Declining tobacco control awareness and support among Polish adolescents: Trends from the Global Youth Tobacco Survey 2003-2022.

INTRODUCTION

The Global Youth Tobacco Survey (GYTS) is a cross-sectional, schoolbased survey that provides insight into tobacco use and related behaviors among adolescents aged 13-15 years. This study examines trends in tobacco-related attitudes, education, and media exposure among Polish youth, using data from the 2022 GYTS alongside previous surveys conducted in 2003 and 2016.

METHODS

The study sample was stratified by geographical regions: rural areas, small towns, and large cities. Data were collected from 98 schools across Poland, involving 95 schools (96.9%), 224 classes (97.8%), and 3985 students (78.9%). The primary analysis focused on 3573 students aged 13-15 years. Data from 2003 and 2016 GYTS editions were also used for comparison. Sampling, data weighting, and the methodological framework followed WHO guidelines.

RESULTS

Between 2003 and 2022, there was a notable decline in the proportion of Polish adolescents receiving tobacco education in school, from 61.4% to 43.1%. Perceptions of the harms of secondhand smoke also fell substantially, from 65.8% to 34.4%. Support for smoke-free policies weakened, with a decline in support for both indoor and outdoor smoking bans. Exposure to anti-tobacco messages in media dropped dramatically, from 89.4% in 2003 to 34.9% in 2022. On the other hand, perceptions that smoking enhances social interactions rose from 40.8% to 45.5%, while tobacco industry advertising and depictions of tobacco use in media remained prevalent, though declining over time.

CONCLUSIONS

The findings suggest concerning trends in tobacco-related attitudes and behaviors among Polish adolescents, indicating weakened prevention efforts and a shift towards pro-tobacco norms. The decline in tobacco education, public support for smoke-free policies, and media exposure to anti-tobacco messages highlight the need for renewed public health interventions. Strengthening school-based education, reinforcing smoke-free policies, and regulating tobacco portrayals in media are critical to reversing these trends. Additionally, policy measures such as plain packaging and a ban on tobacco displays at points of sale are necessary to protect future generations from tobacco initiation. Without decisive action, there is a risk of undermining the progress made in tobacco control.