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Although the number of smokers has declined worldwide over recent decades, tobacco use still claims more than seven million lives each year. At the same time, the growing popularity of new tobacco and nicotine products presents fresh challenges for prevention efforts. In Hungary, smoking rates are highest among adults aged 40–54, but figures among young people aged 15–24 are also alarmingly high. Experts warn that tobacco use remains one of the most significant public health risks, while the increasing appeal of novel nicotine products among young people is a growing cause for concern. The good news is that it is never too late to quit smoking: health benefits begin to appear from the very first day.

For nearly four decades, 31 May has been observed as World No Tobacco Day, an initiative established by the World Health Organization (WHO) to raise awareness of the dangers of tobacco use and the importance of prevention and smoking cessation. Although the number of smokers has declined worldwide over recent decades, tobacco use remains one of the leading preventable causes of death. Today, more than seven million people die each year as a result of tobacco use, including an estimated 1.6 million deaths caused by exposure to second-hand smoke.

According to the WHO’s latest report, tobacco use has declined significantly worldwide compared to previous decades. While an estimated 1.38 billion people used tobacco products in 2000, that figure had fallen to 1.2 billion by 2024. Since 2010 alone, the global number of tobacco users has decreased by approximately 120 million. Despite this progress, around one in five adults still uses a tobacco or nicotine product.

The situation remains particularly concerning in the WHO European Region, which currently has the highest smoking prevalence in the world. In 2024, 24.1% of adults in the region smoked. Europe also records the highest rate of smoking among women, with a prevalence of 17.4%, compared to less than 10% in all other WHO regions.

Smoking rates in the European Union remain similarly high. According to a 2023 survey, 24% of people aged 15 and over reported smoking, although considerable differences exist between individual member states. In Hungary, 26% of the population aged 15 and over reported smoking in 2023, including 32% of men and 21% of women. The highest prevalence was recorded among adults aged 40–54, where more than one-third (36%) smoked. However, the figures among younger people are also concerning: nearly one in three individuals aged 15–24 (31%) reported smoking.

Emerging nicotine products pose new challenges for tobacco control

One of the major challenges in tobacco control is that, since the 2000s, the tobacco industry has continuously introduced new products and technologies, including e-cigarettes, heated tobacco products, and nicotine pouches. These are often accompanied by aggressive marketing strategies targeting the general population, particularly younger age groups. However, these novel tobacco and nicotine products cannot be considered harmless, as a growing body of evidence points to their adverse health effects.

According to WHO estimates, more than 100 million people worldwide now use e-cigarettes, primarily in high-income countries. Of these users, at least 15 million are children and adolescents aged 13–15. The use of nicotine pouches is also expanding rapidly, especially among young people. In its latest report published in May this year, the World Health Organization noted that global sales of these products exceeded 23 billion units in 2024, representing an increase of more than 50% compared to the previous year.

In Hungary, recent data are equally concerning. According to a 2022 study, among students in grades 5–11, the prevalence of regular smoking, which had declined between 2010 and 2018, began to increase again in 2022. While approximately 13% of students reported regular smoking in 2018, this figure rose to 16% by 2022. At the same time, the growing popularity of new nicotine products is clearly evident. In 2022, around 34–35% of ninth-grade students and 38–39% of eleventh-grade students reported using e-cigarettes. Use of heated tobacco products was also widespread, with 33% of eleventh-grade students reporting use.

“There is no safe form of smoking,” emphasises Dr Erika Balogh, senior lecturer at the Department of Public Health Medicine at the University of Pécs Medical School, and specialist in preventive medicine and public health. “Reducing tobacco use is a shared responsibility. Prevention, protecting young people, and supporting cessation can save lives. All forms of smoking are harmful, and complete avoidance of both traditional and novel tobacco and nicotine products is recommended to protect health. In Hungary, smoking represents a major public health burden, with more than 27,000 deaths attributed to smoking each year.”

She adds that smoking can damage nearly every organ in the body. It plays a key role in the development of cardiovascular diseases, harms the respiratory system, significantly increases the risk of chronic obstructive pulmonary disease (COPD), and contributes to the development of numerous cancers. Smoking also complicates the treatment of existing diseases and worsens their progression.

