Introduction Since regaining of independence Lithuania has instituted comprehensive tobacco control legislation (the law on Tobacco control in 1995, total ban on tobacco advertising in 2000, smoking ban in the bars and restaurants in 2007). This was followed by excise tax increase in 2009. The aim of the study was to demonstrate the impact of the tobacco control legislation on adult smoking prevalence.

Methods National health behaviour monitoring system was set up in Lithuania in 1994 within the Finbalt Health Monitor project. The data for the study was derived from nine cross-sectional surveys conducted during 1994–2010. An independent national random sample of 3000 inhabitants aged 20–64 was taken from National Population Register for every survey. The data were collected through postal surveys. The response rate varied from 53.8% to 74.4%.

Results The prevalence of smoking among men was increasing up to the year 2000 (from 43.8% to 51.5%) afterwards it started to decline reaching 34.2% in 2010. The proportion of smoking women increased from 6.8% in 1994 to 15.8% in 2000 remaining stable over the last decade. Smoking was more common among younger and less educated people in both genders. The age and educational inequalities among men remained similar over the period of observation. Since 1994 the proportion of smoking women has increased among less educated, but it did not change among highly educated.

Conclusion Tobacco control legislation can be associated with positive changes in adult smoking prevalence in Lithuania; however, further strengthening of tobacco control activities is needed.