Objectives: Regular monitoring of health-related behaviours among vulnerable populations is of public health importance. This study examines trends in cigarette smoking among Czech adolescents following the marked changes reported in the mid-2010s. Methods: Data from three recent rounds of the Health Behaviour in School-aged Children (HBSC) study conducted in Czechia in 2014, 2018, and 2022 were analysed. Temporal trends were assessed for two indicators of adolescent cigarette use: (i) lifetime cigarette use and (ii) cigarette use in the last 30 days. Binary logistic regression was used to test for temporal changes between survey periods. In 2022, the same two indicators were also calculated for electronic cigarette use. Results: A continuing decline in adolescent cigarette use was observed for both indicators, extending the trends reported in the mid-2010s into the 2020s. However, the findings also highlight the increasing prevalence of electronic cigarette use among Czech adolescents. Conclusions: Although conventional cigarette use among adolescents continues to decline, the growing popularity of electronic cigarettes undermines efforts to reduce overall nicotine exposure and, in the long term, could counteract the intended trends in nicotine-related harms.

The study was financially supported by the Ministry of Education, Youth and Sports of the Czech Republic, the Operational Program OP JAC, project identification number CZ.02.01.01/00/22_008/0004583: „Research of Excellence on Digital Technologies and Wellbeing (DigiWELL)“.