Objectives: Generation Z, defined as "post-millennial," is considered to be the first generation that could end smoking. The objective is also to take into account the evolutionary aspect of the smoking and attitudes of the Generation Z. The aim of this study was to explore the willingness of Generation Z in Slovakia to comply with the legislation adopted in the field of anti-tobacco policy and to investigate some selected social factors-intention, subjective norm and percevied behavioral control-that contribute to a lower rate of compliance. Methods: Global Youth Tobacco Survey (GYTS) data on cigarette smoking among 3,557 adolescents (age range 13-15) in 2016 as well as on attitudes towards tobacco use and control measures were used to explore the level of compliance of adolescents with anti-tobacco regulations in Slovakia within the Framework Convention of Tobacco Control (FCTC). We used the concept of intention as explained in Ajzen's theory of planned behaviour (1985), focusing on the role of subjective norm and perceived behavioural control. Results: We found a decrease in ever smoking, current smoking and frequent smoking. We found that these adolescents start experimenting with dependence-causing substances, such as tobacco, regardless of existing rules. Conclusion: Adolescents were attracted to smoking, although they were aware of health effects of passive smoking, and a vast majority liked smoke-free places. They are also influenced by their peers and parental models.

Department of Labour Law and Social Security Law Comenius University Bratislava Slovakia

Department of Public Health Jessenius Faculty of Medicine in Martin Comenius University Bratislava Slovakia

Faculty of Medical Sciences University Medical Center Groningen Groningen Netherlands

Faculty of Medicine University of Pavol Jozef Šafárik Kosice Slovakia

Theological Faculty Palacký University Olomouc Olomouc Czechia

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Iberdrola I. Generation Z: Transforming the System (2020). Available from: https://www.iberdrola.com/talent/generation-x-y-z (accessed November 15, 2020).

Iqbal N. Generation Z: ‘We Have More to Do than Drink and Take drugs.’ the Guardian (2018). Available from: https://www.theguardian.com/society/2018/jul/21/generation-z-has-different-attitudes-says-a-new-report (accessed November 15, 2020).

Matthews-King A. Generation Z Teens “More Depressed Despite Fall in Drinking and Drugs (2019). Available from: https://www.independent.co.uk/news/health/teenage-depression-mental-health-drugs-antisocial-behaviour-generation-z-a8800291.html (accessed November 15, 2020).

Patalay P, Gage SH. Changes in Millennial Adolescent Mental Health and Health-Related Behaviours over 10 Years: a Population Cohort Comparison Study. Int J Epidemiol (2019) 48(5):1650–64. 10.1093/ije/dyz006 PubMed DOI PMC

British Pregnancy Advisory Service. The Decline in Teenage Pregnancy Rates (2018). Available from: https://www.bpas.org/about-our-charity/press-office/press-releases/bpas-report-released-on-the-decline-in-teenage-pregnancy-rates/(accessed November 17, 2020).

Centers for Disease Control and Prevention. Youth and Tobacco Use (2020). Available from: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm (accessed November 19, 2020).

Perry CL, Pérez A, Bluestein M, Garza N, Obinwa U, Jackson C, et al. Youth or Young Adults: Which Group Is at Highest Risk for Tobacco Use Onset? J Adolesc Health (2018) 63(4):413–20. 10.1016/j.jadohealth.2018.04.011 PubMed DOI PMC

World Health Organization. The Secret´s Out: the Tobacco Industry Targets a New Generation. Geneva, Switzerland. World Health Organization; (2020).

Howse R, Teitel R. Beyond Compliance: Rethinking Why International Law Really Matters. Glob Pol (2010) 1:127–36. 10.1111/j.1758-5899.2010.00035.x DOI

Evangelista LS. Compliance: a Concept Analysis. Nurs Forum (1999) 34:5–11. 10.1111/j.1744-6198.1999.tb00230.x PubMed DOI

Ingram TL. Compliance: a Concept Analysis. Nurs Forum (2009) 44:189–94. 10.1111/j.1744-6198.2009.00142.x PubMed DOI

Playle J. Concepts of Compliance: Understandings and Approaches. Br J Fam Plan (2000) 26:213–9. 10.1783/147118900101194823 PubMed DOI

Stover RV, Brown DW. Understanding Compliance and Noncompliance with Law: The Contributions of Utility Theory. Soc Sci Q (1975) 56:363–75.

