Southeast Asia’s tobacco toll meets India’s tough tax move

Tobacco kills more people in Southeast Asia each year than any other preventable cause. Yet, the region may now be at a turning point. India has significantly hiked taxes on tobacco

Tobacco remains the world’s leading cause of preventable death. It claims 1.1-1.6 mn deaths annually in Europe. Southeast Asia has 3.2 mn of tobacco-related deaths annually.

Beginning February 1, India’s reform of tobacco taxation—raising GST on tobacco products from 28% to 40%--represents a decisive use of fiscal policy to protect health. The reform aligns with global evidence showing that higher prices are among the most effective tools to reduce tobacco consumption, particularly among youth and low-income populations, while also helping offset the heavy costs tobacco use imposes on households and health systems.


These actions build on important progress across the region. Over the years, countries have implemented large graphic health warnings on tobacco packs, adopted plain packaging and strengthened alignment with WHO's Framework Convention on Tobacco Control (FCTC). Yet, the scale of challenge remains daunting.

Nearly one-third of the world’s tobacco users —around 322 mn people—live in Southeast Asia. Despite notable declines in tobacco use prevalence since 2000, the region continues to record some of the highest levels of adult tobacco use globally.

Smokeless tobacco remains a major driver of this burden, with more than 288 mn users—over 80% of the global total—residing in here. Adolescents are particularly vulnerable, with Southeast Asia accounting for nearly 21% of the world’s tobacco users aged 13-15. At the same time, novel nicotine products such as e-cigarettes and nicotine pouches are reported gaining ground among young people.

Southeast Asian laws alone, however, are not enough. Without effective enforcement, even the strongest policies risk falling short. Sub-optimal implementation, regulatory gaps, illicit trade, limited access to cessation services and persistent tobacco industry interference continue to undermine tobacco control efforts. Success requires sustained, multisectoral action based on 'whole-of-government' and 'whole-of-society' approaches.

Recognising this, countries in the region adopted a regional strategic framework in 2025 to address smokeless tobacco, novel nicotine products, and areca nut use, reaffirming their commitment to comprehensive implementation of the WHO FCTC and the MPOWER package.

The recent actions taken by India show what is possible when governments act decisively to protect health. Tobacco remains the single-most important modifiable risk factor for noncommunicable diseases, including cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, across the world.

The writer is head, Southeast Asia, WHO.