Youth

Globally, the estimated numbers of boys and girls 13–15 years old who smoke cigarettes or use smokeless tobacco products are approximately 25 million and 13 million, respectively.

From the beginning of the Global Youth Tobacco Survey in 1999 and through 2016, 108 countries completed at least two surveys at some point. Of these countries, 43 countries saw no statistically significant change in tobacco use prevalence among boys and girls aged 13-15 years. Tobacco use prevalence among both boys and girls decreased in 20 countries, but they increased in 18 other countries. In 27 countries, the trends for boys and girls were mixed.

Most countries with a reduction in tobacco use among boys and girls are countries with a very high human development index (HDI). Currently, countries with the highest prevalence of tobacco use among youth are generally non-very-high HDI countries. In several of these countries, tobacco use among adolescent girls is now more common than among adult women, indicating that historically lower prevalence of tobacco use among females in many populations worldwide may not continue in the near future.

Although cigarette smoking is the most common type of tobacco use among youth worldwide, the use of other tobacco products is very common in some populations. For example, smokeless tobacco was the most common tobacco product used by boys and girls aged 13-15 in Nepal in 2011, with prevalence of 19.7% and 12.9%, respectively, while prevalence of any tobacco product use was 24.6% among boys and 16.4% among girls. Waterpipe smoking has historically been more common in some parts of Asia and north Africa, but it has become popular among young adults, particularly college students, in some other countries. Prevalence of the use of more novel nicotine-containing products (including e-cigarettes) among youth has substantially increased in some very high HDI countries. In addition to cigarette smoking, the use of all these products needs to be addressed appropriately by tobacco control measures.

Duration of tobacco use is more likely to be longer among those who start tobacco use at earlier ages than those who start it later in life. It has been shown that duration of smoking is a particularly important factor in increasing lung cancer risk. This further underscores the need for implementation of effective tobacco control policies to prevent initiation of tobacco use – and provide help with cessation for those who already use tobacco – among youth. Tobacco taxation is a major important intervention because youth are more sensitive to increases in tobacco price.