Decline in smoking among 13-15 year olds worldwide, still too limited and uneven

A recent study assessed the prevalence of smoking among young adolescents aged 13 to 15 between 1999 and 2018 in 143 countries. The downward trend in prevalence over these two decades, however, remains uneven and insufficient, while the situation is stagnating or even deteriorating in 40% of the countries studied.[1].

The study published in the journal The Lancet Child & Adolescent Health[2] used the most recent data from global tobacco surveys of adolescents aged 13 to 15 years from 143 countries or territories that conducted at least one survey between 1 January 2010 and 31 December 2018, and data from 140 countries that conducted two or more surveys between 1 January 1999 and 31 December 2018. The study found that the prevalence of young people who had smoked at least one cigarette in the past 30 days decreased in 80 countries (57%) but remained unchanged or increased in 60 countries (43%).

Despite an overall reduction in cigarette consumption over the past two decades, nearly one in six boys (17.91%) and more than one in 10 girls (11.51%) in this age group worldwide used tobacco at least once in the past month during the survey, between 2010 and 2018.

Significant disparities by region, gender and type of product

The decline was more measured in the European region, with an overall decline in 5% consumption between 1999 and 2018 among 13- to 15-year-olds. However, the region as a whole has a high smoking prevalence among girls, with over 23% of young girls smoking in Bulgaria and Italy. Some Eastern European countries have also seen an increase in consumption among adolescents, which the authors attribute to the low cost of cigarettes, poor enforcement of smoking bans in public places, weak measures to ban tobacco advertising and promotion, or the sale of single cigarettes.

The study also examined the use of other tobacco and nicotine products, such as chewing tobacco, snuff, cigars, cigarillos, shisha tobacco, and e-cigarettes. The prevalence of use of these other products was highest in the Eastern Mediterranean region (16.7% among boys and 9.0% among girls). For example, in Saudi Arabia, the prevalence of use of other tobacco products has increased by 33.3% every 10 years since 1999.

The need for proper enforcement of tobacco control measures

According to the researchers, regional differences stem from the existence and effectiveness of tobacco control measures. For example, Uruguay, which has been at the forefront of tobacco control, with the introduction of a complete ban on tobacco promotion and advertising and extensive graphic health warnings, saw its adolescent tobacco consumption drop from 20% in 2007 to 8% in 2014.

According to the authors, current public policies need to be supplemented to account for the emergence of new tobacco and nicotine products in recent decades. For example, hookah consumption has spread to many countries and has literally exploded in the Eastern Mediterranean region. This development is due in particular to the proliferation of new flavors and the misperception that hookah tobacco is less harmful than traditional cigarettes.

Keywords: Smoking, adolescents, new products

©Generation Without Tobacco

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[1] The Lancet Child & Adolescent Health: 40% of countries show no progress in reducing cigarette smoking in adolescents over last 20 years, EurekAlert Press Release, February 2, 2021, accessed February 3, 2021 [2] Chuanwei Ma, MSc, Prof Bo Xi, MD, Zilin Li, BSc, Han Wu, MSc, Min Zhao, MD, Yajun Liang, MD et al. Prevalence and trends in tobacco use among adolescents aged 13–15 years in 143 countries, 1999–2018: findings from the Global Youth Tobacco Surveys, The Lancet Child & Adolescent Health, February 02 2021, 2021 doi.org/10.1016/S2352-4642(20)30390-4 National Committee Against Smoking |