State of Smoking and Health in Slovakia

In Slovakia, tobacco use affected 30.2% of the population in 2022, with higher rates among males (35.4%) compared to females (25.4%). Tobacco-related health impacts are substantial, accounting for approximately 7,000 deaths annually and causing significant losses in disability-adjusted life years (DALYs), particularly from ischemic heart disease, stroke, lung cancer, and COPD.

Tobacco Use and Trends

  • In 2022, an estimated 1.4 million people (784.6 thousand males and 599.6 thousand females) aged 15 years and older were tobacco product users in Slovakia. This positions the country as the 74th globally and the 26th 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, 25% of respondents (34% males and 16% females) were currently smoking tobacco products (cigarettes, cigars, cigarillos or pipe). Tobacco smoking was more prevalent in the youngest 15-24 age group at 34%, followed by the 40-54 age group at 31%, then the 25-39 age at 22%, lastly, the oldest age group 55 years and over at 19%.

    • Among those tobacco smokers, 78% were daily cigarettes and 6% were daily hand-rolled cigarettes smokers.

  • In 2019, 29% of youths (26% boys and 33% girls) aged 15-16 years were current cigarette smokers in Slovakia.

  • Demand for per capita cigarettes in Slovakia has experienced fluctuations, beginning at 46 packs in 2002 and reaching a peak of 119 packs in 2007. However, since 2010, the demand has steadily declined, decreasing by 12% from 68 packs in 2010 to 60 packs in 2021. Fine-cut tobacco (e.g. roll your own RYO) was not popular tobacco product in Slovakia initially. However, it gained traction in 2017, starting at 1.3 packs of 20gr weight and increasing to 3 packs of 20gr weight in 20211 (Figure 1).

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

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

Nicotine Alternatives

  • In 2020, 12% of respondents (16% males and 8% 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 33%, followed by the 25-39 age group at 17%, then the 40-54 age group at 10%, and lastly the 55 years old and older age group at 3%.

    • 1% adults were current e-cigarettes users.

  • In 2020, 9% of respondents (13% males and 7% 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 29%, followed by the 25-39 age group at 12%, then the 40-54 age group at 8%, lastly the 55 and over age group at 2%.

    • The current HTPs prevalence in adults was 2%.

  • In 2020, 83% of respondents who tried stopping and ex-smokers said they had either quit or attempted to quit without any assistance.

    • Approximately 5% utilized Nicotine Replacement Therapy (NRT), and 3% sought medical support. Meanwhile, 5% utilized e-cigarettes and 6% opted for HTPs, while nearly none opted for oral, chewing, nasal tobacco products in their quitting journey.

  • In 2019, 18% of youths (22% boys and 14% girls) aged 15-16 years were current e-cigarettes users in Slovakia.

Health and Economic Burden From Tobacco Use

  • In 2021, it was estimated that tobacco was the 3rd highest risk factor driving the most deaths and disability combined in Slovakia.

  • Tobacco was responsible for an estimated 7.0 thousand deaths, which is about 20.0% of total deaths.

    • Of tobacco-related deaths, 6.0 thousand or 85.0% were due to smoking, and 1.3 thousand or 18.3% were due to secondhand smoke.

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

    • Tobacco was responsible for an estimated 2.6 thousand or 16.1% of all IHD deaths, 721.8 or 13.2% of all Stroke deaths, 1.6 thousand or 85.8% of all Lung Cancer deaths, and 382.9 or 64.7% of all Chronic Obstructive Pulmonary Disease (COPD) deaths.

  • In 2021, tobacco use caused an estimated loss of 199.7 thousand disability-adjusted life years (DALYs), which was about 22.7% of total DALYs. Tobacco accounts for 57.4 thousand DALYs for IHD, 19.4 thousand DALYs for Stroke, 40.3 thousand DALYs for Lung Cancer, and 10.9 thousand DALYs for COPD.

Regulatory Environment and Economics

Public Health Commitment
  • Slovakia ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2004, and WHO Illicit Trade Protocol in 2017.

  • Slovakia 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
Taxation Policy
  • In 2022, total tax rate on retail prices of a pack of cigarette was 76.7%.

  • In 2023, HTPs are subject to a specific excise of EUR 187.8/kg, while no excise is imposed on e-cigarettes.

  • A differential excise tax policy is applied between CCs and HTPs. The excise value for HTPs is EUR 1.15/pack, with its share (28.64%) on the retail price (EUR 4.00/pack) in 2023. The excise value of CCs is EUR 2.84/pack, with its share (56.84%) on retail selling price (EUR 5.00/pack) in 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 Slovakia in 2022.
Age Restrictions
  • Tobacco products and e-cigarettes with nicotine cannot be sold to individuals younger than 18 years of age.
Illicit Cigarette Trade
  • Estimated figures indicate that illicit cigarette trade in Slovakia remained consistently below 5% from 2008 starting at 5% to 2017 reaching a low of 4.4%, but showed consistent increase, thereafter, reaching 7.2% in 2022.

  • In 2021, an estimated 0.2 billion counterfeit & contraband (C&C) cigarettes were consumed in Slovakia. The market share of C&C was approximately 2.7% of the total cigarette market, costing the government an estimated EUR 25 million in total tax revenue.

Tobacco Production and Diversification

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