Cigarette access and purchase patterns among adolescent smokers aged 12-16 years in 140 countries/territories, Global Youth Tobacco Survey 2010-2018

Background Few studies have examined access to cigarettes among adolescents. To address this, we aimed to examine cigarette access and purchase patterns among ado-lescent cigarette smokers based on the most recent data from the Global Youth Tobac-co Surveys (GYTS).Methods We used the most recent school-based GYTS data (2010-2018) on 49 856 adolescent cigarette smokers aged 12-16 years in 140 countries/territories (here after "countries") to examine cigarette access and purchase patterns among adoles-cent smokers.Results Over half (51.2%) of adolescent smokers bought cigarettes from commercial vendors (ie, stores/shops/street vendors/kiosks) and one-third of smokers (32.7%) got cigarettes from private persons (ie, peers or adults). Males (vs females), older adolescents (vs younger ones), and adolescent smokers from low-income countries (vs those from middle-or high-income countries) were more likely to buy cigarettes from commer-cial vendors. Younger adolescents (vs older ones) and adolescent smokers from low-in-come countries (vs those from middle-or high-income countries) were more likely to get cigarettes from private persons. As many as 39.6% of adolescent smokers reported that they were not denied buying cigarettes from commercial vendors due to age restric-tions, especially among males (vs females), among older adolescents (vs younger ones), and among adolescent smokers from upper-middle-income or high-income countries (vs those from low-income countries). Purchasing cigarettes as single sticks was more likely to occur in males (vs females), in older adolescents (vs younger ones), and in ad-olescent smokers from low-income countries (vs those from upper-middle-income or high-income countries), with inverse findings for purchasing cigarettes in full packs.Conclusions Adolescent smokers often obtained cigarettes from commercial vendors or private persons. Additionally, adolescent smokers often purchased cigarettes in packs and as individual sticks. These findings emphasize the need to strengthen measures to reduce the supply of cigarettes to minors.