Introduction:

Despite historical progress in reducing tobacco use, recent years have seen a resurgence in nicotine product use among youth in Poland, especially with the rise of electronic nicotine delivery systems (ENDS). This trend raises concerns given the risks nicotine poses to adolescent brain development. This study aimed to assess the prevalence and patterns of use of traditional and novel nicotine products among Polish adolescents, as well as their perceptions of harm.

Material and methods:

A cross-sectional online survey was conducted in June 2024 among 3,181 students aged 14-18 years from selected Polish schools. The questionnaire assessed use of conventional cigarettes, ENDS, heated tobacco products (HTPs), nicotine pouches, and non-nicotine alternatives. Respondents also rated the perceived harmfulness of various products. The sample was non-random and responses were anonymous. Current use was defined as at least one use in the past 30 days; daily use referred to daily consumption during this period.

Results:

Over one-third (35.3%) of respondents reported having experimented with nicotine products, and 18.1% were current users. ENDS were the most commonly used product (16%), followed by tradi­tional cigarettes (12%). Daily use was reported by 6.4% (ENDS) and 5.1% (cigarettes). Dual use was pre­valent: 9.7% reported current use of both cigarettes and ENDS, with 3.4% using both daily. Initiation before age 14 was reported by 41.3% of users. Girls and older students, especially in vocational and technical schools, showed higher prevalence rates. Harm perceptions were lower among users than non- users, with cigarettes and HTPs perceived as more harmful than ENDS or pouches.

Conclusions:

Nicotine product use, especially ENDS and dual use, remains alarmingly high among Polish adolescents. Continued surveillance and targeted prevention efforts are necessary, particularly those addressing misperceptions of harm and appealing product features such as flavors and accessibility.