3.1.c, d Smoking rate among adolescents and adults
Data on smoking prevalence among adolescents aged 12 to 17 is collected through substance use surveys conducted by the Federal Institute for Public Health (BIÖG) using computer-assisted telephone interviews. Initially, these surveys were carried out every three to four years; since 2001, they have been conducted every one to two years. To ensure comparability over time, results are weighted by gender, region, and age. The 2023 sample comprised 7,001 adolescents.
Data on smoking prevalence among adults aged 15 and over is derived from the Microcensus conducted by the Federal Statistical Office, which is carried out every four years. The Microcensus is the largest household survey in both Germany and Europe and is based on a 1 % sample of the total population. Information on smoking behaviour is provided voluntarily, with 65 % of respondents doing so in 2021.
Among adolescents, the proportion of smokers initially rose from 22.5 % in 2003 to 23.5 % in 2004, but has since declined almost continuously, reaching a historic low of 6.1 % in 2021. In 2023, a slight increase to 6.8 % was observed (6.4 % among females and 7.2 % among males). The politically defined target for 2030 has thus already been undercut in this age group.
Among the adult population, 18.9 % reported occasional or regular smoking in 2021 – a marked decrease from 27.4 % in 2003. As a result, the politically set target for 2030 was met for the first time already in 2021. Of the adult smokers, 14.5 % were regular and 4.4 % occasional smokers. Women smoked significantly less frequently than men, with a prevalence of 15.7 % compared to 22.3 %, respectively. Since 2003, the proportion of female smokers declined by 6.4 percentage points, and that of male smokers by 10.9 percentage points.
In 2021, 85.4 % of adult smokers preferred cigarettes. The health risk increases with the intensity of tobacco consumption. Among regular cigarette smokers, 10.8 % were classified as heavy smokers – defined as consuming more than 20 cigarettes per day – compared to 16.3 % in 2003. An additional 76.3 % smoked between 5 and 20 cigarettes daily. There were notable gender differences: one in seven male regular cigarette smokers was a heavy user, compared to only one in fifteen among female smokers.
Smoking constitutes a significant yet preventable health risk. In 2023, 4.5 % of all deaths were attributable to typical smoking-related diseases, including lung, bronchial, laryngeal, and tracheal cancers (females: 3.6 %, males: 5.4 %). The average age at death from these conditions was 72.0 years in 2023, which is seven years below the average age at death across all causes (79.1 years). A declining smoking rate can therefore make a substantial contribution to reducing premature mortality (see also Indicator 3.1.a "Mortality preventable through prevention and treatment").