Cigarette use

The ESPAD results provide evidence of positive developments with regard to teenage smoking, against a backdrop of tobacco policy measures introduced over the last two decades.

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.


Most recent scientific literature on cigarette use based on ESPAD data:

Kuipers, M. A. G., Brandhof, S. D., Monshouwer, K., Stronks, K. and Kunst, A. E. (2017), ‘Impact of laws restricting the sale of tobacco to minors on adolescent smoking and perceived obtainability of cigarettes: an intervention-control pre-post study of 19 European Union countries’, Addiction 112 (2), pp. 320-329, doi:10.1111/add.13605.

Van Hurck, M. M., Nuyts, P. A. W., Monshouwer, K., Kunst, A. E. and Kuipers, M. A. G. (2019), ‘Impact of removing point-of-sale tobacco displays on smoking behaviour among adolescents in Europe: a quasi-experimental study’, Tobacco Control 28 (4), pp. 401-408, doi:10.1136/tobaccocontrol-2018-054271.

Perelman, J., Leão, T. and Kunst, A. E. (2019), ‘Smoking and school absenteeism among 15- to 16-year-old adolescents: a cross-section analysis on 36 European countries’, European Journal of Public Health 29 (4), pp. 778-784, doi:10.1093/eurpub/ckz110.

Li, S., Keogan, S., Taylor, K. and Clancy, L. (2018), ‘Decline of adolescent smoking in Ireland 1995-2015: trend analysis and associated factors’, BMJ Open 8 (4), p. e020708, doi:10.1136/bmjopen-2017-020708.