Cigarette consumption in the adolescent population in the Republic of Serbia: Prevalence, characteristics and related factors

Tobacco cigarette and e-cigarette use among adolescents represents a significant public health challenge, with an increasing risk of regular and dual use of nicotine products. This study aimed to assess the prevalence of consumption and regular use of tobacco cigarettes and e-cigarettes, as well as associated factors in the adolescent population. A cross-sectional study was conducted using an anonymous questionnaire on a convenience sample of high school students, analysing sociodemographic data, patterns of cigarette and e-cigarette use, initiation motives, the impact of stress, family communication and health indicators. Seventy percent of the respondents had tried cigarettes, and 65% had tried e-cigarettes, while 55% had had their first experience with cigarettes during high school. Regular use of tobacco cigarettes was reported by 35% of respondents, regular use of e-cigarettes by 25%, and dual use by 20%. Peer influence is the dominant initiating factor, and 80% of respondents report increased use in stressful situations. Only 20% of adolescents discuss the topic with their parents, while 15% recognize the possible connection between smoking and poorer health. High levels of experimentation, regular and dual use of nicotine products were observed, with a significant role of peer influence and stress and limited family communication and risk perception. The findings indicate the need for integrated school-based prevention programs focused on health literacy, peer norms, and the development of stress coping skills.