Tobacco Free Initiative (TFI)

About youth and tobacco

Tobacco use among young people has been referred to as both a "paediatric disease"(1) and a "paediatric epidemic."(2)

The vast majority of smokers begin using tobacco products well before the age of 18 years (3,4). It was predicted that if the pattern seen nowadays continued, a lifetime of tobacco use would result in the deaths of 250 million children and young people alive today, most of them in developing countries (5). Today, surveillance of tobacco use among youth in several countries has revealed that the problem is of equal concern in developed and developing countries (6). Statistics reveal that the use of any form of tobacco by 13–15 year old students is greater than 10%. In addition, almost one in four students (13-15 years old) who ever smoked cigarettes smoked their first cigarette before the age of 10. Further, recent studies have revealed that there is little difference between the genders in cigarette smoking or in use of other tobacco products (7).

There are various determinants of tobacco use among youth. These include cultural and religious norms, availability of different types of tobacco products, tobacco control policies and strategies, and, perhaps most importantly, tobacco industry behaviour to promote tobacco use and undercut tobacco control strategies. Advertising, promotion and marketing efforts of the tobacco industry influence adolescent smoking behaviour, often to a greater extent than it influences the behaviour of adults. (8)

The Tobacco Free Initiative is gathering available evidence for development of policy recommendations for effective youth interventions, as part of a comprehensive tobacco control strategy.

The various demand reduction measures outlined in the WHO FCTC, when implemented, will protect youth from the tobacco epidemic. Further, Article 16 of the WHO FCTC – Sales to and by minors - addresses the issues of sales of tobacco products to minors, distribution of free tobacco products, etc.

'Article 16: Sales to and by minors

  • Each Party shall adopt and implement effective legislative, executive, administrative or other measures at the appropriate government level to prohibit the sales of tobacco products to persons under the age set by domestic law, national law or eighteen. These measures may include:
    • requiring that all sellers of tobacco products place a clear and prominent indicator inside their point of sale about the prohibition of tobacco sales to minors and, in case of doubt, request that each tobacco purchaser provide appropriate evidence of having reached full legal age;
    • banning the sale of tobacco products in any manner by which they are directly accessible, such as store shelves;
    • prohibiting the manufacture and sale of sweets, snacks, toys or any other objects in the form of tobacco products which appeal to minors; and
    • ensuring that tobacco vending machines under its jurisdiction are not accessible to minors and do not promote the sale of tobacco products to minors.
  • Each Party shall prohibit or promote the prohibition of the distribution of free tobacco products to the public and especially minors.
  • Each Party shall endeavour to prohibit the sale of cigarettes individually or in small packets which increase the affordability of such products to minors.
  • The Parties recognize that in order to increase their effectiveness, measures to prevent tobacco product sales to minors should, where appropriate, be implemented in conjunction with other provisions contained in this Convention.
  • When signing, ratifying, accepting, approving or acceding to the Convention or at any time thereafter, a Party may, by means of a binding written declaration, indicate its commitment to prohibit the introduction of tobacco vending machines within its jurisdiction or, as appropriate, to a total ban on tobacco vending machines. The declaration made pursuant to this Article shall be circulated by the Depositary to all Parties to the Convention.
  • Each Party shall adopt and implement effective legislative, executive, administrative or other measures, including penalties against sellers and distributors, in order to ensure compliance with the obligations contained in paragraphs 1-5 of this Article.
  • Each Party should, as appropriate, adopt and implement effective legislative, executive, administrative or other measures to prohibit the sales of tobacco products by persons under the age set by domestic law, national law or eighteen.’


(1) Kessler DA. Nicotine addiction in young people. N Engl J Med 1995, 333:186.
(2) Perry CL, Eriksen MP, Giovino G. Tobacco use: a pediatric epidemic. Tobacco Control 1994, 3:97–8
(3) US Department of Health and Human Services. Preventing tobacco use among young people. A report of the Surgeon General. Atlanta, Georgia: Public Health Service, Centers for Disease Control and Prevention, Office on Smoking and Health, 1994. (US Government Printing Office Publication No S/N 017-001-00491-0.). Reprinted with corrections, July 1994.
(4) Secretary of State for Health and Secretaries of State for Scotland, Wales and Northern Ireland. Smoking kills. A White Paper on tobacco, 30 November 1999. London, HM Stationery Office, 1999.
(5) Peto R, Lopez AD, Boreham J, et al. Developing populations: the future health effects of current smoking patterns. In: Mortality from smoking in developed countries, 1950-2000. Oxford: Oxford University Press, 1994, A101-3.
(6) The Global Youth Tobacco Survey Collaborative Group (US Centers for Disease Control and Prevention; the World Health Organization, the Canadian Public Health Association, and the U.S. National Cancer Institute). Tobacco use among youth: a cross country comparison. Tobacco Control 2002, 11: 252-270.
(7) The Global Youth Tobacco Survey Collaborative Group Differences in worldwide tobacco use by gender: Findings from the Global Youth Tobacco Survey. Journal of School Health, August 2003, Vol. 73, No. 6: 207-215.
(8) Pollay RW, Siddarth S, Siegel M, et al. The last straw? Cigarette advertising and realized market shares among youths and adults, 1979-1993. Journal of Marketing 1996, 60:1–16.