National trends in electronic cigarette use, tobacco consumption, and tobacco exposure among Paraguayan adolescents: findings from the Global Youth Tobacco Survey, 2019–2025

This study compared national indicators of electronic cigarette use, tobacco consumption, second-hand smoke exposure, access, cessation, preventive messages, advertising, knowledge, and attitudes among Paraguayan students aged 13-15 years between the 2019 and 2025 Global Youth Tobacco Survey (GYTS) waves. An observational, descriptive study of repeated cross-sectional national survey indicators was conducted using secondary aggregate data from the Paraguay GYTS fact sheets. The two survey waves were treated as independent school-based samples. Prevalence estimates were reported as percentages, and absolute percentage-point differences and descriptive relative changes were calculated. Inferential comparisons were not performed because comparable confidence intervals and standard errors were unavailable for the 2019 estimates. Current electronic cigarette use increased from 12.5% in 2019 to 20.0% in 2025. Current cigarette smoking rose from 3.0% to 7.4%, while current use of any tobacco product increased from 8.1% to 11.4%. Second-hand smoke exposure increased at home and in public places. Purchasing single cigarettes increased from 19.5% to 37.9%. Among current smokers, the desire to quit rose from 33.4% to 62.8%, whereas exposure to anti-tobacco media messages declined from 60.8% to 55.4%. These findings indicate a worsening adolescent nicotine exposure environment, highlighting the need for stronger regulation, prevention, enforcement, and cessation support.