Gaps in learning about dangers of tobacco products use at school amid comprehensive tobacco control in Panama. Results from the Global Youth Tobacco Surveys 2002, 2008, 2012, 2017, and 2023.

Objective: To assess secular trends in learning about dangers of tobacco products use at school (LADTAS) using the Panama Global Youth Tobacco Surveys 2002, 2008, 2012, 2017 and 2023. Study design: We analysed nationally representative data from the Global Youth Tobacco Survey (GYTS) cross-sectional studies conducted in Panama in 2002, 2008, 2012, 2017, and 2023 among students aged 13-15 years. Methods: The key indicator was self-reported learning about dangers of tobacco products use at school in the past 12 months. Weighted proportions and logistic regression models were used to examine trends and correlates, adjusting for age, sex, and tobacco use status. Results: The proportion of students reporting LADTAS declined from 64.6 % in 2002 to 55.0 % in 2023. Compared with 2002-2008, students surveyed from 2012 onwards had higher odds of not receiving tobacco education (adjusted OR 1.44; 95 % CI 1.31-1.59). No significant differences were observed by sex or age. Former tobacco users were less likely than never-users to report receiving instruction (adjusted OR 1.40; 95 % CI 1.23-1.59). Conclusions: Despite Panama's comprehensive tobacco control policies, classroom education on tobacco risks has declined over the past two decades. Reinvestment in systematic, multi-year, and up-to-date curricula-including coverage of emerging products-is needed to complement structural measures and sustain progress toward a tobacco-free generation.