Background Tobacco use is an important public health issue. Morocco implemented a tobacco control programme, which has been ongoing among students at middle and secondary schools since 2010. Aim This study aims to compare the trend in smoking among the programme beneficiaries with the results of the initial study conducted prior to the implementation of the programme. Setting This study was conducted in middle and secondary schools of the Gharb Region in Morocco between 2010 and 2015. Methods Two cross-sectional studies were conducted in 2010 and 2015 in the middle and secondary schools of the Gharb Region. Multistage cluster sampling was used. The information was collected using a self-administered questionnaire. Results In the first study in 2010, 5312 students participated, and in the second one in 2015, 4208 students participated. The level of information on smoking and its effects was higher in 2015 (94.0%) than in 2010 (92.5%). In 2010, parents, primary schools and television and radio were more involved in student information on smoking compared to 2015. The proportion of students claiming that tobacco was not a pleasure (86.3%) and that it does not calm nerves (76.5%) was significantly higher in 2015 than in 2010. The prevalence of smoking increased significantly in 2015 (2.9%) against 2010 (1.8%). Conclusion This study reports the general positive evolution in knowledge about smoking and its effects. Despite that the prevalence of smokers increased in 2015. The results suggest the need to address family influences on adolescent smoking and to investigate participation of schools in education and training students in tobacco dependence prevention.