Despite the decline in the number of smokers worldwide, rolling tobacco use has increased in recent years in many countries, which may slow the downward trend in smoking. The objective of this study was to analyze the evolution of the number of people who use rolling tobacco and other tobacco between 2013 and 2018 in the Basque Country and to determine whether socioeconomic inequalities exist in this consumption.

An observational and cross-sectional study was conducted on a representative sample of the population residing in the Basque Country aged sixteen to fifty-nine (n = 6,929 in _{2013 and n = 7,961 in 2018} ) based on the Basque Country Health Survey (2013 and 2018) and the Euskadi Addiction Survey (2018). The prevalence of regular tobacco use in general and rolling tobacco was calculated according to different socioeconomic variables for the years 2013 and 2018, as well as the prevalence ratios for estimating the change between those years and according to the previous variables using robust Poisson regression models. The analyses were stratified by sex and by two age groups.

The prevalence of overall tobacco use decreased between 2013 (men = 27.7% and women = 24.1%) and 2018 (men = 24.1% and women = 18.6%), but remained stable for rolling tobacco use (in 2013, men = 5.1% and women = 3.2%; in 2018, 5.4% and 3.5%, respectively). Unlike overall tobacco use, which showed a clear socioeconomic gradient, rolling tobacco use was more prevalent among young people (in 2018, men = 6.4% and women = 4.1%), a group in whom the pattern by socioeconomic position was less evident.

Given the continued use of rolling tobacco, it is also necessary to target the fight against smoking towards this type of product, as well as to monitor and supervise its use, especially among young people.