Tobacco now and then: what has changed?

JRC explains | 29 May 2026 | Joint Research Centre

While tobacco smoking is down in the EU, the use of electronic cigarettes and heated tobacco products is booming, in particular among young people. JRC scientists investigated the use of smoke-free products, the associated costs and what it means for Europe's health and care system.

How prevalent is smoking in the EU?

Tobacco smoking is still a major habit across the EU, with roughly 24 % of adults reporting smoking, compared to 28% of adults who smoked back in 2012. Over the same period (2012-2023), the share of young smokers aged 15-24 has seen a larger decline, from 29% to 22%.

But the use of tobacco and related products has changed dramatically since 2012, when only 7% of people had tried e-cigarettes, while 23 % did not know what an e-cigarette was and 31% hadn’t heard of it. Electronic cigarettes and heated tobacco products have become increasingly popular since 2019 and are now reshaping the EU tobacco product landscape.

Their growth is most noticeable among people under 30 years of age. The share of e-cigarettes daily users for this age group has more than doubled between 2020 and 2023, raising from 1.4% to 3%. The use of heated tobacco products for the same period has increased for those aged 25-39 (from 2% to 3%) and 40-54 (from 1% to 2%).

For many teenagers, e‑cigarettes are the first product they use regularly, with roughly one‑in‑five 15‑19‑year‑olds and more than one‑in‑ten 20‑24‑year‑olds who began with e‑cigarettes rather than cigarettes or other traditional tobacco products.

What is the EU doing?

The European Commission carried out an evaluation of the EU’s tobacco control framework, comprising two laws: the Tobacco Products Directive (2014/40/EU) and the Tobacco Advertising Directive (2003/33/EC). The findings show that EU rules have contributed to a significant decline in smoking, as mentioned above, and to a lower rate of tobacco-related deaths. Nevertheless, the rapid emergence of novel tobacco and nicotine products is a growing challenge.

The evaluation identifies the rise of e-cigarettes, heated tobacco products and nicotine pouches, as introducing new public health concerns and as a gateway to nicotine addiction and in some cases, traditional smoking, in particular for younger generations.

How does JRC work feed into the evaluation?

JRC research, combining new data generation with syntheses of existing knowledge, underpinned the Commission’s Staff Working Document on the evaluation.

Three JRC studies provided crucial scientific support for the findings of the evaluation, particularly on the health-related costs of tobacco use, the health impacts of novel tobacco and nicotine products, and on the trends and patters of use of tobacco and nicotine products in the EU.

The evaluation emphasises the need to adapt the regulatory framework, proceeding with an impact assessment and proposal for a revision of the tobacco control framework.

In this context, the JRC also analysed the responses of a targeted consultation with EU countries on the administrative efforts and costs related to the implementation of the current EU tobacco control framework, providing key evidence on the efficiency and effectiveness of the legal framework to support the evaluation.

How safe are smoke-free products?

The relative novelty of these products makes it difficult to assess long‑term health effects, as they have not been on the market long enough. Nevertheless, current evidence points to several concerns:

E-cigarettes have been shown to be related to adverse short- and medium-term health outcomes, mainly in the cardiovascular and respiratory systems. They can cause addiction and dependence and while their use appears less harmful than conventional tobacco there are concerns around the inhalation of nicotine together with metals and other substances with unclear toxicity as well as potential links to tumor development and detrimental pregnancy impacts.
Heated-tobacco products have been associated with similar cardiovascular and respiratory risks, as well as potential developmental and pregnancy harms. Their aerosol contains substances with unclear long‑term toxicity.
Nicotine pouches currently lack robust evidence on health effects because they have been available only recently. They appear to deliver fewer toxicants than smoked products but still pose a risk due to their nicotine content.

Tobacco impact on our healthcare systems

Traditional tobacco use already costs the EU roughly 80.7 billion euro each year – half in direct health‑care expenses and half in lost productivity and informal care. Chronic obstructive pulmonary disease (COPD) accounts for 33.4% of direct costs, followed by diabetes (21.7%) and ischemic heart diseases (8.8%). Health‑related tobacco costs vary considerably across EU countries.

On average, direct tobacco use-related healthcare costs represent 2.5% of total healthcare expenditure in the EU. While it is currently not possible to analyse the healthcare costs associated with the emerging products, as accurate risk estimation is lacking due to insufficient evidence and relatively short follow-up time, the use of e-cigarettes by young people seems to increase the likelihood of transitioning towards the use of other tobacco products, including cigarettes. This could further affect future health-related tobacco costs.