Trends in tobacco use among children and adolescents in Israel, 1998–2015

Abstract Objectives This study aims to measure trends in cigarette smoking among children and adolescents in Israel, focusing on school grade, sex, and ethnicity. We hypothesized that smoking would be higher among boys and Arab-Israelis, rates would grow with age, and there would be a decline over time. Methods Data were derived from the Health Behavior in School-aged Children study between 1998-2015 in Israel. The total sample included 56,513 students in grades 6, 8, and 10, with 29,411 girls and 27,102 boys. Descriptive analysis described trends of smoking behavior according to grade, sex, ethnicity, family affluence, and year of study. Multivariate logistic regression analysis examined predicting variables. Results Smoking was higher among boys in all grades, ethnic groups, and years of study, with the highest frequencies among Arab-Israelis. Trends over the years show a decline from 1998-2004, followed by an increase for both sexes. The increase was more prominent among girls. Logistic regression analysis revealed strong associations between smoking and grade, sex, ethnicity, and year of study. Conclusions The results of this study can significantly enhance the development and implementation of smoking prevention and control programs among students in Israel. Key messages Our calibrated results engender important policy implications for the development of cigarette smoking prevention programs for Israeli youth, specifically in the school environment. health inequities needs to be a key part of a comprehensive strategy when discussing health promotion and development.