Policy brief — Ethiopian Organization for Cancer Prevention and Research
On WHO’s 2024 MPOWER scoring Ethiopia reaches 5 out of 5 on five tobacco control measures and 3 out of 5 on taxation, the measure WHO identifies as the most cost-effective of them.
THE ISSUE
Ethiopian law covers, on WHO’s MPOWER data and Ethiopia’s 2025 report under the Framework Convention: smoke-free coverage complete across all eight venue categories WHO tracks, colour graphic pack warnings, an advertising ban, a minimum sale age of 21. In 2018 five of those eight categories were still not smoke-free, several permitting separate enclosed smoking rooms; all eight were complete by the 2020 reporting round, either side of Proclamation 1112/2019. Two things sit outside it. Total tax on the most-sold cigarette brand was 45.93% of retail price in 2024, against WHO’s benchmark of 75%, and Ethiopia is neither Party nor signatory to the Protocol to Eliminate Illicit Trade in Tobacco Products.
THE EVIDENCE
Tobacco causes more than 20 types or subtypes of cancer (opens in a new tab) and 60–70% of preventable lung cancer (opens in a new tab) worldwide, on WHO’s lung cancer fact sheet as published in 2026. In Ethiopia in 2024, lung cancer was the ninth most commonly diagnosed cancer and the sixth largest cause of cancer death (opens in a new tab) — an estimated 2,314 cases against 2,078 deaths.
Adult current tobacco use in 2024 was 4.6% as surveyed (opens in a new tab) (WHO Global Health Observatory, indicator TOBACCO_MPOWER_M1_PREVALENCE); WHO’s modelled estimate for the same year and age range, M_Est_tob_curr, is 4.5%. Both are on the record and neither is adopted here. The Global Youth Tobacco Survey measured current smoking among 13–15-year-olds at 10.3% in 2023 — 10.9% among boys, 8.0% among girls. The both-sexes value of 10.3% does not reconcile with a male 10.9% and a female 8.0%, so the three figures should not be read as one set. The primary survey report is not published, so no source used here settles why they differ, and neither reading is adopted. The adult and adolescent surveys differ in year, age range and instrument, so the figures are not a like-for-like pair; each stands on its own.
The 2024 tax on the most-sold brand, as a share of retail price: specific excise 16.67%, ad valorem excise 16.22%, value added tax 13.04%, import duties and other taxes nil. Total 45.93%, a shortfall of 29.07 percentage points. Forty-one countries met the benchmark in the 2025 global tobacco epidemic report (opens in a new tab), which names young people and low-income groups as most responsive to price.
Ethiopia ratified the WHO Framework Convention on Tobacco Control on 25 March 2014 and reported on implementation on 29 May 2025 (opens in a new tab). The Illicit Trade Protocol is a separate instrument, in force since 25 September 2018 with 73 Parties and 54 signatories, and Ethiopia appears on neither list (opens in a new tab). WHO estimates one in every ten cigarettes consumed globally is illicit.
AREAS FOR CONSIDERATION
The distance between 45.93% in 2024 and the 75% benchmark (WHO report on the global tobacco epidemic, 2025) is the decision this evidence bears on. Specific excise stood at 16.67% of retail price that year and ad valorem at 16.22%, and no source used here describes how the two behave as prices and incomes move. Accession to the Protocol is a separate question; WHO’s position is that illicit trade can be tackled while taxes are being raised.
Affordability, the ratio that determines whether a price change reduces consumption, cannot be computed from public data: the Global Health Observatory holds no 2024 cigarette retail price for Ethiopia. An annual price series for the most-sold brand would make the effect of any tax decision observable.
The 2024 adult survey was presented in Addis Ababa on 3 April 2025; as of August 2026 there is no report, fact sheet or summary tables, and the WHO NCD Microdata Repository (opens in a new tab) does not hold it. The link goes to the WHO NCD Microdata Repository’s full catalogue, which is global and unfiltered; searching it for Ethiopia is what shows the absence. The 2023 youth survey is readable only through a WHO database carrying an Ethiopian youth “any tobacco use” value of 13.1% both sexes against 12.4% male and 11.3% female — a set that cannot hold under any weighting, and which is not used here. The smoking rows in the same dataset are internally consistent and are used instead, with the weighting question set out above.
WHAT WE DO NOT KNOW
There is no public Ethiopian figure for second-hand smoke exposure, quit attempts, advice to quit from a health worker, or beliefs about tobacco — all standard domains of the 2024 survey, unpublished. No waterpipe prevalence measurement was located, although waterpipe tobacco is reported as banned, and no khat estimate more recent than the 2015 national NCD risk-factor survey could be found.
No tobacco-specific cancer attributable fraction appears here: WHO’s widely quoted “nearly a quarter of cancer deaths” bundles tobacco with four other risk factors and cannot be decomposed. Nor is there a verified Ethiopia-specific estimate of tobacco-attributable deaths.
The direction of WHO’s 1–5 MPOWER scale is inferred here from the underlying indicators rather than read from the printed legend in the 2025 report.
WHO’s modelled series has female age-standardised smoking prevalence drifting up from 0.7% in 2000 to 1.0% in 2024 (WHO Global Health Observatory, indicator M_Est_smk_curr_std). Against that, a figure attributed to the Director General of the Ethiopian Food and Drug Authority has female current tobacco use falling from 2.1% in 2016 to 0.5% in 2024. That figure reaches the record second-hand: the dissemination forum was the Ethiopian Public Health Institute’s, and the EFDA statement is quoted in an EPHI news item rather than in a report. The two are unlikely to be measuring the same quantity, and no source used here reconciles them. Ethiopia’s status on plain packaging could not be established.