Abstract
Background: Tobacco and other addictive substances are among the leading preventable causes of mortality worldwide. In Turkey, the Household Health Survey on Noncommunicable Disease Risk Factor Prevalence (The WHO STEPwise approach to NCD risk factor surveillance, STEPS) was first conducted in 2017, providing standardized monitoring of risk factors associated with noncommunicable diseases (NCDs). The repetition of the survey in 2023 offered an opportunity to assess temporal changes in tobacco, alcohol, and illicit drug use, as well as passive exposure and public attitudes toward tobacco control legislation.
Methods: This study compared the 2017 and 2023 STEPS data for Turkey, supported by Turkish Statistical Institute (TurkStat) datasets. Descriptive statistical analyses were performed, and Microsoft Excel and OpenEpi were used, with the significance level set at p<0.05. Findings were analyzed by sex and age groups under the headings of tobacco use, alcohol use, illicit drug use, passive exposure at home and in the workplace, and attitudes toward tobacco control legislation.
Results: Tobacco use increased from 31.5% in 2017 to 34.8% in 2023. The increase was 15.1% in men and 30.3% in women, with a significant sex difference (p<0.001). Alcohol consumption rose from 8.0% to 10.2%, with the highest increase observed among women aged 30–44 years (112.2%). The prevalence of not using illicit drugs increased from 97.0% to 97.4%, with a greater rise among men. Passive exposure to tobacco smoke at home rose from 27.5% to 37.8%, and workplace exposure increased from 21.9% to 29.1%, with higher exposure particularly among younger age groups. Support for tobacco control legislation remained high (88.1% in 2017 and 88.5% in 2023) but was relatively lower among younger groups.
Conclusions: This study revealed increasing trends in tobacco and alcohol use, widespread passive exposure to tobacco smoke, and consistently high support for tobacco control legislation in Turkey, while highlighting vulnerabilities particularly among women and younger populations. The findings underscore the need to revisit existing tobacco and alcohol control policies, develop gender-sensitive strategies, and strengthen protective measures for younger groups.
Keywords: WHO, STEPS, tobacco, alcohol, illicit drugs, passive exposure, legislation
References
- T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü. Türkiye Hanehalkı Sağlık Araştırması 2023. Ankara: Sağlık Bakanlığı; 2023. Available at: https://hsgm.saglik.gov.tr/media/attachments/2025/05/12/turkiye-hanehalki-saglik-arastirmasi-2023.pdf (Accessed on Aug 19, 2025).
- World Health Organization (WHO). WHO global report on trends in prevalence of tobacco use 2000-2030. Geneva: World Health Organization; 2024. Available at: https://www.who.int/publications/i/item/9789240079364 (Accessed on Aug 19, 2025).
- World Health Organization (WHO). Tobacco. Geneva: World Health Organization; 2025. Available at: https://www.who.int/news-room/fact-sheets/detail/tobacco (Accessed on Aug 19, 2025).
- Calikoglu EO, Koycegiz E. Tobacco control policies in Turkey in terms of MPOWER. Eurasian J Med 2019; 51: 80-84. https://doi.org/10.5152/eurasianjmed.2018.18009
- World Health Organization (WHO). MPOWER package of data-driven tobacco control measures helps protect up to 5 billion lives. Geneva: World Health Organization; 2021. Available at: https://www.who.int/news-room/feature-stories/detail/mpower-package-of-data-driven-tobacco-control-measures-helps-protect-up-to-5-billion-lives (Accessed on Aug 26, 2025).
- Erbaydar T, Lawrence S, Dagli E, Hayran O, Collishaw NE. Influence of social environment in smoking among adolescents in Turkey. Eur J Public Health 2005; 15: 404-410. https://doi.org/10.1093/eurpub/cki040
- International Agency for Research on Cancer (IARC). Evaluating the effectiveness of smoke-free policies. IARC handbooks of cancer prevention. Lyon, France: World Health Organization, International Agency for Research on Cancer; 2009. Available at: https://cancercontrol.cancer.gov/sites/default/files/2020-06/m21_6.pdf (Accessed on Aug 26, 2025).
- Satpathy N, Jena PK, Sahoo M, et al. Changes in smoking patterns in Turkey before and after the ban on loose cigarettes: an ecological perspective from global tobacco surveillance data. Cureus 2024; 16: e69657. https://doi.org/10.7759/cureus.69657
- Bulca Acar A, Köksal Yasin Y. Pandemiyi bütüncül olarak değerlendiren nitel bir çalışma: pandemi sürecinin sigara kullanım alışkanlıklarına etkisi. ESTÜDAM 2023; 8: 252-259. https://doi.org/10.35232/estudamhsd.1288371
Copyright and license
Copyright © 2025 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
