Kiran Paudel, Kamal Gautam, Sandhya Niroula, Sandesh Bhusal, Jeffrey A Wickersham, Safaet Hossain Sujan, Bhakta KC, Tara B Adhikari, Roman Shrestha
Tobacco Prevention & Cessation, March 2026. Abstract
INTRODUCTION: Tobacco consumption is a significant public health problem in Nepal, accounting for 39200 deaths each year, accounting for 23.7% of all deaths. While Nepal has taken several policy measures to strengthen tobacco control, the persistent burden of tobacco and the associated health risks highlight the need for continuous monitoring and evaluation. Therefore, this study assessed the trend in age-specific and sex-specific mortality and disability attributable to different forms of tobacco use (smoking, chewing tobacco) in Nepal from 1990 to 2021. METHODS: This observational study used publicly available data from Nepal’s Global Burden of Disease (GBD) 2021 estimations. The age-standardized and age-specific summary exposure value (SEV), mortality, and disability-adjusted life years (DALYs) were extracted to measure the burden and trend of tobacco use. The data are presented as percentages or rates per 100000 population. RESULTS: From 1991 to 2021, the age-standardized SEV of tobacco consumption for both sexes at all ages decreased from 44.1% to 28.2%. The age-standardized deaths attributable to tobacco use, including all forms of tobacco products, decreased by (46.7%) from 262.9 (95% UI: 193.5–344.3) per 100000 in 1990 to 140.2 (95% UI: 101.1–181.9) per 100000 in 2021. CONCLUSIONS: Despite declines in SEV, and DALYs from 1990 to 2021, tobacco use remains a major public health concern. Strengthening smoking cessation programs, enforcing stricter tobacco control policies, raising taxes on tobacco products, and expanding public awareness campaigns are essential to reducing its burden.