Trends in adolescent cigarette smoking in Czechia: findings from the HBSC study 2014–2022

Objectives: Regular monitoring of health-related behaviours among vulnerable populations is of public health importance. This study examines recent trends in adolescent cigarette smoking in Czechia following the marked changes reported in the mid-2010s.

Methods: Data from three recent rounds of the Health Behaviour in School-aged Children (HBSC) study conducted in Czechia in 2014, 2018 and 2022 were analysed. Temporal trends were assessed for two indicators of adolescent cigarette use: lifetime cigarette use and cigarette use in the last 30 days. Survey-adjusted binary logistic regression models were used to test changes between survey periods. In 2022, the prevalence of electronic cigarette use was additionally estimated using the same indicators.

Results: A continued decline in adolescent cigarette use was observed for both indicators, extending the downward trends reported in the mid-2010s into the 2020s. The decline was most pronounced between 2014 and 2018, with smaller but persistent decreases thereafter, particularly among older adolescents. However, the findings also highlight the substantial prevalence of electronic cigarette use. In 2022, more than one-third of 15-year-olds in Czechia reported lifetime electronic cigarette use (35.1% among boys and 36.6% among girls), and approximately one in five reported use in the last 30 days (19.6% among boys and 23.0% among girls).

Conclusions: While conventional cigarette use among adolescents continues to decline, electronic cigarette use represents an important component of contemporary adolescent smoking-related behaviour. In the long term, the phenomenon of electronic cigarettes may counteract intended trends in nicotine-related harms. These findings underscore the need for continued surveillance and prevention efforts in Czechia that address both conventional and emerging smoking-related products.