European girls aged 13-15 rank first globally for tobacco use in their age group
While global progress on tobacco control accelerates, Europe is projected to remain the world’s largest consumer of tobacco until at least 2030, with public health officials warning of a mounting crisis driven by the deliberate targeting of young people and persistent policy gaps across the continent.
Analysis by the World Health Organization reveals a particularly alarming trend: European girls aged 13 to 15 now have the highest tobacco use rates among their age group anywhere in the world. “That is not an accident, it’s the result of deliberate industry strategy,” said Dr Hans Kluge, the WHO’s regional director for Europe.
A Generation Targeted
The scale of nicotine use among Europe’s youth is unprecedented. One in seven adolescents (14.3%) aged 13 to 15 in the WHO European Region are regular users of vapes and e-cigarettes, the highest prevalence of teenage regular users worldwide. This means an estimated 4 million adolescents in that age bracket are using tobacco products. Disturbingly, e-cigarettes are now used more than traditional cigarettes among 15-year-olds in Europe, with adolescents three times more likely to use them than adults. In Lithuania, the figure peaks at almost 60% for 15-year-olds.
Health authorities directly attribute this surge to sophisticated commercial tactics. The industry is accused of targeting young people with flavoured products—such as fruit and candy—and exploiting social media through influencer marketing, paid advertisements, and branded content. Marketing at the point of sale is also strategically focused, with products often displayed near snacks and sweets at children’s eye level.
“We have a responsibility to change course now: to shield young people from nicotine addiction, prevent industry interference in health policy, and enforce the regulations that will prevent a lifetime of avoidable harm,” Dr Kluge stated.
Adult Use and a Deadly Toll
The problem extends far beyond the classroom. In 2024, 24.1% of adults in the European Region—173 million people—used tobacco, a rate higher than the global average. The region also bears a grim distinction for female smokers, hosting over 40% of the world’s adult female smokers, approximately 62 million women. Progress in reducing tobacco use among women has been markedly slower than for men. According to the WHO Europe, Greece has the largest percentage of female smokers in Europe at 34.7%.
For adult e-cigarette use, Europe has the second-highest prevalence globally, after Asia, at 4.6%—more than double the global average. Among men, Armenia has the highest smoking rate in Europe at 51.7%.
The human cost is staggering. Tobacco use causes an estimated 1.1 million deaths across Europe each year, accounting for 18% of all deaths from noncommunicable diseases in the region in 2020.
A Patchwork of Policies
WHO officials warn that decades of public health gains are at risk due to uneven and lagging regulation. “Decades of progress is at risk unless policies keep pace with a rapidly evolving nicotine landscape,” said Kristina Mauer-Stender, a WHO regional adviser for tobacco control.
The data underscores critical gaps. Only 18 out of 53 countries in the region have comprehensive smoke-free laws covering all public spaces. While countries like Ireland, the UK, and Greece have strict provisions, others such as the Czech Republic, Romania, and Austria offer weak or unenforced legislation, providing little protection from second-hand smoke.
Similarly, comprehensive bans on tobacco advertising, promotion, and sponsorship exist in only 13 countries. In 19 nations, cigarettes are more affordable today than in 2014, a trend that could fuel increased consumption. Regulation of e-cigarettes remains fragmented, and only 11 countries provide sufficient support to help people quit.
There are, however, pockets of progress. The UK is on track to achieve a 30% relative reduction in tobacco use among those aged 15 and older, and with a 13% rate, it has the third-lowest prevalence in Europe, after Turkmenistan and Iceland. Sweden boasts the lowest share of smokers in the EU at 8%.
Countries like Belgium, Denmark, and the Netherlands are cited as proving that pushback is possible through regulating novel products, banning flavours, and restricting advertising. “Every country in this region should be doing the same, to protect future generations,” Dr Kluge urged.
The European Union context shows a stark divide: while Sweden has the lowest smoking rates, Bulgaria, Greece, and Croatia have the highest overall smoking shares in the bloc. This disparity highlights the urgent need for coordinated, accelerated action to prevent Europe from cementing its status as the world’s worst-performing region on tobacco control for years to come.
