Trends in tobacco use among adolescents in Spain (2002-2018).

Smoking is the single greatest preventable cause of death in the world today. Adolescence is the developmental period during which smoking is most commonly initiated and addiction is likely to happen. The aim of this study is to examine trends in tobacco use among school-aged adolescents in Spain from 2002 to 2018 by sex and age. The sample is composed of 51,046 adolescents aged 15 to 18. Data is representative of the adolescent school population in Spain in 2002, 2006, 2010, 2014 and 2018. The smoking questionnaire provided by the international team of the study Health Behavior in School-aged Children (HBSC) was used. Odds Ratios and 95% confidence intervals were estimated using logistic regression. Data show a decrease in daily tobacco use between 2002 (26.5%) and 2018 (8.7%), but no change was found between 2006 (17.9%) and 2010 (17.4%). This decreasing pattern is stronger in girls than boys to the extent that no differences by sex were found in 2018. Similarly, the decrease was greater in older adolescents, but in this case, the differences by age remained. Daily smoking prevalence among Spanish adolescents aged 15 to 18 in 2018 is 8.7%. Results confirm the need to maintain tobacco prevention and control policies. Measures are presented in order to fight this public health problem.