Alex Jung
Smoking remains a serious health issue in the Pacific Islands region, with most nations having higher rates of cigarette smoking than the global average.
Person smoking a cigarette. M Ahmad. CC BY-NC 4.0.
Oceania collectively has one of the highest rates of cigarette smoking in the world, and Nauru, a small island nation on the continent, has the highest smoking rate of any country, with 46.7% of the adult population being smokers. Nauru is not an outlier; Papua New Guinea, Kiribati, Solomon Islands, Tuvalu, Tonga and the Marshall Islands all have smoking rates higher than 30%, which is significantly higher than the global average of 20.9%. Notably, while smoking rates are often higher in men for most countries, the average smoking rate for women in the Pacific Island nations also exceeds the 7.4% global average.
Smoking was introduced to the Pacific Islands as early as the 16th century through European settlement and colonial movements, and by the 1800s, it became a widespread practice among many non-European communities. Tobacco has since been imported and traded with Pacific Island nations regularly.
A study conducted by the University of Michigan concluded that Pacific Islander teens were much more likely than other adolescents to engage in risky behaviors such as drinking and smoking. This suggests that youth exposure and experimentation with smoking is much higher in the Pacific Islander communities. Young people are more vulnerable to addiction due to their developing adolescent brains, which also leads to greater vulnerability to peer and societal pressure. With high rates of tobacco addiction among the youth, it is no surprise that the overall rates of smoking in the adult population are also high. A further study conducted by the Bulletin of the World Health Organization claimed that rural areas in the Pacific Islands had a higher prevalence of smoking than urban areas. Following the colonial era, many rural locations in the Pacific began to cultivate their own tobacco. Through a public policy lens, these two studies suggest that the banning of tobacco products may be important, but ultimately, rehabilitation efforts and education programs to prevent youth addiction could be equally, if not more, effective.
There are undeniable harmful health effects of cigarette smoking. Experts in cancer epidemiology assert that it is indeed lung cancer that is the leading cause of cancer-based deaths in the Pacific Islands. In Micronesia specifically, lung cancer is the third most prominent form of cancer, but it has a mortality rate of 30.5%, which is much higher than any other site of cancer in the region. The correlation between high rates of smoking and lung cancer death suggests that the fatalities can be reduced by lowering the rates of smoking.
As of Nov. 29, 2025, 14 countries in the Pacific Islands have ratified the World Health Organisation's Framework Convention on Tobacco Control. This convention requires the nations to follow strict tobacco control measures, including tobacco control legislation, to promote long-term public health. The Tobacco Atlas finds that Nauru, with the highest rate of smoking in the world, has also implemented various policies to prevent smoking. This includes designated smoke-free areas in most public healthcare, educational and leisure facilities. Nauru has continued national anti-tobacco campaigns on various forms of mass media, including national TV and radio. Nauru has also increased the tax rates of tobacco products by 20% and has continuously increased the standard prices to reduce affordability and accessibility. Many other Pacific Island nations are implementing similar reforms. While the Pacific Island nations may have higher rates of smoking, effective policy implementation is being utilized to decrease smoking rates and promote stronger public health.
Alex Jung
Alex is from New Zealand and South Korea, and is currently a student at the University of Chicago. He is majoring in Political Science and International Relations, and minoring in Middle Eastern Studies. He is passionate about social justice for minorities and indigenous communities. In his free time, he enjoys learning languages (Korean, English, Mandarin, and Persian) and writing novels and short stories.