What does this research mean for the field?

Between 2012 and 2023, waterpipe use among young people in the European Union significantly declined while e-cigarette use substantially increased, exhibiting divergent patterns across sociodemographic groups. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate long-term trends and sociodemographic disparities in waterpipe and e-cigarette use among youth across the European Union between 2012 and 2023.

August 15, 2026The Lancet Regional Health - EuropeOpen Access

Trends in waterpipe and e-cigarette use among young people in the European Union, 2012–2023: a repeated cross-sectional study

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To evaluate long-term trends and sociodemographic disparities in waterpipe and e-cigarette use among youth across the European Union between 2012 and 2023.
Analyzed five waves of repeated cross-sectional Special Eurobarometer survey data (2012–2023) covering 26 EU Member States (N=20,466; ages 15–30).
Calculated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) using multilevel Poisson regression models adjusted for country-level factors.
Ever waterpipe use fell from 31.2% (95% CI: 29.1–33.3%) in 2012 to 14.9% (95% CI: 13.2–16.8%) in 2023 (aPR vs 2017: 0.52, 95% CI: 0.42–0.66), and current use decreased from 2.5% (95% CI: 1.8–3.5%) to 1.8% (95% CI: 1.2–2.7%).
Ever e-cigarette use increased from 12.2% (95% CI: 10.8–13.8%) in 2012 to 25.8% (95% CI: 23.7–28.2%) in 2023, while current use rose from 1.6% (95% CI: 1.1–2.3%) to 5.3% (95% CI: 4.0–6.8%), peaking in 2023 (aPR vs 2017: 4.27, 95% CI: 2.73–6.67).
By 2023, ever e-cigarette use was significantly higher among women (aPR: 1.41, 95% CI: 1.18–1.69), urban residents (aPR: 1.27, 95% CI: 1.11–1.46), and youth without financial difficulties (aPR: 1.38, 95% CI: 1.20–1.60).

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Implication

Repeated cross-sectional study reveals rising e-cigarette use alongside declining waterpipe use among young Europeans, highlighting the need for targeted youth nicotine regulations.

Cite This Study

Tan et al. (2026) studied this question.

synapsesocial.com/papers/6a80197375c2e31742c8571b https://doi.org/10.1016/j.lanepe.2026.101815

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Implication

Repeated cross-sectional study reveals rising e-cigarette use alongside declining waterpipe use among young Europeans, highlighting the need for targeted youth nicotine regulations.

Trends in waterpipe and e-cigarette use among young people in the European Union, 2012–2023: a repeated cross-sectional study

Key Points

Discussion

Implication

Cite This Study

Trends in waterpipe and e-cigarette use among young people in the European Union, 2012–2023: a repeated cross-sectional study

Key Points

Discussion

Implication

Cite This Study

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