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Cigarettes are losing ground, but nicotine isn't going anywhere. New research from Austria and Ireland shows that as traditional smoking declines, e-cigarettes and other alternative nicotine products are filling the gap — especially among teens and young adults. Clinicians are being urged to screen for all nicotine products, not just cigarettes.
Cigarette smoking rates are falling, but the overall nicotine burden is far from over. Data presented at the European Respiratory Society International Congress reveal that the decline in traditional smoking is being offset by a sharp rise in e-cigarettes, heated tobacco products, and nicotine pouches — particularly among younger populations in Austria and Ireland.
In Austria, a 12-year study of over 15,000 people found that current smoking dropped from 24.2% in 2012 to 16.2% in 2024. But alternative nicotine product use among current smokers surged from 0% to 17.2% over the same period, and multi-product use more than tripled. In Ireland, fewer teens are smoking cigarettes than in 2015, but e-cigarette use has climbed — and by 2024, over 76% of teen e-cigarette users had never smoked a cigarette, suggesting vaping is increasingly a standalone habit rather than a smoking substitute.
By the Numbers:
Why it matters: Falling cigarette rates can create a false sense of security. Researchers and clinicians stress that nicotine addiction — in any form — carries health risks, and that clinical screening must now extend beyond cigarettes to capture the full picture of nicotine use, especially in adolescents and young adults.