by 2022.

  • In 2022, Moldova utilized approximately 200 hectares of land for tobacco cultivation, reflecting a 95.4% decrease 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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