Nominal and real cigarette Price trends from a global dataset, 2008-2024 and implications for the World Health Organization's 3 by 35 initiative: a longitudinal study and forecasting analysis

Introduction In July 2025, WHO launched the 3 by 35 Initiative calling on countries to increase real prices of tobacco, alcohol, and sugary drinks by at least 50% by 2035 to secure an additional $ 1 trillion in public revenue. While the effectiveness of excise taxes and prices in reducing tobacco use is well-documented, the feasibility of this call to action has not been evaluated empirically across the world. Methods Trend changes in countries nominal and inflation-adjusted retail prices were investigated using the most-sold brand of cigarettes over windows ranging from 2 to 16 years over the period 2008-2024, derived from nine editions of the World Health Organization Report on the Global Tobacco Epidemic. Statistical models of the association of cigarette excise taxes and prices from the panel of 195 countries were estimated. The frequencies of cigarette prices rising by at least 20% and 50% over preceding periods was estimated, and the length of time countries would need to reach these targets based on past trends were predicted. Results Over one- fifth of nominal cigarettes prices (and up to 40% in WHOs African region) were sticky across successive periods, even in countries with high overall consumer price inflation. Between 2008 and 2024, inflation-adjusted international dollar cigarette prices rose at a least squares annual trend growth rate of 2.9% (95% UI 2.8-3.0%) Excise tax increases strongly predict price increases. One-third of countries saw real prices at least 50% higher than 10 years prior. Conclusion Many of the instances of real price increases of 50% or more over 10-year periods occurred without countries implementing a conscious strategy to raise taxes. It is feasible to achieve and even surpass WHOs 3 by 35 call to action for tobacco if countries strategize and accelerate tobacco tax increases.