One out of ten deaths worldwide among adults is attributable to tobacco use. Most people begin using tobacco before the age of 18. The European Region of WHO faces nearly one third of the worldwide burden of tobacco-related diseases. We aimed to study the prevalence of tobacco use among Kosovar schoolchildren, knowledge and behaviors related to tobacco use and its health impact. A cross-sectional study was performed, using anonymous self-administered questionnaire carried out among 7088 students in 110 schools. The target population group were students aged between 13 and 15 years were enrolled in all the targeted grade levels. The questionnaire consists of two main parts developed especially for the European region. Statistical analysis and the complex sampling design were done by EPI Info 2000 statistical software package. Around one-third (2622=37%) of all students, reported to have smoked cigarettes. One-fifth (20.9%) of ever smokers initiated smoking before the age often. Significantly more boys than girls ever smoked cigarettes (43.5% and 30.4% respectively). Over one-third (37.0%) had ever smoked cigarettes, as compared to over one-half (53.9%) of secondary students. There is a high probability of an increased burden of disease from tobacco in the future decades in Kosova. Special attention should be paid to the cessation needs of current smokers, school-based programs on environmental tobacco smoke, and the health risk of exposure due to smoking by siblings and friends.
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