Cambodia is waging a multi-sector battle against tobacco, but while policies are tightening, the country faces persistent challenges in curbing smoking rates. With around 15,000 tobacco-related deaths annually and an economic toll of 2.7 trillion Khmer Riels ($663 million) per year, the government has ramped up its anti-smoking efforts through stricter regulations, taxation, and public health campaigns.
The results are beginning to show. Cambodia has earned international recognition for its tobacco control measures, becoming one of just nine Western Pacific nations enforcing smoke-free laws in eight public spaces, according to the WHO’s 2023 Global Tobacco Epidemic Report. Several cities, including Siem Reap, Preah Sihanouk, and Kampot, have been designated as “Smoke-Free Tourism Cities,” reflecting a shift that extends beyond health into urban planning and tourism policy.
Yet, the fight is far from over. Smoking rates among men remain stubbornly high at 35.5%, and secondhand smoke exposure continues to be widespread in public areas. Meanwhile, the rise of e-cigarettes and online sales threatens to undermine years of progress, pushing policymakers into a new regulatory battle.
A Decade of Policy Reform
Cambodia’s anti-tobacco efforts gained momentum with the 2015 Law on Tobacco Control, which provided the first comprehensive legal framework for regulating tobacco use. This was followed by the 2016 Sub-Decree on Banning Smoking in Workplaces and Public Spaces, implemented in partnership with the Ministry of Tourism. By 2022, more than 500 businesses had adopted smoke-free policies, signaling a shift in the private sector’s approach to public health.
Parallel to these legal efforts, the government has expanded cessation programs, establishing 135 counseling centers across 11 provinces. However, access to these services remains limited, particularly in rural areas where tobacco use is deeply ingrained.
Taxation has also emerged as a key tool in the government’s strategy. With WHO’s backing, Cambodia’s Excise Policy Framework 2024-2028 aims to increase tobacco taxes, reduce consumption, and curb illicit trade. The approach mirrors global best practices, where higher taxes have been linked to declining smoking rates. However, the effectiveness of this measure will depend on enforcement and public compliance.
E-Cigarettes and Youth Consumption
While traditional tobacco control measures are in place, Cambodia is now grappling with a surge in e-cigarette use, particularly among young people. According to the National Adult Tobacco Survey 2021, 82% of vape users are between 15-35 years old, with over 80% purchasing their products online—a regulatory loophole that has allowed the market to flourish.
In response, the Ministry of Health and the Ministry of Education, Youth and Sport are finalizing a sub-decree banning the import, sale, advertising, and possession of e-cigarettes and shisha. But enforcement remains a challenge, as the industry quickly adapts to new restrictions, shifting sales to informal markets and social media platforms.
A Public Health and Economic Balancing Act
Despite global recognition for its policies, Cambodia’s progress in reducing tobacco use has been incremental. The 2023 WHO STEPS survey shows that while smoking rates among 25-64-year-olds have remained stagnant since 2016, exposure to secondhand smoke remains alarmingly high:
- 16% of adults are exposed to secondhand smoke in public areas.
- 51% of people report exposure in restaurants.
- 62% of public transport users encounter secondhand smoke.
These figures highlight the gap between policy and implementation, with enforcement inconsistencies limiting the effectiveness of smoke-free laws.
Dr. Chhea Chhordaphea, Director of the National Center for Health Promotion, acknowledges both progress and the need for continued action. “We have made great strides, but we must remain vigilant. Strengthening partnerships—both within Cambodia and across the region—will be crucial in sustaining our success,” she says.
The Road to a Tobacco-Free Cambodia
With increased taxation, stricter regulations, and growing public awareness, Cambodia has laid the groundwork for long-term tobacco control. However, the rapid rise of alternative nicotine products and persistent tobacco consumption among men pose ongoing challenges.
Dr. Marianna Trias, WHO’s representative to Cambodia, warns that youth-targeted marketing by the tobacco industry remains a major threat. “Tobacco companies see young people as their next generation of consumers. Strong regulations, education campaigns, and youth-led advocacy are essential to protecting them,” she says.
For Cambodia, the next phase of tobacco control will depend on enforcement, public compliance, and adaptation to emerging trends. The government’s strategy has been effective in setting the foundation, but ensuring sustained impact will require constant vigilance, stronger penalties, and continued cross-sector collaboration.
The battle is not just about health—it is an economic, social, and policy challenge that will shape the country’s future for years to come.
