The German Study on Tobacco Use (DEBRA) is a bi-monthly representative household survey on the use of tobacco and electronic nicotine delivery systems in the German population. The study has been registered at the German Clinical Trials Register (registration IDs: DRKS00011322, DRKS00017157), and its protocol has been published in the international journal BMC Public Health (DOI: 10.1186/s12889-017-4328-2). The study is coordinated by the Addiction Research and Clinical Epidemiology unit at the Institute of General Practice of the Heinrich-Heine-University Düsseldorf. The study has been funded by the German Ministry of Health (2019 – current) and the Ministry for Innovation, Science and Research of the German Federal State of North Rhine-Westphalia (2016 – 2019).


The prevalence of tobacco smoking in Germany is still at a very high level (nearly 30%). Timely tracking of national patterns of tobacco smoking and data on the “real-world” effectiveness of smoking cessation methods are needed to inform policies and develop campaigns aimed at reducing tobacco-related harm. Since 2006, the Smoking Toolkit Study (STS) has been successfully tracking such key performance indicators in England, resulting in the implementation and adaptations of tobacco control policies and leading to a reduction in smoking prevalence. However, direct transferability of this data to the German health policy context is not possible. The German Study on Tobacco Use (DEBRA) addresses this issue and aims to timely track key variables relating to patterns and trends of smoking and quitting in Germany. DEBRA will thereby provide nationally representative information for policy health strategies and future scientific studies. The methodology of the study is closely aligned to the STS, allowing international comparisons of data.


The DEBRA study begun in June 2016 and consists of cross-sectional, computer-assisted household interviews in people aged 14 years and older. Every two months a new, representative sample of approximately 2,000 respondents will complete the survey every two months (total of 18 waves = approximately 36,000 respondents). Per wave, about 500-600 people are expected to smoke tobacco daily or occasionally or to be recent ex-smokers (<12 months). At baseline and six months later, this group will answer detailed questions about rates, duration and success of quit attempts, internal and external triggers of quit attempts, exposure to health professionals’ advice on quitting, and use of behavioural and pharmacological cessation aids, including electronic cigarettes. Variables will be analysed considering potential confounders (e.g., strength of urges to smoke and sociodemographic characteristics). Last-year smokers will be asked to complete a telephone survey 6 months later. This prospective element allows, amongst others, to analyse the “real-world” effectiveness of smoking cessation methods.