Introduction:
Tobacco smoking in Lithuania among adolescence is highly prevalent but has been decreasing over the past 20 years. There have been major tobacco control policy changes during the same period in Lithuania, with varied degree of implementation, which contributed to changes in smoking patterns. Failure of control policy to prohibit access of e-cigarettes has led to increased prevalence among adolescents.

Objectives:
To assess changes in prevalence of smoking and accessibility of cigarettes among 13-15-year-old students in the GYTS sample for 2001-2022.

Methods:
Data from five editions of GYTS were used: from 2001 to 2022.

Results:
Prevalence of current tobacco users in GYTS 2001 to 2022 samples show a reduction from 33.8 % (2001) to 22.6 % (2018) to 14.2 % (2022), with no difference in prevalence among boys and girls in the latest samples. E-cigarette use, which has been assessed for the first time in Lithuanian GYTS sample was reported at total 23 % for current use (19 % of boys and 27 % girls), comparable with other studies in Lithuania. The e-cigarette prevalence is accompanied with a lower prevalence of cessation attempts and willingness to quit among adolescence. Results show positive changes in young people exposure to second hand smoke and access to tobacco products: 65.8 % of respondents in 2001 bought tobacco in stores, while only 10.9 % did the same in 2022, exposure to smoking at home fell from 47.0 % to 35.2%.

Conclusions:
There is a long-term trend in Lithuania for lower prevalence of tobacco use among adolescents, especially for traditional cigarettes. There is a very high prevalence of e-cigarette use, especially among girls. Monitoring tobacco and nicotine consumption among adolescents helps inform tobacco control and public health policies.