Tobacco Use and Trends
- In 2022, an estimated 4.4 million people (2.9 million males and 1.5 million females) aged 15 years and older were tobacco product users in Romania. This positions the country as the 37th globally and the 10th 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 (38% males and 23% females) were currently smoking tobacco products (cigarettes, cigars, cigarillos or pipe). Tobacco smoking was more prevalent in the 25-39 age at 44%, followed by the 40-54 age group at 39%, then the youngest 15-24 age group at 27%, and lastly, the oldest age group 55 years and over at 16%.
Among those tobacco smokers, 93% were daily cigarettes and 2% were daily hand-rolled cigarettes smokers.
In 2019, 31% of youths (30% boys and 32% girls) aged 15-16 were current tobacco smokers in Romania.
Demand for cigarettes per capita reduced by 20% in Romania from 86 packs in 2005 to 69 packs in 2020. The demand for fine-cut tobacco (e.g. roll your own RYO) has been negligible in Romania. (Figure 1)
Figure 1 Cigarette and Fine Cut Tobacco Consumption in Romania 2002-2021
Source: European Commission, Releases for consumption of cigarettes and fine cut tobacco (2002-2022)
Nicotine Alternatives
In 2020, 7% of respondents (10% males and 4% females) said they at least tried e-cigarettes.
The “at least tried out” category, the rate was the highest among the youngest 15-24 age group at 15%, followed by the 25-39 age group at 12%, then the 40-54 age group at 6%, lastly the 55 years old and older age group at 1%.
1% adults in 2020 were current e-cigarettes users.
In 2020, 5% of respondents (7% males and 4% females) said they at least tried heated tobacco products (HTPs).
The “at least tried out” category, the rate was more prevalent among the youngest 15-24 age group at 13%, followed by the 25-39 age group at 8%, then the 40-54 age group at 6%. Nearly none of the 55 and over age group had at least tried HTPs.
The current HTPs prevalence was 1%.
In 2020, 85% of respondents who tried stopping and ex-smokers said they had either quit or attempted to quit without any assistance.
Approximately 7% utilized Nicotine Replacement Therapy (NRT), and 5% sought medical support. Meanwhile, 5% utilized e-cigarettes and 2% opted for HTPs or oral, chewing, nasal tobacco products in their quitting journey.
In 2019, 14% of youths (14% boys and 13% girls) aged 15-16 years were current e-cigarette users in Romania.
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 Romania.
Tobacco was responsible for an estimated 29.5 thousand deaths, which is about 17.1% of total deaths.
Of tobacco-related deaths, 25.5 thousand or 86.4% were due to smoking, and 4.9 thousand or 16.7% were due to secondhand smoke.
In 2021, the top 10 causes of the most deaths in Romania included Ischemic Heart Disease (IHD) ranking 1st, Stroke ranking 3rd, Lung Cancer ranking 5th and Chronic Obstructive Pulmonary Disease (COPD) ranking 10th.
Tobacco was responsible for an estimated 8.0 thousand or 13.8% of all IHD deaths, 4.5 thousand or 9.9% of all Stroke deaths, 7.1 thousand or 87.5% of all Lung Cancer deaths, and 2.7 thousand or 63.9% of all COPD deaths.
In 2021, tobacco use caused an estimated loss of 865.1 thousand disability-adjusted life years (DALYs), which was about 21.6% of total DALYs. Tobacco accounts for 196.2 thousand DALYs for IHD, 112.1 thousand DALYs for Stroke, 186.9 thousand DALYs for Lung Cancer, and 70.9 thousand DALYs for COPD.
Regulatory Environment and Economics
Public Health Commitment
Romania ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2006.
Romania adopted graphical health warnings (GHWs) on combustible cigarettes (CCs) in 2008, covering 65% of the front and 65% of the back of the packages.
Diverse Tobacco Market
HTPs and e-cigarettes are allowed and marketed.
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 e-cigarettes.
Taxation Policy
In 2022, total tax rate on retail prices of a pack of cigarette was 69.1%.
In 2023, HTPs are subject to a specific excise of RON 834.63/kg, and e-cigarettes at RON 0.72/ml. Excise rates on HTPs and e-cigarettes will progressively increase until 2026.
A differential excise tax policy is applied between CCs and HTPs. The excise value for HTPs is RON 5.09/pack, with its share (26.80%) on the retail price (RON 19.00/pack) in 2023. The excise value of CCs is RON 12.52/pack, with its share (50.64%) on retail selling price (RON 24.72/pack) in 2023.
Smoking and Advertising Bans3
- Complete smoking bans with complete level of compliance, and moderate advertising bans with complete level of compliance were enforced in Romania in 2022.
Age Restrictions
- Tobacco products cannot be sold to individuals younger than 18 years of age.
Illicit Cigarette Trade
Estimated figures indicate that illicit cigarette trade in Romania remained high in 2008 with 20%, reached its peak in 2010 with 28%, but consistently fell thereafter, reaching its lowest rate at 6.6% in 2022.
In 2021, an estimated 2.1 billion counterfeit & contraband (C&C) cigarettes were consumed in Romania. The market share of C&C was approximately 7.9% of the total cigarette market, costing the government an estimated EUR 310 million in total tax revenue.
Tobacco Production and Diversification
In 2022, Romania produced about 190 tons of unmanufactured tobacco. This positioned Romania as the 105th largest tobacco producer in the world.
When compared to 2010, when Romania produced about 3 thousand tons of unmanufactured tobacco, there was a 93.6% decrease by 2022.
In 2022, Romania utilized approximately 280 hectares of land for tobacco cultivation, reflecting an 81.7% decrease compared 2010. (FAOSTAT [accessed January 2024])