Cigarette use

Between 1995 and 2019, ESPAD averages for cigarette use declined for lifetime use (68% to 42%); current use (33% to 20%) and daily use (20% to 10%).

It is also important to note that, with the exception of few countries, the proportion of adolescents who initiated daily smoking at a very early age (13 or younger) has decreased over the last 24 years.

Looking at the overall ESPAD trends for cigarette smoking, gender differences seem to have narrowed over time. In 1995 boys showed higher rates than girls with regard to all indicators. In 2019 these differences were negligible at the overall level and usually rather small in most countries.

The decreasing trend in smoking may be considered to be at least partially driven by policy measures, including restrictions on the underage purchase of tobacco products and restrictions on tobacco advertising, that have been implemented in the majority of European countries.

Although cigarette smoking is the most common form of tobacco use worldwide, considering only this may lead to an underestimation of current nicotine consumption because of the growing use of alternative products and new nicotine delivery technologies. For this reason, in the 2019 survey, questions asking about cigarette smoking were reformulated to explicitly exclude e-cigarettes, and new questions on the use of e-cigarettes and other nicotine-based products were introduced.