Aims With the Sustainable Development Goals 2016-2030 increased attention is given to adolescents’ health and well-being, and the multiple challenges they face related to their health and wellbeing with trajectories of importance for their later adult health. A recent trend within childhood and youth studies acknowledges commonalities of lived experiences of young people in middle- and low-income countries, where the majority of them lives, vis-à-vis high-income countries. In sub-Saharan Africa adolescents comprise 23% of the population compared to 12% in high-income countries. Here we describe and analyse the prevalence of smoking and use of alcohol by Bissau-Guinean adolescents aged 15-16 and compare to peers European cities.

Methods Survey with locally adapted and pilot tested Planet Youth questionnaire was conducted in June 2017 in 16 secondary schools in the capital Bissau, Guinea-Bissau. It targeted adolescents aged 15-16 years in randomly selected classes with information that is comparable with data from eight European cities in 2015-2016.

Results In Bissau, 871 adolescents aged 15-16 participated (52% girls and 46% boys) compared to 6,534 peers in eight European cities (49% girls and 51% boys). In total, 2.2% of the Bissau-Guineans reported daily smoking (boys=3.9%; girls=0.7%) compared to 11.3% of their European peers (boys=13.2%; girls=9,4%). About 1/3 of the Bissau Guineans had life-time experience of drinking alcohol compared to about 2/3 of the European ones, with no difference among boys and girls; 10,6% of Bissau-Guineans reported having been drunk during the last 30 days compared to 14% of the Europeans, the prevalence being slightly higher among boys compared to girls.

Conclusions Bissau-Guinean adolescents aged 15-16 report less smoking and drinking than European peers. Against a background of intensive marketing of alcohol and tobacco in Guinea-Bissau, it is urgent to initiate health promotional activities in secondary schools in Bissau to inform and educate adolescents and teachers on the detrimental effect of such behaviours on their long-term health and wellbeing.