Public health campaigns, graphic warning labels, and steep taxes have pushed smoking rates down across much of the world over the past two decades. Yet in a handful of countries, cigarettes remain a daily fixture of life, sometimes at rates that catch visitors and even public health researchers off guard. The reasons vary from cultural tradition to weak enforcement of existing tobacco laws, but the outcome looks similar everywhere: a lot of people still lighting up despite decades of warnings.
What follows is a look at seven nations where smoking has proven unusually resistant to decline, based on the most recent government and World Health Organization data available.
Indonesia
Indonesia stands out as one of the few large countries where smoking has not meaningfully declined in recent years. In 2024, Indonesia reported a significant prevalence of tobacco smoking among adults aged 15 years and older, with the adult current smoking prevalence at 30.4%, including 59.7% of males and 1.2% of females. That gender gap is one of the widest anywhere in the world.
The total number of smokers in 2024 was approximately 64.4 million, a slight decrease from 64.5 million in 2020. Smoking-related mortality remains a critical public health issue, accounting for 12.27% of all deaths in the country in 2021, including 17.77% of male deaths. Weak enforcement of advertising rules and widely available clove cigarettes, known locally as kretek, help keep the habit deeply embedded in daily life.
Serbia
Serbia currently holds one of the highest tobacco use rates on the entire European continent. According to estimates for 2025, the share of smokers in Serbia is 39%. That figure places it at or near the very top of WHO’s regional rankings, ahead of most of its Balkan neighbors.
A peer-reviewed analysis of the 2023 WHO tobacco report found that many Balkan countries have adopted strong tobacco-control policies on paper, but that in many cases there is a lack of implementation. The laws often exist, but the enforcement and the real-world tax levels lag behind. That gap between regulation on paper and behavior on the street helps explain why Serbia’s numbers have stayed stubbornly high even as awareness of health risks has grown.
Bulgaria
Bulgaria trails Serbia by only a fraction of a percentage point, making it the second most smoke-heavy country in Europe. Bulgaria ranks second in Europe after Serbia in terms of the share of the population that smokes, with estimates for 2025 putting the figure at 38.8%. That rate has held remarkably steady for years despite EU-wide tobacco directives.
Eastern European countries typically have a higher prevalence of smokers than other parts of Europe due to a historical smoking culture, weaker tobacco control policies, and higher rates of economic hardship. A 2021 pan-European study found that lower socio-economic status is a key factor influencing smoking habits in both men and women. Cigarette prices in Bulgaria remain among the lowest in the EU, which likely reinforces the habit rather than discourages it.
Greece
Greece has long carried a reputation as one of Europe’s heaviest smoking nations, and current figures suggest that reputation is still largely earned. There are approximately 3.5 million people smoking in the country, with 39.1% of the adult population classified as current smokers, down from 42% in 2006, and 45.3% of men smoking compared with 32.8% of women. The decline has been slow rather than dramatic.
The most recent data show there were 22,759 annual deaths attributable to tobacco smoking, with the annual percentage of all deaths attributable to tobacco smoking at 20.87%. Cafe culture and a strong social tradition around smoking breaks continue to normalize the habit across generations. Even newer nicotine alternatives like heated tobacco products have grown alongside cigarettes rather than fully replacing them.
Turkey
Turkey’s smoking culture is tightly woven into daily social life, from tea houses to workplaces, and the statistics reflect that. Turkey’s daily tobacco consumption rate stands at 27.3 percent, placing it among the highest in the wider European region alongside Bulgaria, Greece, and Hungary. That figure has only edged downward slightly over the past several years despite repeated tax increases on tobacco products.
Turkish authorities have introduced indoor smoking bans and packaging warnings similar to those used across the EU, yet enforcement in informal settings such as street cafes and smaller businesses remains inconsistent. The habit also carries strong intergenerational roots, with many smokers picking up cigarettes as teenagers in households where parents smoked openly. Public health officials continue to cite affordability and cultural acceptance as the two biggest obstacles to further reductions.
France
France is a reminder that high smoking rates are not confined to lower income countries or post-communist states. France sits at 34.6% tobacco use, a figure higher than many would guess for a wealthy Western European nation. France has the highest smoking rate in Western Europe, above the European average and closer to the level of the Balkan countries.
French smoking rates have proven notably resistant to the kind of steep declines seen in the UK or Scandinavia over the same period. Cigarette prices have risen sharply through repeated tax hikes, yet consumption has not fallen at the pace policymakers hoped for. Many public health researchers point to stress, social smoking during breaks, and a slower cultural shift compared with neighboring countries as contributing factors.
North Macedonia
North Macedonia posts one of the highest smoking rates recorded anywhere in the world, a fact that surprises many outside the Balkans. Data from the Public Health Institute published on World No Tobacco Day in 2024 shows that 45.4 percent of the country’s population are active smokers, significantly higher than the average in the European Union and among the highest in the world. That figure sits well above even Serbia and Bulgaria, the two countries most often cited as Europe’s heaviest smoking nations.
The country’s small size means its numbers rarely make international headlines, yet the underlying pattern mirrors its neighbors: strong social acceptance of smoking, affordable cigarette prices, and limited enforcement of existing restrictions in cafes and public spaces. Health officials in the country have flagged rising interest in cessation programs, but the overall smoking rate has not shown a clear downward trend in recent years. It remains one of the clearest examples of how geography and cultural habit can outweigh formal tobacco control policy.
Taken together, these seven countries show that high smoking rates today are not limited to any single region, income level, or stage of economic development. Balkan nations, a major Southeast Asian economy, and even a wealthy Western European country all appear on the list for different underlying reasons, from weak enforcement of existing laws to deep cultural roots that have proven difficult to shift.
