Tunisia: smoking mainly affects men and people with less education

The results of the latest MICS survey show the relative stability of smoking in Tunisia, which affects one in two men and remains very high at home. Smoking prevalence is decreasing among men aged 15-19 even in rural areas and increasing in urban areas. This persistence of significant smoking calls for strengthening tobacco control measures.

The Multiple Indicator Cluster Survey (MICS) is an international survey program developed by UNICEF. Tunisia has already experienced five waves of this survey since 2000, the last one in 2023.

MICS Tunisia 2023 is based on a sample of 11,000 households, two thirds of which are in urban areas and one third in rural areas(1). It includes several health indicators that include maternal health, child health, education, drinking water and social coverage. One of its parts is devoted to the consumption of tobacco and alcohol.

MICS Tunisia 2023, implemented by the National Institute of Statistics (INS) and coordinated by the Ministry of Economy and Planning (MEP), benefited from technical and financial support from UNICEF and contributions from the United States Agency for International Development (USAID) and the German Development Bank (KfW).

Heavy smoking, especially in men

Smoking appears relatively stable, but shows a very slight increase in Tunisia since the 2018 MICS survey. It is present especially among men, and at a significant level. According to this survey, smoking prevalence is 49.8% in 2023 compared to 49.4% in 2018 for men and 1.9% in 2023 compared to 1.7% in 2018 for women. The prevalence of smoking increases significantly among men aged 20–24 (49.9% in 2023 versus 44% in 2018) and 35–39 (58.9% in 2023 versus 47.5% in 2018), while it decreases in men. aged 15–19 (16.5% in 2023 compared to 22.4% in 2018).

This smoking is mainly concentrated in urban areas: 52.3% of male smokers (50.4% in 2018) live in urban areas and 44.8% (47.3% in 2018) in rural areas, while 2.8 % of female smokers (2.3% in 2018) live in urban areas and that in rural areas this consumption appears to be exceptional or even non-existent and is below 0.5%.

The social-educational level plays in two different directions. Among men, the prevalence of smoking is higher when the level of education is low. A decreasing prevalence is noted, ranging from 59.4% in 2018 to 56.5% in 2023 among men with primary education and from 60.1% in 2018 to 50.4% in 2023 among uneducated men. On the other hand, it increases for men with higher education, from 41.4% in 2018 to 44.4% in 2023. The wealthiest households show a slightly higher prevalence (48.3% for men and 4.1% for women) than the most modest (46.2). % in men, 0.3% in women).

High mortality rate due to smoking

Smoking prevalence remains particularly high among Tunisian men, placing Tunisia first among the Maghreb countries in terms of smoking. The weight of smoking in Tunisia is estimated at 20% of the total mortality.

On the occasion of World No Tobacco Day in May 2023, the Prime Minister and nine ministers signed a charter aimed at strengthening the fight against tobacco(2). In particular, this charter was intended to restart the implementation of measures recommended by the World Health Organization (WHO) Framework Convention on Tobacco Control. The results of this latest survey highlight the issues(3).

Key words: Tunisia, survey, UNICEF, smoking prevalence, smoking

©Tobacco Free Generation


(1) Mother and child situationMultiple Indicator Cluster Survey (MICS) Tunisia 2023, 24 p.

(2) WHO – Eastern Mediterranean region, Meeting of the Ministerial Group on Tobacco Control in Tunisiaaccessed 22 February 2024.

(3) Ben Yahia M, Tunisia: Tobacco, a man’s curseRéalités Online, published February 14, 2024, consulted February 22, 2024.

National Committee Against Smoking |

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