This report provides an overview of the trends in nicotine product use among youth, as well as regulatory developments across the Nordic and Baltic countries from 2018 to 2024. Overall, there is a growing use of new nicotine products across countries, and regulative initiatives are still evolving in response to this.

While cigarette smoking continues to decline among youth in most countries, daily and occasional use of e-cigarettes and oral nicotine products has increased significantly in nearly all included countries. Since 2021, there has been a rapid increase in most of the included countries in e-cigarette use among youth, likely due to the introduction of disposable e-cigarettes. Similarly, the use of oral nicotine products, i.e. snus and nicotine pouches, is increasing in this region. A notable trend is the growing popularity among girls. In most included countries, girls’ use of e-cigarettes has exceeded the use among boys. Oral nicotine products are still most prevalent among boys, although the gap between genders seems to narrow.

Frameworks such as the Tobacco Product Directive (TPD) and the WHO Framework Convention on Tobacco Control (FCTC) make cigarette regulations relatively uniform across the Nordic and Baltic countries. However, regulations for new nicotine products vary markedly. For e-cigarettes, there are widely differing restrictions across the Nordic and Baltic region in terms of characteristic flavours, taxation, and the plain packaging requirement. Regulations on oral nicotine products are similarly inconsistent. For example, there is a sales ban on snus in all countries, except for Sweden and Norway. Also, nicotine pouches are subject to different regulations regarding taxation, use restrictions, restriction of characteristic flavours, and advertising across the Nordic and Baltic countries.

The findings of the report underline the importance of a continued strategic political focus – both within and between countries. Harmonising regulations across the Nordic and Baltic countries could help secure a more unified and proactive approach in preventing the use of new nicotine products among youth. Regulations on new nicotine products are still developing; hence, concluding on their effectiveness would not be meaningful at present. However, sharing how the Nordic and Baltic countries are working with this extremely important public health challenge can be used to inform and inspire future preventive initiatives.