Tobacco Sector Analysis in North Macedonia: Subsidies, Production, and Policy Perspectives

Abstract

Tobacco use in North Macedonia represents a critical public health issue, with one of the highest global smoking prevalence rates at 48.4%. A significant portion of smokers (51.3%) begin smoking between 18 and 24 years, and 44.4% consume over 20 cigarettes daily. Smoking contributes substantially to mortality, with 170.17 deaths per 100,000 people attributed to smoking in 2019. North Macedonia's low cigarette prices and minimal illicit tobacco trade create significant potential for effective tobacco tax policy improvements. Smoking, a major risk factor for non-communicable diseases (NCDs) such as cardiovascular diseases and cancers, underscores the need for comprehensive tobacco control measures to reduce premature mortality and enhance mental health. This study examines tobacco demand in North Macedonia, analyzing consumption patterns, trends, and product types. It underscores the importance of understanding the socio-economic, cultural, and policy dimensions driving tobacco use. The methodology involves a multi-resource desk research approach, drawing on academic literature, government reports, and data from international organizations to provide a comprehensive overview of tobacco demand. Key findings reveal a high smoking prevalence with a slight decline over recent years. Economic factors, especially cigarette prices, significantly influence smoking rates. While the average number of cigarettes smoked per day remains high, there is evidence of reduced smoking prevalence among youth, attributed to increased health awareness and preventive measures. Despite legal restrictions, smoking remains socially accepted, complicating public health efforts. The paper highlights the urgent need for enhanced tobacco control policies, including increased taxes, stricter smoking bans, and targeted interventions to reduce smoking rates, particularly among vulnerable populations. These measures, combined with continuous monitoring and research, are crucial for achieving significant public health improvements and aligning with Sustainable Development Goals.