Evidence on the harmful health effects of new tobacco and nicotine products is also steadily increasing. Their use has been associated with respiratory and cardiovascular disorders, as well as the development and persistence of nicotine dependence. In response to a rise in poisoning cases and respiratory complaints in recent years, a nationwide monitoring system was introduced in Hungary last year to more accurately assess and track the health impacts of tobacco and nicotine-containing products.

The expert pointed out that smoking can lead to a dual form of dependence, involving both physical and psychological (behavioural) addiction. Nicotine, the main component of tobacco and nicotine-containing products, plays a key role in the development and maintenance of addiction and can produce a particularly strong dependence. Addiction can develop rapidly, especially among young people, and may also increase the likelihood of using other tobacco and nicotine products. However, nicotine is not only highly addictive; a growing body of evidence also points to a range of other harmful effects. It damages blood vessels, increases the risk of atherosclerosis and insulin resistance, and has a negative impact on immune function and fetal development. Nicotine is particularly harmful for children, adolescents and young adults, as it also affects brain development, which continues until approximately the age of 25.

The sooner you quit smoking, the better

According to Dr Erika Balogh, quitting smoking is one of the most important steps smokers can take to improve their health, and it is strongly recommended not to delay cessation. Although quitting earlier in life brings greater benefits, significant health gains can still be achieved even after many years of smoking. Smoking cessation has a wide range of positive effects:

• It improves overall health and quality of life
• It reduces the risk of cardiovascular diseases
• It lowers the risk of respiratory diseases (e.g. COPD)
• It decreases the risk of more than 10 different types of cancer
• It reduces the risk of other conditions such as diabetes and osteoporosis
• It increases the chances of conception and is an important step for healthy fetal development when planning a pregnancy
• It can extend life expectancy by an average of 10–14 years (the younger a person quits, the greater the benefit)

The body begins to recover almost immediately after smoking is stopped. While some benefits can be observed within days or weeks, others take longer to emerge.

• Within the first day, heart rate and blood pressure begin to decrease, while carbon monoxide levels in the blood return to normal.
• Within 2–12 weeks, circulation and lung function improve.
• Within 1–9 months, coughing and shortness of breath decrease.
• Approximately 1–2 years after quitting smoking, the risk of heart attack is reduced by about 50% compared to that of current smokers and continues to decline over time.
• Within 5–10 years, the risk of cancers of the mouth and larynx is reduced by about half, while the risk of stroke also declines.
• After 10 years, the risk of lung cancer is approximately 50% lower than that of a smoker.
• After 15 years, the risk of coronary heart disease becomes similar to that of a non-smoker.

Help is available – Don’t hesitate to seek support

“Quitting smoking is not easy for many people. As mentioned earlier, long-term tobacco use can lead to both physical and psychological dependence. Overcoming addiction is often a lengthy process, and relapse may occur along the way. Long-term success also requires changes in behaviour and everyday habits,” Dr Balogh explained.

“The chances of quitting successfully can be significantly improved through professional support, behavioural interventions that promote lasting lifestyle change, and, when necessary, medication. In Hungary, specialised smoking cessation programmes—known as intensive cessation support services—are available through pulmonary care centres, selected Health Promotion Offices and some workplaces. These programmes are offered in both individual and group formats, and telephone counselling is also available through the national quitline (+36 80 44 20 44), which can be called free of charge. Whether participating in a face-to-face or telephone-based programme, individuals receive support from trained smoking cessation counsellors throughout the quitting process.”

For people with stronger nicotine dependence, medication may be recommended alongside behavioural support to help manage withdrawal symptoms and cravings. Smoking cessation medications generally fall into two categories: nicotine replacement therapies, such as patches and gum, and prescription medications that do not contain nicotine. Appropriate treatment should always be discussed with a healthcare professional.

Those considering quitting can find practical advice and further information on the websites leteszemacigit.hu and eljtisztatudovel.hu, while the mobile application “Gond? Egy szál se!” also offers useful support for smokers ready to take the first step towards a tobacco-free life.

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