| Summary: | <i>Background and Objectives</i>: The aim of the study was to evaluate trends in smoking among middle-aged men and women based on the data from the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program between 2009 and 2016. <i>Materials and Methods</i>: A community-based cross-sectional study comprised 92373 Lithuanian adults (41.6% men and 58.4% women). We compared the prevalence of smoking, smoking cessation activity and smoking intensity by gender and age groups. <i>Results</i>: There was a statistically significant upward trend in the number of smoking subjects (average annual percent change (AAPC) 2.99%, <i>p</i> < 0.001). The number of smoking male subjects remained much higher than the number of smoking female subjects during the 2009–2016 period. The study showed a significant increase in the percentage of smoking quitters in the whole group (AAPC 7.22%, <i>p</i> < 0.001) and among men and women separately. There was no significant change in smoking intensity in groups of male and female smokers separately. <i>Conclusions</i>: The analysis showed that the prevalence of smoking in Lithuania is still increasing due to women smoking despite all the governmental tobacco control efforts to reduce it.
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