Introduction:
Previous research showed association of psychosocial and behavioural factors with self-rated health and health complaints among adolescents. In Serbia, there is high prevalence of smoking among both adolescents and adults. The aim of this analysis was to obtain national specific results on this topic that should additionally support advocacy for stronger implementation of tobacco control in Serbia.

Material and Methods:
This is a secondary analysis of data obtained through collaborative cross-sectional study Health Behaviour in School-aged Children Survey (HBSC) implemented in Serbia in 2018 by the Institute of Public Health of Serbia “Dr Milan Jovanovic Batut” on nationally representative sample of students 11,13 and 15 years old. In order to observe differences between smokers and non-smokers in self rated health, life satisfaction and health complaints data obtained from 15 year old secondary school students in Serbia were used. In total, data obtained from 1605 students in this age group were included in analysis. A p-value of 5% or lower was considered to be statistically significant.

Results:
In total, 19.6% of 15 years old students in Serbia smoke. There is statistically significant difference in self rated health with higher percentage of non-smokers who rated their health as excellent (62.0%) compared to smokers (40.2%). More smokers in comparison to non-smokers reported having various health complaints almost every day such as headache (11.9% vs. 6.2%), feeling low (11.6% vs. 5.1%), feeling nervous (41.7% vs. 21.3%) and having difficulties in sleeping (18.6% vs 8.2%). There was also statistically significant difference in life satisfaction with mean value 7.2 among smokers and 8.0 among non-smokers on the scale 1-10 (with 1 being the lowest and 10 the highest life satisfaction).

Conclusions:
Results show high percentage of various health complaints among adolescent smokers, including those related to mental health. Results also emphasize the need for targeted and more intensive interventions specifically designed for adolescents needs.