Pavlikova B, Freel L, van Dijk JP. To Comply or Not to Comply: Roma Approach to Health Laws. Int J Environ Res Public Health (2020) 17(9):3087. 10.3390/ijerph17093087 PubMed DOI PMC

International Compliance Association. What Is Compliance? (2020). Available from: https://www.int-comp.org/careers/a-career-in-compliance/what-is-compliance/(accessed on December 2, 2020).

Kingsbury B. The Concept of Compliance as a Function of Competing Conceptions of International Law. Mich J Int L (1998) 19:345–72.

Guzman AT. A Compliance-Based Theory of International Law. Calif L Rev. (2002) 90:1823–87. 10.2307/3481436 DOI

WHO. WHO Framework Convention on Tobacco Control (2020). Available from: https://www.who.int/tobacco/framework/WHO_FCTC_english.pdf?ua=1 (accessed December 15, 2020).

Wood L, Letcher T, Winstanley M, Hanley-Jones S. 5.15 Tobacco Advertising and Promotion Targeted at Young People. In: Greenhalgh EM, Scollo MM, Winstanley MH, editors. Tobacco in Australia: Facts and Issues. Melbourne: Cancer Council Victoria; (2020).

Tobacco Tactics. Advertising Strategy (2020). Available from: https://tobaccotactics.org/wiki/advertising-strategy/(accessed December 20, 2020).

Slov-lex. 147/2001 Coll. – Act on Advertising [Zákon O Reklame a O Zmene a doplnen] - Slov-Lex (2001). Available from: https://www.slov-lex.sk/pravne-predpisy/SK/ZZ/2001/147/20190101 (accessed December 20, 2020).

Warren CW, Jones NR, Peruga A, Chauvin J, Baptiste JP, Costa de Silva V, et al. Global Youth Tobacco Surveillance, 2000-2007. MMWR Surveill Summ (2008) 57(1):1–28. PubMed

Baska T, Warren CW, Basková M, Jones NR. Prevalence of Youth Cigarette Smoking and Selected Social Factors in 25 European Countries: Findings from the Global Youth Tobacco Survey. Int J Public Health (2009) 54(6):439–45. 10.1007/s00038-009-0051-9 PubMed DOI

Baška T, Warren CW, Hudečková H, Ochaba R, Sťastný P, Lea V, et al. The Role of Family Background on Cigarette Smoking Among Adolescent School Children in Slovakia: Findings from the 2007 Slovakia Global Youth Tobacco Survey. Int J Public Health (2010) 55(6):591–7. 10.1007/s00038-010-0168-x PubMed DOI

Warren CW, Jones NR, Eriksen MP, Asma S. Global Tobacco Surveillance System GTSS collaborative group. Patterns of Global Tobacco Use in Young People and Implications for Future Chronic Disease burden in Adults. Lancet (2006) 367:749–53. 10.1016/S0140-6736(06)68192-0 PubMed DOI

Ajzen I. From Intentions to Actions: A Theory of Planned Behavior. In: Kuhl J, Beckmann J, editors. Action Control; SSSP Springer Series in Social Psychology. Berlin/Heidelberg, Germany: Springer; (1985). p. 11–39. 10.1007/978-3-642-69746-3_2 DOI

Slovak Collection of Laws. Slovak Collection of Laws (2021). Available from: https://www.slov-lex.sk/web/en (accessed January 15, 2021).

European Union law. Access to European Union Law (2021). Available from: https://eur-lex.europa.eu/(accessed January 15, 2021).

Global Youth Tobacco Survey Collaborative Group. Global Youth Tobacco Survey (GYTS): Indicator Definitions. Atlanta, GA: Centers for Disease Control and Prevention; (2014).

Shah BV, Barnwell BG, Bieler GS. Software for the Statistical Analysis of Correlated Data (SUDAAN): User’s Manual, Release 7.5, 1997 [software Documentation]. North Carolina, US: Research Triangle Institute; (1997).

Tap Web. Slovaks Smoke More from Year to Year, but 17% Wants to Limit Smoking (2020). Available from: https://www.tovarapredaj.sk/2019/02/12/slovaci-fajcia-z-roka-na-rok-viac-17-chce-fajcenie-obmedzit/(accessed November 25, 2020).

