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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.

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