The use of e-cigarettes among young people in the European Union has doubled over the past decade, while waterpipe use has fallen to less than half its previous level. These are among the main findings of a study co-led by the Tobacco Control Unit (UCT) at the Catalan Institute of Oncology (ICO) and recently published in The Lancet Regional Health – Europe. The study examines patterns of tobacco and nicotine use among more than 20,000 Europeans aged 15 to 30 between 2012 and 2023.
Based on five waves of Eurobarometer surveys conducted across 26 EU countries, the research shows that the proportion of young people who had ever tried an e-cigarette rose from 12.2% in 2012 to 25.8% in 2023. Over the same period, current e-cigarette use increased from 1.6% to 5.3%.
By contrast, waterpipe use declined steadily. The percentage of young people who reported having ever used a waterpipe fell from 31.2% in 2012 to 14.9% in 2023, while current use dropped from 2.5% to 1.8% between 2017 and 2023.
Changing habits among younger generations
The researchers point out that alternative tobacco and nicotine products continue to pose a challenge for tobacco-control policies. Attractive flavours, social influence and the misconception that these products are less harmful to health are thought to have contributed to their growing popularity among young people.
The study also found differences according to social and demographic characteristics. The increase in e-cigarette use was particularly pronounced among women, people living in urban areas, and young people who reported having fewer difficulties making ends meet. Current use of these devices increased across all groups analysed.
The authors warn that the sustained rise in e-cigarette use among young Europeans could undermine progress made in the fight against smoking. They therefore stress the need to strengthen tobacco prevention and control policies, while continuing to closely monitor the use of new nicotine products among young people to ensure that they do not jeopardise the progress achieved over recent decades.
Article reference
Tan MS, Filippidis FT, Li CX, Laverty AA, Fernández E, Martínez C, et al. Trends in waterpipe and e-cigarette use among young people in the European Union, 2012–2023: a repeated cross-sectional study. The Lancet Regional Health – Europe (2026).