Ružinská V. (2015). More cigarettes to be added to each pack, to the detriment of smokers‘ health? Available from: https://spravy.pravda.sk/ekonomika/clanok/357277-cigariet-v-skatulke-pribudne-na-ukor-zdravia-fajciarov/(accessed December 13, 2020).

World Health Organization. WHO Framework Convention on Tobacco Control (2004). Available from: http://apps.who.int/iris/bitstream/handle/10665/42811/9241591013.pdf;jsessionid=9CF8405D9A68FC0FB7D8143675DF5478?sequence=1 (accessed December 16, 2020).

Operacny Program Formatizacia Spolocnosti. Act No. 377/2004 Coll. On Protection of Non-smokers (2020). Available from: https://www.slov-lex.sk/pravne-predpisy/SK/ZZ/2004/377/20160520 (accessed December 18, 2020).

Fidler JA, Wardle J, Brodersen NH, Jarvis MJ, West R. Vulnerability to Smoking after Trying a Single Cigarette Can Lie Dormant for Three Years or More. Tob Control (2006) 15(3):205–9. 10.1136/tc.2005.014894 PubMed DOI PMC

US Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services; (2014).

World Health Organization. WHO Global Report on Trends in Prevalence of Tobacco Use 2000–2025. 3rd ed. Geneva: World Health Organization; (2019).

Hublet A, Bendtsen P, de Looze ME, Fotiou A, Donnelly P, Vilhjalmsson R, et al. Trends in the Co-occurrence of Tobacco and Cannabis Use in 15-Year-Olds from 2002 to 2010 in 28 Countries of Europe and North America. Eur J Public Health (2015) 25(2):73–5. 10.1093/eurpub/ckv032 PubMed DOI

Pénzes M, Foley KL, Balázs P, Urbán R. Patterns of Alternative Tobacco Product Experimentation Among Ever Smoker Adolescents. Cent Eur J Public Health (2019) 27(1):3–9. 10.21101/cejph.a5364 PubMed DOI

McCarthy M. E-Cigarette Use Doubles Among US Middle and High School Students. Br Med J (2013) 347:f5543. 10.1136/bmj.f5543 PubMed DOI

Nădăşan V, Foley KL, Pénzes M, Paulik E, Mihaicuta S, Abram Z, et al. Use of Electronic Cigarettes and Alternative Tobacco Products Among Romanian Adolescents. Int J Public Health (2016) 61:199–207. 10.1007/s00038-015-0774-8 PubMed DOI PMC

DiFranza JR, Wellman RJ, Sargent JD, Weitzman MJ, Hipple BJ, Winickoff JP, et al. Tobacco Promotion and the Initiation of Tobacco Use: Assessing the Evidence for Causality. Pediatrics (2006) 117:e1237–e1248. 10.1542/peds.2005-1817 PubMed DOI

Wakefield M, Flay B, Nichter M, Giovino G. Role of the media in Influencing Trajectories of Youth Smoking. Addiction (2003) 98(1):79–103. 10.1046/j.1360-0443.98.s1.6.x PubMed DOI

Hanewinkel R, Isensee B, Sargent JD, Morgenstern M. Cigarette Advertising and Adolescent Smoking. Am J Prev Med (2010) 38(4):359–66. 10.1016/j.amepre.2009.12.036 PubMed DOI

Slater SJ, Chaloupka FJ, Wakefield M, Johnston LD, O’Malley PM. The Impact of Retail Cigarette Marketing Practices on Youth Smoking Uptake. Arch Pediatr Adolesc Med (2007) 161(5):440–5. 10.1001/archpedi.161.5.440 PubMed DOI

Lantz PM, Jacobson PD, Warner KE, Wasserman J, Pollack HA, Berson J, et al. Investing in Youth Tobacco Control: a Review of Smoking Prevention and Control Strategies. Tob Control (2000) 9(1):47–63. 10.1136/tc.9.1.47 PubMed DOI PMC

Palladino R, Hone T, Filippidis FT. Changes in Support for Bans of Illicit Drugs, Tobacco, and Alcohol Among Adolescents and Young Adults in Europe, 2008-2014. Int J Public Health (2018) 63(1):23–31. 10.1007/s00038-017-1025-y PubMed DOI PMC

Duh-Leong C. How Cigarette Advertisements Influence Teens. HealthyChildren.Org (2020). Available from: https://www.healthychildren.org/English/family-life/Media/Pages/How-Cigarette-Advertisements-Influence-Teens.aspx (accessed December 19, 2020).