Data on tobacco and nicotine product use was already collected within each participating country. Representatives from each Nordic and Baltic country provided information about relevant reports, national statistics, and other sources. The representatives were designated by the Nordic Welfare Centre, and came from national organisations, such as ministries, health authorities, or scientific institutes. In addition, supplementary searches were conducted among public health authorities and government websites to complement the information provided by the representatives. Sources were included only if they contained data on the use of nicotine products by youth under 29 years of age, both overall and stratified by gender. Data from the period 2018 to 2024 were requested. At least two data points in this period were required to be included. However, for some countries, data from certain years were unavailable, resulting in variation in periods between countries in the figures. If specific data were unpublished or unavailable, the representatives were contacted for further guidance on where to locate it. In some cases, if data was not publicly available, it was given specifically for the purpose of this report.

Information on the national regulations on nicotine products was gathered through a combination of input from the national representatives and supplementary searches on national legal websites. As part of the process, representatives from each country were given the opportunity to review the presented prevalences and regulations for their own countries. Additionally, representatives were also given the opportunity to provide insights into the results and the observed trends within their countries in order to help qualify the findings.

The content of this report was finalised in mid-December 2024, which therefore served as the cut-off date for the included data, regulations, and other information.

The products included in this report are cigarettes, e-cigarettes, and oral nicotine products (covering snus, nicotine pouches, and/or chewing tobacco – see table 1). The combined category of oral nicotine products is a response to lack of prevalence data of only nicotine pouches in some of the included countries and the fact that youth don’t often distinguish between snus and nicotine pouches (Pedersen et al., 2022a).

The current use of each product in this report is defined as daily and occasional use. Generally, tobacco and nicotine use in youth has a very experimental character, and occasional smoking may turn into daily smoking over time. The use of more than one tobacco or nicotine product or a shift between products is also quite common (Heinly & Walley, 2023; Raitasalo et al., 2022). Further, experimental use at a young age may predict daily use later in life (Jordan & Andersen, 2017; Sargent et al., 2017). Therefore, when it comes to youth, occasional tobacco and nicotine product use gives cause for great concern from a public health preventive perspective.

There are some methodological considerations to be aware of when reading this report. First, the measuring procedures, such as the definition of daily and occasional use and product definition, vary between countries (and even within some countries due to changing measures in the period). An overview of this is presented in table 1. Secondly, the respondents’ differing age groups also impacts the direct comparability of the cross-country prevalences and development of use. Therefore, age groups are presented in every graph to secure transparency in the interpretation of results. Lastly, one should be specifically aware of the representability of the studies included. This concerns the number of respondents, data collection in a geographic subgroup or at a national level, and use of weighting or other statistical methods to reduce the risk of bias. Details of the studies are described in the following section.

Denmark: Danish Smoking Habits 2019 + §SMOKE Study 2020–2023
Data on cigarette, e-cigarette, and oral nicotine product use among Danish youth in 2019 comes from The Danish Smoking Habits study (Danskernes Rygevaner), carried out by the National Institute of Public Health in Denmark for the Danish Health Authority. Information on nicotine product use among youth from 2020 and onwards stems from the §SMOKE study (§RØG-undersøgelsen), also carried out by the National Institute of Public Health (Andersen & Bast, 2021; Jarlstrup et al., 2020; Jarlstrup et al., 2023; Lund et al., 2024; Pedersen et al., 2022b). Due to two data collections in 2021, the prevalences for this year are an average of the two data collections. As with both surveys, prevalences for subgroups of 15–24-year-olds were calculated specifically for this report.

