Over the past 25 years the prevalence of smoking amongst men has fallen in many Northern, Southern and Western European countries. The prevalence of smoking amongst women has also fallen in some, but not all, of these countries. In many countries where there has been a decline in the prevalence of smoking amongst women the decline has been less marked. For example between 1980 and 2005 the prevalence of smoking in Swedish men fell by nearly 60% but in Swedish women it fell by just 35%. This has meant that the difference in smoking prevalence between men and women has become less pronounced in recent years.

In Western European countries the male premature mortality rate due to smoking fell between 1990 and 2000 (in some countries by between 40% and 50%), whereas this mortality rate increased in Belarus, the Russian Federation, Romania and Ukraine over this time period. The pattern is not as clear in women, where the premature mortality rate due to smoking increased in some Western (Netherlands, France) and Eastern (Hungary, Poland) European countries, and fell in other Western and Eastern countries.

Trend data on the prevalence of smoking in 15 year olds around Europe seem to suggest a general increase, especially amongst girls, but the data are sparse.