The Use of Alternative Tobacco Products by Adolescents During Wartime

The Department of the Safety of Children’s Population Vital Functions at the State Institution «Marzieiev Institute for Public Health of the National Academy of Medical Sciences of Ukraine» carried out a study on the prevalence of alternative tobacco and nicotine product use among adolescents aged 15–17 during full-scale military aggression.

The survey results showed that the prevalence of tobacco and nicotine-containing product use in any form among adolescents is 29.3±2.0%. Depending on age and gender, between 8.2% and 23.1% of respondents noted that the military aggression against Ukraine influenced their decision to start smoking. The highest number of such adolescents was observed among 17-year-old boys (18.8%) and girls (23.1%).

The group of regular smokers consisted of 55.8% of boys and 44.4% of girls who had smoked in the past month, as they use tobacco or nicotine-containing products daily. These are predominantly 17-year-olds. The majority were adolescents who smoked fewer than 5 cigarettes or any of the latest tobacco and nicotine-containing products per day. This includes 58.8% of 15-year-old boys and 64.7% of 15-year-old girls, 66.7% of 16-year-old boys and 73.3% of 16-year-old girls, as well as 50.4% of 17-year-old boys and 60.8% of 17-year-old girls. The percentage of adolescents who smoke 5–10 cigarettes or any tobacco products per day ranges from 24.9% (15-year-olds) to 36.0% (17-year-olds).

Over the past decade, the popularity of new types of tobacco and nicotine-containing products (e-cigarettes, tobacco heating devices, and hookahs) has been rapidly growing among young people in Ukraine. Most respondents who smoke indicated that they use alternative types of tobacco and nicotine-containing products. For example, the percentage of 15-year-olds who smoke and use alternative tobacco and nicotine-containing products was 83.2%, which is on average 4.9 times higher than the proportion of daily smokers of commercially manufactured cigarettes (p ≤ 0.05).

Both boys (70.8%) and girls (94.4%) aged 16 also prefer new types of tobacco and nicotine-containing products (p ≤ 0.05). The proportion of 17-year-olds who use alternative tobacco products is 88.8%, which is 8 times higher than the proportion of daily smokers of conventional cigarettes—11.2% of respondents (p ≤ 0.05). Among alternative nicotine-containing products, e-cigarettes and vapes are the most popular among 15-year-olds—21.6%. In second place are tobacco heating systems (THR)—18.9%. 14.6% of boys and 17.6% of girls smoke hookah.

The study revealed an alarming fact: nearly one in ten (9.7%) 17-year-old current users of tobacco and nicotine products use two or three types of products. The most common combination is traditional cigarettes and heated tobacco products. In other words, the study group of adolescents showed a higher prevalence of e-cigarettes, heated tobacco products, and hookah use compared to traditional cigarettes.

A high level of awareness among students regarding the health risks of smoking was found. The percentage of such adolescents ranges from 96.9% among 17-year-olds to 100.0% among 15-year-olds. It was found that 75.9% of current smokers wish to quit smoking in the future. A positive trend is the increase in the proportion of such adolescents with age (65.8% among 15-year-olds and 71.3% among 17-year-olds).

CONCLUSIONS

  1. A high prevalence of smoking new types of tobacco and nicotine-containing products was found. Specifically, 83.6% of 15-year-olds, 82.6% of 16-year-olds, and 88.8% of 17-year-olds use these products, which is on average 5.7 times higher than the percentage of those who smoke cigarettes daily.
  2. The military aggression against Ukraine has influenced changes in adolescents’ smoking behavior. The percentage of respondents who attribute the start of their smoking to Russia’s aggression ranges from 8.2% to 23.1%, depending on age and gender.
  3. Positive trends were identified regarding the potential for developing health-promoting behaviors: high awareness among adolescents of the harmful effects of tobacco on the body (95.3%) and a desire among adolescent smokers to quit smoking in the future (75.9%).
  4. More detailed results of the study are presented in the article

Рlatonova A., Yatskovska, N., & Shkarban, K. (2026). Characteristics of the Prevalence of Smoking Among Adolescents Aged 15–17 in the City of Kyiv During the Russian Military Aggression. Environment & Health, 119(2), 4-11. https://doi.org/10.32402/dovkil2026.02.004 

Prepared by:

Alina PLATONOVA – Doctor of Medical Sciences, Head of the Department of the Safety of Children’s Population Vital Functions.

Natalia YATSKOVSKA – Senior Researcher, Candidate of Medical Sciences, Department of the Safety of Children’s Population Vital Functions.

Kateryna SHKARBAN – Researcher, Department of the Safety of Children’s Population Vital Functions.

(date of publication on the website: 01.09.2026)