HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES
TOBACCO
• Smoking behaviour is typically established during adolescence. Most adult smokers have their first cigarette or
were already addicted to nicotine by the age of 18.
• The duration of smoking and number of cigarettes required to establish nicotine addiction is lower for
adolescents than for adults, so addiciton is established more quickly in young people.
• Tobacco use is related to other types of risk behaviour (e.g., alcohol and cannabis use) and negative health
outcomes in adolescents.
Countries with the highest and lowest rates of
reported weekly smoking in 15-year-olds
Gender inequalities in reported
weekly smoking in 15-year-olds
Tobacco use is the leading cause of preventable death
in the world. A high burden on the health-care system
may be predicted in countries with high rates of
adolescent smoking.
Overall, smoking is more common among teenage boys, and boys tend to start smoking at a younger age.
However, this pattern is reversed in some countries, as shown below.
Norway
8
9
United States
7
9
Canada
8
8
Iceland
7
9
Armenia
1
11
girls
aged 15
(%)
Prevalence of weekly smoking increased significantly
with age for boys and girls in most countries and
regions. The increase in prevalence from ages 11 to 15
exceeded 15% in a minority of countries.
15
10
5
0
Czech Republic
17
19
Spain
AVERAGE
20
England
25
27
girls
aged 15
(%)
25
Wales
Croatia
boys
aged 15
(%)
30
AVERAGE
Latvia
22
32
35
Armenia
29
25
boys
aged 15
(%)
40
Romania
Austria
45
Latvia
21
34
50
Lithuania
Lithuania
55
Ukraine
61
53
Reported weekly smoking (%) in 15-year-olds
Greenland
60
Health Behaviour in School-Aged Children (HBSC) study, a WHO collaborative cross-national study,
collects data on 11-, 13- and 15-year-old boys’ and girls’ health and well-being, social environments and
health behaviours every four years. The first HBSC study was conducted in 1983/1984 in five countries.
The study has grown to include 43 countries and regions across Europe and North America. Around 1,500
young people in each HBSC country were selected from each age group for the 2009/2010 survey, totalling
approximately 200,000 adolescents. The HBSC 2009/2010 International Report is available to download
from the WHO website.
HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES HBSC FACTSHEET SERIES
TOBACCO
The WHO Framework Convention on Tobacco Control (WHO FCTC) is a powerful international legal tool and
provides the framework for building effective tobacco control legislation. It asserts the importance of strategies
such as sales to and by minors, packaging and labelling, and protection from exposure to tobacco smoke (e.g.,
smoke free school premises). In addition, increasing the price of tobacco through higher taxes is considered to be
the single most effective way of reducing consumption and encouraging tobacco users to quit.
Socio-economic background and smoking initiation by gender
15-year-olds were asked at what age they first smoked a cigarette, defined as “more than a puff”. The graphs below show
the differences (%) in likelihood of starting to smoke aged 13 or younger between low and high family affluence groups.
GIRLS
No country shows a significant
relationship between coming
from an affluent background
and starting to smoke aged 13 or
younger.
Negative percentages mean that
young people from deprived backgrounds are more likely to start
smoking at a young age.
Likelihood increases
with affluent
background
-30
Positive percentages mean that
young people from affluent backgrounds are more likely to start
smoking at a young age.
*Iceland
*Denmark
Luxembourg
-35
Likelihood increases
with deprived
background
-25
*Norway
Iceland
*Denmark
*Luxembourg
*Norway
*Belgium (Fr)
*Germany
Armenia
MKD
Croatia
Netherlands
-35
-20
Belgium (Fr)
-30
-15
Germany
-25
-10
Armenia
-20
Likelihood increases
with deprived
background
-15
0
-5
MKD
-10
5
Croatia
0
-5
10
Netherlands
5
not statistically significant
15
Spain
10
statistically significant
Difference in likelihood of smoking (%) between
LOW and HIGH family affluence groups
Likelihood increases
with affluent
background
not statistically significant
15
Spain
Difference in likelihood of smoking (%) between
LOW and HIGH family affluence groups
statistically significant
BOYS
* In some countries, there is a
significant relationship between deprivation and starting
to smoke aged 13 or younger.