Major tobacco-tax reforms in several emerging economies have sharply increased cigarette prices and helped drive down smoking, offering powerful lessons for countries seeking to protect health, raise revenue and advance the World Health Organization’s 3 by 35 Initiative.
A new independent analysis of 15 countries finds that every country made improvements to cigarette taxation between 2009 and 2025. The strongest results came where governments acted boldly, substantially raising taxes, simplifying tax systems and preventing cigarettes from becoming more affordable as incomes rose.
WHO urges countries to use health taxes to increase the real prices of tobacco, alcohol and sugary drinks by 2035. The 3 by 35 Initiative aims to reduce consumption of products that drive noncommunicable diseases and injuries, while generating resources that governments can invest in health and development.
“The evidence is clear: when governments make harmful products significantly more expensive, people consume less, lives are saved and public revenues rise,” said Dr Etienne Krug, Director, Department of Health Determinants, Promotion and Prevention, WHO. “Small, irregular tax adjustments are too easily swallowed by inflation or manipulated by industry. Countries need predictable and ambitious increases that make tobacco, alcohol and sugary drinks progressively less affordable.”
The Philippines stands out as the clearest example of a major tobacco-tax reform. Following its landmark 2013 reform, the real price of the country’s most-sold cigarette brand rose dramatically. Across the full 2008–2024 period, the analysis estimates a 638% real-price increase, while cigarette-smoking prevalence fell by roughly one third between 2010 and 2025.
The Philippines also linked tax policy to health financing. Revenue from higher tobacco taxes was earmarked to expand universal health coverage, illustrating how a health tax can simultaneously discourage consumption and help finance public priorities.
Ukraine recorded an estimated 659% real increase in the price of its most-sold cigarette brand between 2008 and 2024. Mexico, the Philippines and Ukraine all experienced significant declines in smoking following major tax and price increases, while taxation operated alongside other tobacco-control measures.
Across the 15 countries, adult tobacco use prevalence declined substantially in many settings. Between 2010 and 2025, the analysis reports relative reductions of about 43% in India, 37% in Pakistan, 34% in Brazil and 29% in both Bangladesh and the Philippines.
The progress, however, has been uneven. Cigarettes became less affordable over the longer term in only a limited number of the countries studied. In others, income or inflation outpaced price increases.
The analysis points to four recurring ingredients of stronger tobacco-tax policy: substantial and regular increases; simpler tax structures; greater reliance on specific excise taxes; and automatic adjustment for inflation and income growth.
The same opportunity exists for sugary drinks and alcohol
WHO’s latest global data show that governments remain far from using beverage taxes to their full public-health potential.
At least 116 countries levy a national excise tax on one or more types of sugar-sweetened beverage. Yet the global median excise-tax share on a comparable carbonated sugary drink is only 2.4% of its retail price. Sugary drinks became less affordable between 2022 and 2024 in just 34 countries; in 62, they became more affordable.
Only around one quarter of countries with the relevant tax systems base their taxes on sugar content, a design that can encourage consumers to choose lower-sugar products and incentivize manufacturers to reformulate. Just 14% automatically adjust specific taxes, leaving most vulnerable to erosion by inflation.
Several countries are nevertheless demonstrating useful approaches. Azerbaijan, France, Hungary, the Philippines and the United Republic of Tanzania direct a portion of sugary-drink revenues towards expanded health coverage. Panama, the Russian Federation and Zimbabwe use revenues for programmes addressing cancer, diabetes or other noncommunicable diseases, while Poland and Portugal channel funds towards broader health purposes.
WHO data also show that the highest total tax share on the comparable sugary drink was reported in Timor-Leste, at approximately 53% of the retail price. Globally, however, the total tax share averages only about 22%, roughly two-thirds lower than the total tax share imposed on cigarettes.
Alcohol taxes are more widespread but also remain too low. At least 167 countries apply national alcohol excise taxes. On a population-weighted basis, excise represents approximately 21% of the retail price of beer and 28% of spirits, while beer became less affordable between 2022 and 2024 in only 31% of countries and spirits in only 22%.
Fewer than one in four countries with specific alcohol taxes require regular automatic increases, and at least 25 countries continue to exempt wine from excise taxation.
The experience of the past 15 years shows that tax reform is possible even in complex political and economic environments. But it also demonstrates that modest increases are not enough.
The WHO 3 by 35 Initiative calls for a 50% real price increase by 2035, requiring nominal prices to roughly double globally, on average: cigarettes from US$ 4.70 to US$ 9.60 per pack, beer from US $1.30 to US$ 3.10 per 330 ml, and sugar-sweetened beverages (SSBs) from US$ 0.90 to US$ 1.90 per 330 ml. The largest increases are needed in low-income countries, where prices would need to more than triple.
WHO is calling on governments to establish long-term tax roadmaps; automatically adjust taxes for inflation and income growth; close loopholes and eliminate preferential treatment for cheaper products; and ensure that comparable tobacco, alcohol and sugary-drink products are appropriately covered.
To support implementation, WHO has launched the WHO 3 by 35 Initiative on Health Taxes website. The Initiative aims to accelerate health tax implementation, facilitate knowledge exchange, strengthen country-level advocacy, and mobilize global partnerships to keep health taxes high on the global policy agenda.
As the Initiative gains momentum, champions from countries around the world are beginning to voice their support and share perspectives through the Initiative’s platform. WHO will also publish country case studies highlighting progress, experiences and lessons learned as governments advance health tax reforms under the 3 by 35 Initiative.
Notes for editors
The paper Excise Taxes in Emerging Economies: Progress on Cigarette Taxation in the Bloomberg Initiative, 2009–2025 was written by Rajeev Cherukupalli of the Johns Hopkins Bloomberg School of Public Health and published in Tax Notes International. The analysis was supported by Bloomberg Philanthropies under the WHO 3 by 35 initiative.
WHO’s 3 by 35 Initiative calls on countries to use tax increases to raise the real prices of tobacco, alcohol and sugary drinks by 2035, taking into account individual country circumstances.
WHO’s 2025 global reports on sugar-sweetened beverage and alcohol taxes use country-reported data with a cut-off date of 31 July 2024.