One Death per Hour: Smoking Kills 9,500 Annually in Belgium

More than 9,500 people die each year in Belgium from smoking-related causes — equivalent to one death every hour — according to alarming new data released by Sciensano, the Belgian public health institute. The figures, published on World No Tobacco Day, reveal that tobacco consumption accounts for approximately 8% of all deaths in the country, making it one of the leading preventable causes of mortality.

A Plateau in Progress

Belgium has made significant strides in reducing smoking rates over the past decade. In 2018, 15.4% of the population aged 15 and older smoked daily; by 2023–2024, that figure had dropped to 12.8%, according to Sciensano’s latest health survey. However, the institute warns that this pace is far too slow to meet the national target of a tobacco-free generation by 2040.

“A large part of that disease burden would simply not exist if people did not smoke,” said Brecht Devleesschauwer, an epidemiologist at Sciensano. “Behind each figure are diseases and deaths that could have been prevented.”

The data suggests the decline in smoking-related deaths may be plateauing. In 2013, there were 12,851 such deaths (12% of all deaths), falling to 9,413 in 2020 (7% of all deaths). The current figure of over 9,500 indicates that progress has stalled in recent years.

The Human and Economic Toll

The three leading causes of smoking-related death are lung cancer, chronic obstructive pulmonary disease (COPD), and coronary heart disease. Beyond the human cost, the financial burden is substantial: a 2018 study estimated the annual healthcare cost of daily smoking in Belgium at €533 million.

Smoking’s impact is not felt equally across society. Men account for three-quarters of all smoking-related deaths, while residents of Brussels and Wallonia face a 50% higher risk than those in Flanders. Lower-educated populations are also disproportionately affected.

“These inequalities largely reflect social inequalities in smoking behavior,” Devleesschauwer noted. “A next step must be to implement differentiated measures to achieve the necessary progress among the groups that still suffer the most today.”

Plain Packaging Expansion Takes Effect June 1

The release of Sciensano’s data coincides with a major policy milestone: the expansion of Belgium’s plain packaging law, which takes effect on June 1, 2026. Since 2020, neutral packaging — standardized background colors with no logos, bright colors, or brand symbols — has been required for cigarettes, rolling tobacco, and hookah tobacco. Starting tomorrow, the requirement extends to cigars, cigarillos, pipe tobacco, smoking accessories (including pipes, hookahs, and CBD devices), rolling papers, filters, and tubes.

Federal Health Minister Frank Vandenbroucke said the measure aims to “counter the marketing strategies of the tobacco industry, which target adolescents and young adults, because attracting the next generation of smokers is essential to the industry’s survival.” A transition period will allow retailers to sell existing stock before fully complying.

The Shift to New Nicotine Products

Sciensano epidemiologist Sarah Nayani highlighted a growing concern: while traditional smoking is declining, particularly among young people, part of that decrease may be explained by a shift toward emerging nicotine products, especially e-cigarettes.

“If we do not act on both traditional smoking and new nicotine-based products, we risk maintaining the same public health burden in another form,” Nayani warned.

The government is already looking ahead: flavors in e-cigarettes are set to be banned from September 1, 2028.

Public Support for Stronger Action

A 2025 Flemish study found that 77.8% of the population supports anti-tobacco campaigns, providing a strong public mandate for continued regulation. The federal government’s national tobacco plan, approved in December 2022, includes measures to make tobacco products less visible, less accessible, and more expensive, alongside improved access to smoking cessation support.

What to Watch For

As Belgium’s expanded plain packaging law takes effect, attention will turn to enforcement and the tobacco industry’s response. With the 2040 tobacco-free generation target still 14 years away, Sciensano’s data serves as a stark reminder that current efforts, while meaningful, are not yet sufficient. The key question remains whether the government will introduce targeted measures for the most affected communities — men, lower-educated populations, and residents of Brussels and Wallonia — to accelerate progress where it is needed most.