Nicotine consumption varies widely across countries, influenced by differences in culture, regulation, and habits. Determining which country uses the most nicotine is not straightforward, but examining available data on tobacco and nicotine product sales can provide some insights.
Tobacco Use
Tobacco products like cigarettes are the primary source of nicotine consumption worldwide. According to the World Health Organization (WHO), China consumes over 2.5 trillion cigarettes annually, representing nearly 40% of the world’s cigarettes.[1] Other top consuming countries are Indonesia, the United States, Russia, and Japan.
| Country | Annual Cigarettes Consumed (billions) |
|---|---|
| China | 2,500 |
| Indonesia | 220 |
| United States | 210 |
| Russia | 160 |
| Japan | 130 |
However, looking at total consumption alone does not account for differences in population. On a per capita basis, Indonesia consumes the most cigarettes globally at 1,700 per adult per year. China’s massive population means its per capita consumption is lower at 1,150 per adult annually.[2]
Smokeless Tobacco
Some cultures favor smokeless tobacco like chewing tobacco or snuff over smoked products. These also contain substantial amounts of nicotine. India stands out with high smokeless tobacco usage – an estimated 194 million users or over 20% of adults.[3] The Southeast Asia region as a whole accounts for nearly 90% of global smokeless tobacco consumption.[4]
Nicotine Replacement Therapy
Nicotine replacement therapy (NRT) products like gums, patches and lozenges are used to help quit smoking. The US and European markets make up the bulk of global NRT sales. However, Japan also has widespread NRT use with sales over $1 billion annually.[5]
E-Cigarettes
E-cigarettes have grown rapidly as a nicotine delivery method. The United States is the largest e-cigarette market with an estimated 20 million users. But adjusting for population, South Korea stands out with 13% adult usage compared to 6% in the US and UK.[6]
Conclusion
China likely consumes the most total nicotine given its vast population and tobacco use. However, adjusting for population, countries like Indonesia, India and South Korea have very high usage rates driven by tobacco habits and e-cigarette adoption.
Regulation also plays a key role, with looser controls on smoking and availability of alternative nicotine products increasing consumption. Going forward, education efforts and access to cessation resources will be important to reducing nicotine dependence worldwide.
References
- World Health Organization. WHO Report on the Global Tobacco Epidemic, 2019. Accessed October 10, 2023.
- The Tobacco Atlas. Facts and Figures. Accessed October 10, 2023.
- Stepanov I, Yershova K, Carmella S, Upadhyaya P, Hecht SS. Levels of (S)-N’-nitrosonornicotine in U.S. tobacco products. Nicotine Tob Res. 2013;15(8):1305-1310.
- National Cancer Institute and Centers for Disease Control and Prevention. Smokeless Tobacco and Public Health: A Global Perspective. Bethesda, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Institutes of Health, National Cancer Institute. NIH Publication No. 14-7983; 2014.
- Euromonitor International. NRT Smoking Cessation Aids in Japan. July 2017.
- The Guardian. Vaping Rises Globally as Smoking Declines. Accessed October 10, 2023.