Introduction:
From 2008 onwards, Turkey legislated smoke-free, comprehensive TAPS bans, more than 80% tax burden, pictorial health warnings, plain packaging, media campaigns, and quitline service. GATS was run three times, and GYTS four times to monitor implementation. Based on a 13.4% relative decline in prevalence between 2008-2012, in 2013, Turkey was declared the first country protecting its entire population with all MPOWER measures at the highest level. However, GATS 2016 showed that a smoking prevalence of 27.1% in 2012 rose to 31.6 in 2016. Women’s prevalence rose by 46.6% in the same period. The Health Survey 2022 indicated prevalence at 32.1%, a 20% relative increase between 2012-2022. Women’s prevalence rose by 38.3%. To underscore the unprecedented growth in smoking prevalence and volume in Turkey against the backdrop of parallel running supply-side policies.

Methods:
Review of official 2003-2023 data on tobacco manufacturing, trade, and prevalence/volume.

Results:
During 2003-2023, extensive legislation augmenting tobacco manufacturing and trade was adopted. Incentives to tobacco companies specifically geared toward increased manufacturing were granted, and the country underwent a regime change that dismantled existing tobacco control governance, replacing it with a highly centralized, non-transparent, unaccountable anti-addiction rhetoric and administration. Cigarette manufacturing grew by 3.4 billion sticks/year on average. Two new sub-brands were put on the market every month. Legal cigarette sales reached a record 189 billion sticks in 2023, rising by an unprecedented 4.13 % compound annual growth rate since 2013. Manufacturing and consumption growth was even more pronounced in other tobacco products.

Conclusions:
The international tobacco control community should take notice that tobacco control has been grossly undermined in Turkey and draw lessons from the Turkish experience on how to curb the supply side to improve the effectiveness of demand-side measures and avoid regression.