As a crucial part of the Global Tobacco Surveillance System, the Global Youth Tobacco Survey (GYTS) enables monitoring tobacco use among students aged 13-15 years and implementation of key tobacco control indicators. The GYTS has been conducted in over 180 countries worldwide, including more than 35 countries and territories in the WHO European Region. Tobacco use among youth remains to be a significant public health concern in the Region. Despite decreases in tobacco use in some European countries, there are places where more students aged 13 to 15 are using tobacco as evident from the latest GYTS round compared to the previous one. Cigarettes remain the most commonly used tobacco products in the European countries. However, novel and emerging nicotine and tobacco products have been gaining popularity among 13 to 15-year-olds. In some countries of the Region, the prevalence rates of e-cigarette use are equal to or even higher than cigarette use rates. For instance, in San Marino (2022), 16.1% of students currently use e-cigarettes and 10.8% currently smoke cigarettes; in Italy (2022) 19.3% of students currently use e-cigarettes and 14.9% currently smoke cigarettes. Cigarettes remain to be easily accessible to students in almost all countries. In more than half of the countries with GYTS data, over half of young students who currently smoke cigarettes were able to purchase or obtain them from various sources, and more than two-thirds of students who tried to buy cigarettes had not been deterred from doing so considering their age. A limited number of countries in the Region have tailored tobacco-dependence treatment for youth. More than 50% of young people in most of the surveyed countries tried to stop smoking in the past year. However, the proportion of those who received support to quit smoking from a programme or professional was low ranging from the highest of 29.4% in Kyrgyzstan (2019) to the lowest of 3.4% in Slovenia (2017). Although smoking in educational facilities is prohibited in most countries by smoke-free laws, their enforcement has been challenging. The proportion of students who saw people smoking on school premises varies from 80.5% in Bulgaria (2015) to 14.5% in Tajikistan (2019). Exposure to tobacco advertisements is yet another challenge, with more than half of students taking notice of tobacco advertisements on television, or in videos and movies in surveyed countries. The data from GYTS in the WHO European Region show the urgent need to implement bold, comprehensive, and multi-sectoral measures to curtail tobacco use in youth. These measures should be aligned with the guidance provided by the WHO Framework Convention on Tobacco Control and be strictly enforced. School-based prevention programs should be implemented as part of the national tobacco control strategy to prevent youth experimentation and smoking initiation.