Aim and Objective:
Tobacco has been consumed in the region of Macedonia ages ago. Over the years, the characteristics and the profile of the smokers have changed, but the smoking rates remain high. Smoking is not just a bad habit in Macedonia. Tradition of raising, processing and consuming tobacco is also involved, as well as social and cultural aspects. A lot of Macedonian families earn their living from cultivation and processing tobacco. Numerous tobacco factories worked with full capacity in the past. Part of them have been closed or repurposed during the past decade, but tobacco industry is a powerful enemy, managing to keep the high rate of smokers in Macedonia.

Methods & Findings:
In 2013, 46.6 % of the male and 26.8% of the female population in Macedonia were active smokers, rating Macedonia to the highest places in Europe. Up to two decades ago, smoking was allowed everywhere in the country, actually, there was no smoking ban whatsoever. The first law for protection from smoking was passed in 1995, with seven changes and additional laws in the following years. In 2013, smoking was forbidden in all public and indoor places. This regulative lowered slightly the number of smokers, but the accomplished results are far from the desired ones. A great portion of the population does not confine to the laws.

Conclusion:
Unfortunately, in October 2017, the Parliament of the Republic of Macedonia, passed an amendment, allowing smoking in outdoor spaces of the restaurants and pubs, even if they were closed with barriers from all sides. In order to give our contribution to the reduction of tobacco consumption in Macedonia, we have been working on a program for education of doctors and health workers for smoking cessation. The project represents a partnership between the Medical faculty in Skopje and the Henry Ford Health System from Detroit, Michigan, USA.

Funding:
Authors gratefully acknowledge funding through Pfizer Grants for Learning and Change (European Division) and the Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic.