Background and Objective:
Tobacco use among youth is a real public health concern in most developing countries. To provide recent epidemiological data regarding tobacco use among this specific population, a national survey was conducted in Tunisia in 2021. We aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors. We aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors.

Methods:
Data from the Mediterranean school survey on alcohol and other drugs(MedSPAD 2021) were used. Based on three-stage stratification sampling method, first and second grade high school students were enrolled. A self-administered standardized questionnaire was used and weighted prevalence estimates for cigarette smoking “at least once in a lifetime” were studied. Binary logistic regression model was used to assess associated factors and Adjusted Odds Ratios (AORs) were presented. The independent factors included were: sex, area of residence, private or public sector, alcohol and cannabis use, and being exposed to tobacco smoking in family and peer’s environment. CSRpro and STATA software were used for data entry and statistical analysis, respectively.

Results:
Among 6.201 participants with a mean age of 16.8 years, 60.4% were girls; the prevalence of cigarette smoking was 24,75% 95% CI[23.24,26.32], significantly higher among boys (41.1% versus 14.2%,p