The landscape of tobacco use has changed in Europe, as a result of tobacco control policies, the introduction of novel products, such as e-cigarettes and the recent Tobacco Products Directive. We analysed data collected through Eurobarometer surveys across all 28 member states of the European Union (EU) in 2009, 2012, 2014 and 2017 to assess trends and correlates of tobacco use, smoking cessation and support for tobacco control policies. There is wide variation between EU member states in the prevalence of tobacco and e-cigarette use, as well as in trends of use over time. Overall, manufactured cigarette use has declined, while roll-your-own tobacco and e-cigarette use have increased between 2009 and 2017 in the European Union. The use of different cessation methods also varies between member states and trends are associated with national-level tobacco control policies. Use of e-cigarettes for smoking cessation assistance increased, while use of pharmacotherapy and smoking cessation services declined between 2012 and 2017. Individuals living in countries with comprehensive smoking cessation policies were more likely to have used any cessation assistance, pharmacotherapy and smoking cessation services compared with those living in countries with weak smoking cessation policies. In general, countries with more comprehensive tobacco control have performed better in a series of indicators, including use of evidence-based cessation methods, exposure to tobacco advertising and second-hand smoke. Finally, although support for tobacco control is high among EU citizens, the level of support is associated with tobacco and e-cigarette use, with ever and current users less likely to support tobacco control policies, as well as with general political views. Our research provides insights into differences among EU member states and can inform future policies.

Funding This work was supported by a grant from the European Commission (Horizon2020 HCO-6-2015; EUREST-PLUS: 681109).