Introduction:
Tobacco is one of the most widely consumed drugs worldwide. The aim was to describe the tobacco epidemic through different indicators related to tobacco use in Spain.

Material and Methods:
Prevalence of tobacco use in adult population (≥15/16 years) was obtained from the National Health Survey (ENSE) and the European Health Survey in Spain (EESE) from 1987-2020 (1,2). Prevalence of tobacco use in young people (14-18 years) came from the Survey on Drug Use in Secondary Education in Spain (ESTUDES) from 1994-2021 (3). Smoking-attributable mortality (SAM) in the population aged ≥35 years was obtained from studies for 6 different years between 1992-2017 (4–10).

Results:
The prevalence of tobacco use in adults has decreased 16.2 percentage points overall, 29.2 in men and 4.4 in women from 1987 (ENSE) to 2020 (EESE). For the study period, the highest smoking prevalence was concentrated in the 25-44 age group and in the upper secondary education. Among students aged 14-18 years, the highest prevalence of daily, last 30 days and lifetime tobacco use was observed in women between 1994-2021. During this period, among the 14-18 age group, daily use decreased from 17.8% to 8.8% in men and from 25.4% to 16.0% in women; last-30-day use from 26.0% to 21.2% in men and from 36.3% to 26.7% in women; and lifetime use from 56.0% to 35.1% in men and from 65.1% to 41.5% in women. The highest SAM was obtained in 2012 with almost 60,500 deaths. The highest SAM figures were in men and in the ≥75 age group. In two studies that provided estimates of SAM according to educational level, people with the lowest education had the highest SAM figures in 2016 (26,061 and 26,718 deaths).

Conclusions:
The prevalence of tobacco use has decreased in both adults and young people in the last decades. Among the youngest, smoking prevalence is higher in women. SAM increased from the earliest estimates until 2012. Despite the decline in tobacco prevalence and SAM figures, the burden of smoking remains high in Spain.