Prevalence of current, daily, and heavy smokers among adolescents in 97 countries: a global population-based study

<p dir="ltr">Purpose: Understanding adolescent smoking behavior is crucial for developing effective prevention strategies; however, research on adolescent smoking remains limited. Thus, we investigated the global prevalence of current, daily, and heavy smokers among adolescents.</p><p dir="ltr">Methods: We analyzed data obtained from the Global Youth Tobacco Survey conducted by the World Health Organization to investigate the prevalence of current, daily, and heavy smokers. A meta-analysis was performed to examine the prevalence of smoking behaviors based on country, region, income level, and Framework Convention on Tobacco Control (FCTC) ratification status.</p><p dir="ltr">Results: This study analyzed data from 498,981 school-going adolescents (48.49% male) across 97 countries. The overall prevalence of current smokers was 10.24% (95% confidence interval: 9.35–11.13). Among current smokers, 15.59% (14.03–17.16) were daily smokers, and among daily smokers, 20.64% (18.67–22.62) were heavy smokers. In metaregression analyses, low-income countries had lower current (−7.16% [−11.71 to −2.60]) and daily (−13.35% [−18.62 to −8.08]) smoking prevalence compared to high-income countries. Upper-middle income countries showed higher prevalence of heavy smoking (6.75% [1.90 to 11.61]) compared to high-income countries. In addition, countries that ratified FCTC within 0–10 years (−5.05% [−9.56 to −0.55]) and more than 10 years (−5.79% [−10.64 to −0.94]) had lower current smoking prevalence compared to nonratified countries. In contrast, FCTC ratification was not significantly associated with the prevalence of daily or heavy smoking.</p><p dir="ltr">Discussion: While FCTC guidelines may effectively reduce the prevalence of current adolescent smokers, they may be less effective in preventing progression to daily and heavy smoking.</p>