Nominal and real cigarette Price trends from a global dataset, 2008-2024 and implications for the World Health Organization’s 3 by 35 initiative: a longitudinal study and forecasting analysis
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Introduction
In July 2025, WHO launched the “3 by 35” Initiative calling on countries to increase real prices of tobacco, alcohol, and sugary drinks by at least 50% by 2035 to secure an additional $ 1 trillion in public revenue. While the effectiveness of excise taxes and prices in reducing tobacco use is well-documented, the feasibility of this call to action has not been evaluated empirically across the world.
Methods
Trend changes in countries’ nominal and inflation-adjusted retail prices were investigated using the most-sold brand of cigarettes over windows ranging from 2 to 16 years over the period 2008-2024, derived from nine editions of the World Health Organization Report on the Global Tobacco Epidemic. Statistical models of the association of cigarette excise taxes and prices from the panel of 195 countries were estimated. The frequencies of cigarette prices rising by at least 20% and 50% over preceding periods was estimated, and the length of time countries would need to reach these targets based on past trends were predicted.
Results
Over one-fifth of nominal cigarettes prices (and up to 40% in WHO’s African region) were sticky across successive periods, even in countries with high overall consumer price inflation. Between 2008 and 2024, inflation-adjusted international dollar cigarette prices rose at a least squares annual trend growth rate of 2·9% (95% UI 2·8–3·0%) Excise tax increases strongly predict price increases. One-third of countries saw real prices at least 50% higher than 10 years prior.
Conclusion
Many of the instances of real price increases of 50% or more over 10-year periods occurred without countries implementing a conscious strategy to raise taxes. It is feasible to achieve and even surpass WHO’s 3 by 35 call to action for tobacco if countries strategize and accelerate tobacco tax increases.
What is already known
Previous research has evaluated the impact of cigarette and tobacco taxation and found that prices respond to higher excise taxes. However, whether price increases match, exceed or fall short of general price inflation in a country is an empirical question, with some evidence that taxes are over-shifted in high-income settings and that prices tend to be higher in countries with specific (per unit) taxes. In the policy setting, the Task Force on Fiscal Policy for Health modeled the impact of higher taxes that raise inflation-adjusted prices by at least 50% on reducing the consumption of tobacco. The World Health Organization’s database of cigarette product prices and taxes collected every two years is comprehensive and permits analysis covering many more low- and middle-income countries and years than commercial databases.
What this study adds
The study examined the feasibility of WHO’s global call to raise real tobacco prices using all data from available reports of the WHO Report on the Global Tobacco Epidemic from 2008-24. Analysis not previously conducted at this scale (16 years, more than 180 countries) include an examination of the stickiness of nominal cigarette prices, calculation of trends in nominal and real international prices, calculation of the extent of real price increases over multiple time windows, and estimation of country-specific trends real price changes.
How this study might affect research, practice or policy
This study finds that nominal cigarette prices were sticky over short time windows in many countries and that globally, real cigarette prices rose on average 2·9% annually. It affirms that excise taxes on cigarettes tend to be over-shifted to prices (that is, a 1 dollar increase in tax increases prices by more than a dollar) especially when specific excise taxes were introduced or increased. One-third of countries saw real cigarette prices rise 50% or more over 10 years, but applying historical trend rates of real price growth based on their 2008-2024 experience indicated that many other countries would fall short of raising prices by 50%. Countries at all income levels have the potential for large cigarette price increases of 50% or more, but will have to accelerate their efforts substantially to achieve the WHO 3 by 35 global call.
