Tobacco remains a deeply entrenched economic pillar in many African nations, simultaneously presenting significant public health challenges due to its widespread use. This dichotomy has fostered an enduring conflict between a vital economic dependence on tobacco and the urgent imperative to safeguard public health across the continent. Zimbabwe, for instance, stands as Africa's largest producer of flue-cured tobacco, with its 2025 output reaching 355 million kilograms, valued at an estimated US$1.2 billion, according to Tobacco Reporter. Despite this, grower registrations for the 2025/26 farming season saw a decline, with approximately 82,000 growers registered by October 2025, down from 126,000 in the preceding season, as reported by the Tobacco Industry Marketing Board (TIMB). Neighboring Malawi, another substantial tobacco producer, projected a 2025 output of 175 million kilograms, marking a notable 31% increase from the 133 million kilograms recorded the previous year.

The deep-seated reliance on tobacco as a primary source of foreign currency and a significant contributor to Gross Domestic Product (GDP) creates a complex dilemma for many African governments. This economic dependence often impedes the effective implementation of stringent tobacco control measures and equitable taxation policies. In some cases, emerging novel nicotine products face disproportionately higher taxes compared to traditional cigarettes, a strategy often employed to deter their adoption and shield the established tobacco sector from new competition. Sahan Lungu, a Tobacco Harm Reduction practitioner from Malawi, articulated the unpopularity of implementing robust tobacco control measures and taxes in his country, stating, “In Malawi, tobacco is a significant contributor to the economy. It accounts for over 60% of national export earnings. This dependence makes it difficult to implement stringent tobacco control measures without risking economic instability.” Lungu further highlighted that many smallholder farmers view tobacco farming as economically viable due to its profitability relative to other crops. He also pointed to poor coordination among the Ministries of Finance, Agriculture, and Health as a significant barrier to developing holistic Tobacco Harm Reduction strategies, advocating for a collaborative approach to balance health, agriculture, and trade considerations. The public health toll in Malawi is stark, with estimates of over 5,000 annual deaths from tobacco-related illnesses and nearly a million daily tobacco users.

To alleviate the financial burden on small-scale farmers, Malawi currently applies a 1% withholding tax on their sales, a reduction from previous higher rates, thus supporting farmers while still generating state revenue. However, concerns persist regarding corporate tax evasion among major producers, despite existing export levies on tobacco. Joseph Magero, chairman of the Campaign for Safer Alternatives (CASA), emphasized the tobacco industry's sensitive nature for African economies, noting, “Tobacco provides income and employment for millions, especially in rural areas of countries like Malawi, Zimbabwe, and Tanzania, where few alternative cash crops exist.” Yet, farmers often remain caught in cycles of poverty due to low farm-gate prices, debt to leaf-buying companies, and volatile global demand. Magero cautioned that without viable alternatives or investment in crop diversification, a transition away from tobacco could imperil livelihoods and destabilize economies already contending with high unemployment and limited agricultural infrastructure.

Taxation, while a powerful tool for tobacco control, presents a double-edged sword. In Zimbabwe, excise taxes on tobacco products are designated to fund health initiatives and fiscal reforms, reflecting an effort to align taxation policies with public health objectives. However, the challenge of balancing fiscal needs with industry interests was underscored by the reversal of a proposed 10% tax on tobacco farmers in 2017 following industry backlash. Zimbabwe levies excise duty and surtax on manufactured tobacco products, including cigarettes, cigars, and cigarette tobacco. Across Africa, signatory countries to the World Health Organisation Framework Convention on Tobacco Control (WHO-FCTC) have adopted diverse tax regimes to curtail tobacco use. South Africa, for example, between 1994 and 2009, saw a substantial increase in excise taxes alongside strengthened tobacco control laws, leading to a significant decline in smoking rates and considerable revenue gains, as documented in a study published on the Tobacco Control BMJ platform. The country has continued to raise tobacco taxes, with excise duties increasing above inflation levels, including a 4.75% rise in the 2025 national budget, bringing the tax to approximately R21.77 per pack of 20 cigarettes for the 2024/2025 financial year.

Despite these concerted efforts, smoking rates and tobacco-related deaths in South Africa, and other low- and middle-income countries, remain stubbornly high. Data from the Global State of Tobacco Harm Reduction shows that 20.3% of South African adults aged 15 and older smoked regularly in 2022, a figure comparable to 20.2% in 2020 and 20.7% in 2019. The country also recorded approximately 32,400 tobacco-related deaths in 2022, accounting for about 10% of total annual deaths. This persistent high usage begs a critical question: why do these rates persist despite heavy taxation and restrictive policies, and where do smokers acquire their cigarettes? Dr. Mercy Korir, a Medical Doctor from Kenya, suggested that over-taxation can be counterproductive to public health outcomes. “Over-taxation often fuels smuggling and counterfeit markets, especially where enforcement is weak, undermining both health goals and government revenue. These are common challenges across African borders,” Dr. Korir explained, citing Kenya where underage individuals access products online due to unclear legislative frameworks, fostering grey and black markets.

The illicit tobacco industry has burgeoned into a multibillion-dollar global enterprise, with estimates from The Tobacco Atlas and Philip Morris International (PMI) placing the global illicit tobacco market at between US$40 billion and US$50 billion annually, representing 11–15% of the worldwide market. Evidence consistently demonstrates that where taxes and regulatory restrictions are particularly severe, the illicit market tends to expand rapidly. In South Africa, the illicit tobacco trade was estimated to cost the economy around ZAR20 billion in 2023. The South Africa Tobacco Transformation Alliance reports that approximately 37 billion cigarettes are smoked annually in the country, with a substantial portion believed to be illicit. Francois van der Merwe, spokesperson for the Alliance, described the situation as a “national disaster,” emphasizing the gravity when 70% of a major sector like tobacco operates illicitly. Magero underscored that while taxation is a widely adopted tool to discourage smoking, excessive taxes often drive consumers into the black market. “Over-taxation on legal tobacco or nicotine products often pushes prices beyond what many consumers can afford, creating strong incentives for illicit markets to fill the gap with cheaper, unregulated alternatives,” he stated. He warned that this shift leads to governmental revenue loss, absence of oversight, and exposes individuals to unregulated products devoid of safety standards or quality controls, thereby undermining public health goals, fueling criminal networks, and complicating authorities' ability to track consumption and enforce age restrictions.

In response to these multifaceted challenges, legislative efforts are underway. The South African Parliament is actively debating the Tobacco Products and Electronic Delivery Systems Bill, which seeks to tighten regulations concerning both traditional and emerging nicotine products. Similarly, in Kenya, the government has proposed the Tobacco Control Amendment Bill, aiming to amend the Tobacco Control Act (Cap. 245A of 2007) to encompass the regulation of both conventional tobacco products and newer nicotine-delivery systems like e-cigarettes and nicotine pouches.