State of Smoking and Health in Paraguay

In Paraguay, tobacco use in 2022 was estimated at 10.6%, with higher usage among males (17.4%) than females (3.8%). Youth e-cigarette usage rose significantly from 3.7% in 2014 to 12.5% in 2019.

Tobacco Use and Trends

  • In 2022, an estimated 511.3 thousand people (417.8 thousand males and 92.0 thousand females) aged 15 years and older were tobacco product users in Paraguay. This positions the country as the 112th globally and the 17th in the WHO Region of the Americas in terms of number of tobacco users.1,2
  • In 2019, 8.1% of youths (8.8% boys and 7.2% girls) aged 13-15 years in Paraguay were current tobacco users. In the same year, 3% of youths (2.7% boys and 3.3% girls) were reported as current smokers of cigarettes.

  • In 2019, 1.7% (2% boys and 1.3% girls) were currently using smokeless tobacco products in Paraguay.

Nicotine Alternatives

  • In 2019, 12.5% of youths (14% boys and 11.1% girls) aged 13-15 were current e-cigarette users in Paraguay. This represents a significant increase compared to 2014 when only 3.7% of youths (4% boys and 3.3% 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 4th highest risk factor driving the most deaths and disability combined in Paraguay.

  • Tobacco was responsible for an estimated 4.0 thousand deaths, which is about 19.4% of total deaths.

    • Of tobacco-related deaths, 3.5 thousand or 87.5% were due to smoking, and 592.4 or 15.0% were due to secondhand smoke.

  • In 2021, the top 10 causes of the most deaths in Paraguay included Ischemic Heart Disease (IHD) ranking 2nd, Stroke ranking 3rd, Lung Cancer ranking 9th and Chronic Obstructive Pulmonary Disease (COPD) ranking 9th.

    • Tobacco was responsible for an estimated 983.9 or 22.8% of all IHD deaths, 558.2 or 18.2% of all Stroke deaths, 570.2 or 84.8% of all Lung Cancer deaths, and 461.5 or 69.9% of all COPD deaths.

  • In 2021, tobacco use caused an estimated loss of 108.5 thousand disability-adjusted life years (DALYs), which was about 15.0% of total DALYs. Tobacco accounts for 24.8 thousand DALYs for IHD, 14.0 thousand DALYs for Stroke, 13.4 thousand DALYs for Lung Cancer, and 9.5 thousand DALYs for COPD.

Regulatory Environment and Economics

Public Health Commitment
  • Paraguay ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2006 and WHO Illicit Trade Protocol in 2022.

  • Paraguay adopted graphical health warnings (GHWs) on combustible cigarettes (CCs) in 2018, covering 40% of the front and 40% of the back of the packages.

Diverse Tobacco Market
  • Heated Tobacco Products (HTPs) are allowed but not marketed. While e-cigarettes with and without nicotine content are allowed and regulated as “tobacco products”.
Taxation Policy
  • In 2022, total tax rate on retail prices of a pack of cigarette was 19.2%.

  • HTPs and e-cigarettes are subject to an ad valorem excise at 22% of wholesale price.

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

Tobacco Production and Diversification

  • In 2022, Paraguay produced about 5.8 thousand tons of unmanufactured tobacco, accounting for approximately 0.1% of the global production of 5.8 million tons. This positioned Paraguay as the 50th largest tobacco producer in the world.

    • When compared to 2010, when Paraguay produced about 6.3 thousand tons of unmanufactured tobacco, there was an 8.7% decrease by 2022.

  • In 2022, Paraguay utilized approximately 3.6 thousand hectares of land for tobacco cultivation, reflecting a 21.5% 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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