BACKGROUND-AIM:
The Global Youth Tobacco Survey (GYTS) is a global CDC and WHO coordinated survey aimed to monitor the use of tobacco and nicotine products by schoolchildren and their knowledge, beliefs and attitudes toward tobacco and nicotine products use and relevant control policies. This paper evaluates the current prevalence and trends in e-cigarette use in Polish adolescents and makes an attempt to identify current needs and challenges in tobacco and nicotine products control in Poland.

METHODS:
GYTS is based on cross-sectional, nationally representative, school-based and self-administered questionnaire survey of students aged 13 to 15 years. In Poland, GYTS was conducted five times (in 1999, 2003, 2009, 2016 and 2022), with only one survey round based on regional sample of adolescents. GYTS includes a two-stage sampling proportional to school enrollment size, with sizes from approximately 3000 to 4000 schoolchildren. Current analysis of e-cigarette vaping by Polish adolescents is predominantly based on results of youth surveys conducted in Poland since 2010, including GYTS Poland rounds from 2016 and 2022. International comparisons are based on GYTS results from other countries, especially European.

RESULTS:
Currently, the use of e-cigarettes among Polish adolescents is substantially more frequent (22%) than the use of all tobacco products (17%) and almost two times more frequent than smoking of conventional cigarettes (12%) and using heated tobacco (10%). Many young e-cigarette users simultaneously use other tobacco products, in particular conventional cigarettes. Prevalence of e-cigarette use in Polish schoolchildren belongs to the highest in Europe. Results of GYTS Poland and other surveys indicate on sharp increase in e-cigarette and poly-tobacco use among youth in the past decade, especially among boys. GYTS data show that susceptibility of tobacco use tends to steadily and quickly increase in Poland (from 20% in 1999 to 39% in 2022).

CONCLUSIONS:
To refer to current tobacco control needs and future challenges in Polish children and youth, there is an urgent need to enforce the following tobacco control activities: 1/ limiting the price affordability of e-cigarettes and other tobacco and nicotine products among adolescents, 2/ increasing the age limit for selling tobacco and nicotine products to minors, 3/ making tobacco and nicotine products less attractive for adolescents (plain packaging, ban on their display in points of sale, ban on sale of flavor products, 4/ implementing the school-based tobacco control programs at national level, 5/ implementing the ban on the use of e-cigarettes and other tobacco and nicotine products in all public places, 6/ conducting youth-tailored social and media campaign, 7/ creating mobile applications to prevent and quit the use of tobacco and nicotine products by youth, 8/ building the national system for monitoring and evaluation of youth tobacco behaviors, beliefs and attitudes.