Guerra Tort, CarlaLópez Vizcaíno, María EstherSantiago Pérez, María IsolinaRey Brandariz, JuliaCandal Pedreira, CristinaVarela Lema, María LeonorGalán, IñakiRuano Raviña, AlbertoPérez Ríos, Mónica2025-07-032025-07-032025-03-10Carla Guerra-Tort, Esther López-Vizcaíno, María Isolina Santiago-Pérez, Julia Rey-Brandariz, Cristina Candal-Pedreira, Leonor Varela-Lema, Iñaki Galán, Alberto Ruano-Ravina, Mónica Pérez-Ríos, Modelling annual prevalence of tobacco consumption in Spain, 1991–2020, European Journal of Public Health, Volume 35, Issue 2, April 2025, Pages 263–269, https://doi.org/10.1093/eurpub/ckaf0151101-1262https://hdl.handle.net/10347/42382The aim of this study was to estimate the series of tobacco smoking prevalence year-by-year in Spain, by sex and age group, for the period 1991–2020. Based on smoking prevalence obtained from national surveys and smoking-related auxiliary information from public statistics, we fitted a multinomial logistic mixed model with random area and time effects. Joinpoint regression was used to identify changes in the prevalence series across the period. To analyse the precision of the model-based estimates, we calculated the coefficients of variation. Between 1991 and 2020, the prevalence of smoking in Spain decreased in both sexes. In the 15–24 age group, the prevalence of smokers showed no differences by sex until 2007, after which prevalence in men exceeded that of women. However, in women aged 55 and over prevalence of smoking has been rising since 1991. After applying the model, the precision of smoking prevalence estimates improved. The reconstruction of a detailed series of tobacco smoking prevalence provides insight into the evolution of the tobacco epidemic in Spain. A detailed analysis by sex and age shows different trends in the prevalence of smoking among women that should be considered when control measures are formulated.eng© The Author(s) 2025. Published by Oxford University Press on behalf of the European Public Health Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/SmokingReconstructive surgical proceduresSpainTobaccoTobacco useEpidemicsPrecisionSmokersTobacco smokingjournal article10.1093/eurpub/ckaf015open access