Finland: Tobacco Statistics 2019–2023
Data on cigarette, e-cigarette, and oral nicotine product use among youth in Finland was extracted from the Tobacco Statistics (Tupakkatilasto), based on the School Health Survey, a national representative questionnaire-based survey carried out by the Finnish Institute of Health and Welfare (Terveyden ja hyvinvoinnin laitos (THL), 2024). The study is conducted in classrooms among students in grades 8 and 9 of comprehensive school, as well as first- and second-year students in upper secondary schools and vocational institutions, corresponding to youth aged 14 to 20 years. The data is presented as whole (rounded) numbers without decimals. However, in this report, they are presented with a decimal point (.0), which should be taken into account when reading the report. (Terveyden ja hyvinvoinnin laitos (THL), 2024).

Iceland: Public Health Watch 2018–2023
Data on cigarette, e-cigarette, and oral nicotine product use among Icelandic youth were delivered by the Directorate of Health in Iceland. The data is based on monthly online surveys conducted by Gallup, distributed to a random sample of the Gallup attitude group above 18 years old (Directorate of Health). For this report, prevalences for the 18–24-year-olds were calculated by the Directorate of Health.

Norway: Drug Survey 2018–2024
Data on cigarette, e-cigarette, and oral nicotine product use among Norwegian youth were extracted from The Drug Survey (Rusundersøkelsen) carried out by Statistics Norway (Statistisk sentralbyrå). The interview-based Drug Survey is conducted among a randomly drawn group of 16–79-year-old Norwegian citizens. However, in 2024 data collection was a combination of web and telephone interviews (Elgesem, 2023; Elgesem & Falnes-Dalheim, 2024; Statistisk sentralbyrå, 2024; Todorovic, 2019; Torsteinsen, 2020, 2021; Torsteinsen & Holmøy, 2022). For this report, only prevalences among 16–24-year-olds were included.

Sweden: National Public Health Survey 2018–2024
Data on the use of cigarettes, e-cigarettes, and oral nicotine products among Swedish youth from 2018 till 2024 are extracted from the National Public Health Survey carried out by the Public Health Agency of Sweden. The National Public Health Survey is a nationally representative questionnaire-based survey among 16–84-year-old Swedish citizens (Folkhälsomyndigheten, 2023, 2024a, 2024b, 2024c). For this report, only prevalences among 16–24-year-olds were included.

Estonia: Estonian Adult Population Health Behaviour Study 2018–2022
Data on the use of cigarettes, e-cigarettes, and oral nicotine products among Estonian youth were obtained from the Health Behaviour Study among Estonian Adult Population from 2018, 2020, and 2022 by The Health Development Institute in Estonia (Reile et al., 2019; Reile & Veideman, 2021, 2023). For this report, only prevalences among 15–24-year-olds were included.

Latvia: Health Behaviour among Latvian Adult Population 2018–2022
Data on the use of cigarettes and e-cigarettes among Latvian youths were extracted from the Health Behaviour among Latvian Adult Population Study, carried out in 2018, 2020, and 2022 by the Centre for Disease Prevention and Control and Rīga Stradiņš University (Grinberga et al., 2019, 2021, 2023). Adequate information on the daily or occasional use of e-cigarettes was not available in the 2018 survey. Similarly, adequate prevalences on daily or occasional use of oral nicotine products among Latvian youth were not available. For this report, only prevalences among 16–24-year-olds were included.

Lithuania: ESPAD 2019+2024
Data on the use of cigarettes and e-cigarettes among Lithuanian youth are extracted from the European School Survey Project on Alcohol and Other Drugs (ESPAD) in 2019 and 2024, carried out by the Drug, Tobacco and Alcohol Control Department (NTAKD). The data includes 15–16-year-olds, and data collection took place as a random sample of school classes to secure representativeness. Prevalences on daily or occasional use of oral nicotine products among Lithuanian youth were only available for 2024, thus making developing graphs unfeasible (The ESPAD Group, 2020).

¹ Nicotine pouches were included from 2021 onwards.
² Additionally, nicotine pouches were asked separately in 2023. The prevalence is available only by school type, not for the population aged 14–20.
³ Nicotine pouches were explicitly included from 2022 onwards. Prior to 2022, the question was: ‘Do you snus?’