31 July 2026
By Vietnam.vn
Each year, tobacco not only claims over 100,000 lives but also costs Vietnam approximately 108.7 trillion VND in medical expenses and economic losses. Notably, the health insurance fund alone spends trillions of VND on treating tobacco-related diseases, placing significant pressure on the national social security system and healthcare resources.
The economic burden is growing heavier.
According to the results of the 2021 Survey on Non-Communicable Disease Risk Factors (STEPS) conducted by the Ministry of Health , the smoking rate among adults in Vietnam is 20.8%, equivalent to approximately 15.8 million people. Of these, the smoking rate among men is as high as 41.1%, while among women it is only about 0.6%.
Compared to 2010, the smoking rate has decreased from 23.8% to 20.8%. However, a reduction of only about 3 percentage points over more than a decade shows that tobacco control efforts still face many challenges.
Among teenagers aged 13-17, the rate of traditional tobacco use has decreased significantly, from 5.36% in 2013 to 2.78% in 2019. However, according to the Ministry of Health , the increase in e-cigarettes and heated tobacco products among young people is posing new risks to public health and management.
Vietnam remains among the top 15 countries with the highest rates of adult male smoking in the world and ranks third in the ASEAN region. This is a worrying situation, as tobacco is the cause of many dangerous non-communicable diseases such as cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease, stroke, etc., and is one of the leading preventable causes of death.
According to estimates by the World Health Organization (WHO), more than 8 million people die each year from tobacco-related diseases, of which approximately 1.3 million are due to passive smoking. In Vietnam, more than 100,000 deaths are related to tobacco each year. Of these, about 84,500 deaths are due to direct smoking and nearly 18,800 deaths are due to regularly inhaling secondhand smoke.
The total healthcare costs and economic losses caused by tobacco are estimated at VND 108.7 trillion (in 2022), equivalent to approximately 1.14% of GDP. Of these total losses, the cost due to premature death accounts for about 79%.
Notably, the health insurance fund is bearing a significant portion of the “bill” caused by tobacco. Medical expenses related to tobacco use, covered by the health insurance fund, increased from 8.3 trillion VND in 2019 to 8.7 trillion VND in 2022, accounting for approximately 7.5% of the total medical expenses covered by the health insurance fund.
In addition, people still have to directly pay a significant amount for medical treatment. Out-of-pocket medical spending by households increased from 7.7 trillion VND in 2019 to 8.1 trillion VND in 2022.
These figures show that the harm caused by tobacco is no longer just a health problem for smokers, but has become a burden on society as a whole. Every year, trillions of dong from the health insurance fund and family resources are spent on treating diseases that could be completely prevented if tobacco use rates were reduced.
Improving the legal framework to reduce the social burden.
Given the increasingly serious consequences, perfecting policies and laws on preventing and combating the harmful effects of tobacco is becoming an urgent necessity.
Resolution No. 173/2024/QH15 of the National Assembly prohibits the production, trading, import, transportation, storage, and use of e-cigarettes, heated tobacco products, and other products containing addictive substances harmful to human health. The Investment Law has also included these products in the list of prohibited investment and business sectors.
However, according to the Ministry of Health, the Law on Prevention and Control of Tobacco Harm, after more than 13 years of implementation, has revealed some limitations, particularly the lack of specific regulations for e-cigarettes and heated tobacco products, as well as a mechanism for handling violations related to these products. The amendment of the Law aims to fully institutionalize the National Assembly’s policy, ensure consistency within the legal system, and increase the effectiveness of state management.
Smoking in public places remains common, increasing the risk of exposure to secondhand smoke. (Photo: TH)
In reality, the control measures have initially yielded positive results. According to the Poison Control Center at Bach Mai Hospital, before Resolution No. 173/2024/QH15 came into effect, the unit received an average of 5-6 emergency cases per month related to e-cigarettes. After the ban was implemented, this number decreased to about 1-2 cases per month.
In addition, the overt advertising of e-cigarettes on social media, through influencers, and in retail stores has also decreased significantly thanks to increased inspections, checks, and enforcement of violations.
However, according to the Drafting Committee for the Law amending and supplementing several articles of the Law on Prevention and Control of Tobacco Harm (Ministry of Health), in order for these initial results to be sustained, perfecting the legal framework remains an urgent requirement. In reality, besides advertising, product display at points of sale can still become a form of visual marketing that influences consumer behavior, especially among young people.
Therefore, one of the notable aspects of the draft amendment to the Law is the proposal to ban all forms of displaying tobacco products at points of sale. According to the drafting committee, although tobacco advertising has been banned, displaying cigarette packs, shelves, signs, or brand identification items is still a form of promotion that stimulates consumption, especially among young people.
This proposal is also consistent with the recommendations of the WHO Framework Convention on Tobacco Control (FCTC). By the end of 2024, 59 countries had adopted regulations prohibiting the display of tobacco products at points of sale, including many ASEAN countries such as Thailand, Singapore, Brunei, Laos, and Malaysia.
Reducing tobacco use rates not only helps decrease the number of illnesses and premature deaths but also contributes significantly to saving healthcare costs, easing pressure on the health insurance fund, and improving the efficiency of healthcare resource utilization. In the context of Vietnam’s goal of universal health insurance coverage and improving the quality of healthcare, further tightening tobacco control measures is considered one of the crucial solutions to protect public health, ensure social security, and promote sustainable economic development.