Objective:
According to the Global Adult Tobacco Survey (GATS), Panama has the lowest recorded tobacco use prevalence among adults in the Americas (6.4%). Such achievement has been the product of the translation of the Framework Convention for Tobacco Control (FCTC) as the law 13/2008. Several regulations complementary to the law 13/2008 have also been implemented by the health authority.
We aim to assess the secular trends of tobacco use prevalence in Panama among teens aged 13-15 years between 2002 and 2017 in Panama.

Methods:
The Global Youth Tobacco Survey (GYTS) is an international standardized survey of school students aged between 13 and 15 years. The objective of the survey is to monitor key tobacco control indicators. The GYTS was performed in Panama in 2002, 2008, 2012 and 2017. A total of 1296 students participated in the GYTS in 2002, 2716 students participated in 2008, 4077 students participated in 2012, and 2096 students participated in 2017. Definitions of tobacco product use indicators were homologated for all years according to the 2015 GYTS Analysis and Reporting Package.

Results:
Current tobacco use has decreased between 2002 and 2017 from 19.5% to 9.3%. The greatest decrease was observed between 2002 and 2008, with a 52% decrease in current tobacco use in both male and female teens (p value: < 0.01). Between 2008 and 2017, a decrease was clearly observed in male teens but not in females. No statistically significant differences in current tobacco use prevalences were observed between male and female teens in 2017.

Conclusion:
A clear decline in prevalence was observed the same year the 13/2008 law was implemented. The prevalence in male teens also decreased after 2008, but this was not the case in female teens. Current tobacco control policies must be reinforced, and the FCTC must be fully implemented to further decrease tobacco use in teens, particularly among females.