Prevalence of Current, Daily, and Heavy Smokers Among Adolescents in 97 Countries: A Global Population-Based Study

Understanding adolescent smoking behavior is crucial for developing effective prevention strategies; however, research on adolescent smoking remains limited. Thus, we investigated the global prevalence of current, daily, and heavy smokers among adolescents.

We analyzed data obtained from the Global Youth Tobacco Survey conducted by the World Health Organization to investigate the prevalence of current, daily, and heavy smokers. A meta-analysis was performed to examine the prevalence of smoking behaviors based on country, region, income level, and Framework Convention on Tobacco Control (FCTC) ratification status.

This study analyzed data from 498,981 school-going adolescents (48.49% male) across 97 countries. The overall prevalence of current smokers was 10.24% (95% confidence interval: 9.35-11.13). Among current smokers, 15.59% (14.03-17.16) were daily smokers, and among daily smokers, 20.64% (18.67-22.62) were heavy smokers. In metaregression analyses, low-income countries had lower current (-7.16% [-11.71 to -2.60]) and daily (-13.35% [-18.62 to -8.08]) smoking prevalence compared to high-income countries. Upper-middle income countries showed higher prevalence of heavy smoking (6.75% [1.90 to 11.61]) compared to high-income countries. In addition, countries that ratified FCTC within 0-10 years (-5.05% [-9.56 to -0.55]) and more than 10 years (-5.79% [-10.64 to -0.94]) had lower current smoking prevalence compared to nonratified countries. In contrast, FCTC ratification was not significantly associated with the prevalence of daily or heavy smoking.

While FCTC guidelines may effectively reduce the prevalence of current adolescent smokers, they may be less effective in preventing progression to daily and heavy smoking.