TOPLINE:

Youth smoking prevalence in the European Union (EU) decreased from 28.4% in 2012 to 22.2% in 2023. Higher cigarette prices in Europe were associated with a decrease in youth smoking prevalence, with a €1 increase in prices per pack reducing the prevalence among males. Age-of-sale policies showed no significant effect on youth smoking at the EU level.

METHODOLOGY:

• Researchers conducted a longitudinal ecological study analysing data of 12,087 individuals aged 15-24 years across 26 EU countries.
• Data from five Eurobarometer survey waves from 2012 to 2023 were utilised to assess youth smoking prevalence and its association with cigarette prices and 18+ age-of-sale laws.
• One individual per household was interviewed, and those who were current smokers were identified on the basis of self-reported responses to questions about smoking cigarettes, cigars, cigarillos, or a pipe.
• Information on the price of box cigarettes, national age-of-sale laws for tobacco products, the Tobacco Control Scale for the implementation of national policies for tobacco control, year of survey, and EU regions was also noted.

TAKEAWAY:

• Youth smoking prevalence in the EU decreased from 28.4% in 2012 to 22.2% in 2023, with the prevalence declining from 33.7% to 24.3% among males and from 23.0% to 19.6% among females during the same period.
• A €1 increase in cigarette prices per pack was associated with a 3.42 percentage point reduction (95% CI, -6.40 to -0.45) in youth smoking prevalence among males, with no significant effect observed among females.
• No significant association was found between 18+ age-of-sale laws and youth smoking prevalence at the EU level.
• Regional variations were observed, with price increases linked to substantial reductions in youth smoking overall and among both sexes in Southern Europe and among males in Northern Europe. In Eastern Europe, the implementation of the 18+ age-of-sale law was tied to a 15.5 percentage point drop in youth smoking prevalence among females.

IN PRACTICE:

"The findings emphasise the need for sex-specific interventions to achieve greater reductions in youth smoking," the authors of the study wrote. "Strengthening the enforcement of current policies and expanding the implementation of comprehensive tobacco control measures, while addressing disparities across sexes and regions, will be important to achieve substantial reductions in youth smoking," they added.

SOURCE:

This study was led by Ayaka Teshima, Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain. It was published online on October 28, 2025, in The Lancet Regional Health - Europe.

LIMITATIONS:

The study's reliance on self-reported smoking status may have introduced response bias. The ecological analysis, depending on a limited number of country-level observations, cannot reflect individual-level causality. This study focused solely on smoked tobacco, excluding smokeless tobacco, e-cigarettes, nicotine pouches, and heated tobacco products.

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.