Near schools, at bus stops, in kiosks, and even in the hands of young adolescents—e-cigarettes, vapes, and nicotine pouches have long become part of everyday life. If just a few years ago doctors called traditional smoking the main problem, now the latest nicotine products, often presented as a "less harmful alternative," are causing increasing concern.

Maryana Dreval, a general hygiene doctor from the Department of Epidemiological Surveillance and Prevention of Non-Communicable Diseases at the Lviv Regional Center for Disease Control and Prevention, emphasized in a conversation with "Tvoe Misto" that there is no safe way to consume nicotine. And the tobacco industry's biggest target today is the youth.

"Many teenagers are convinced that a vape or a pouch is not a cigarette, and therefore, supposedly not harmful. But this is a dangerous illusion," says the doctor.

"The tobacco industry is specifically targeting the youth"

According to the specialist, smoking among children is changing form today. If traditional cigarettes are gradually losing popularity among teenagers, e-cigarettes, vapes, and nicotine pouches are, on the contrary, gaining momentum.

"The tobacco industry is doing everything to get young people "hooked" on nicotine as quickly as possible. Adults are more accustomed to traditional cigarettes, but the latest products are actively promoted specifically among children and teenagers," explains Maryana Dreval.

Nicotine pouches—small nicotine pads placed under the lip or against the cheek—are of particular concern. Due to the absence of smoke, many mistakenly consider them safe.

"Children often don't even realize that this is also a form of nicotine consumption. And the nicotine content in such pouches can be significantly higher than in regular cigarettes," says the doctor.

Pouches, she adds, contain flavorings that attract young people.

"Nicotine itself is very bitter, so manufacturers add many sweeteners and flavorings with berry, fruit, or candy flavors. This creates an illusion of something “tasty” and safe. But all these substances are of chemical origin and affect the oral mucosa and the body as a whole," she explains.

"A child's body is still forming"

Medics emphasize: nicotine is especially dangerous for children and teenagers because their bodies are still developing.

"On average, children try their first cigarette as early as 9–10 years old. Yet the human body actively forms until at least 18 years of age, and certain systems until 25. Nicotine is a toxic substance that negatively affects this development," says Maryana Dreval.

According to her, addiction forms faster in adolescence than in adults. And the marketing of the latest nicotine products only exacerbates the problem.

"Teenagers aren't just being sold nicotine—they're being sold a lifestyle. Pretty packaging, sweet flavors, bright colors. All this creates the impression that the product is safe," the doctor adds.

Vapes and "vitamins in vapor"

Separately, specialists point to e-cigarettes and vape liquids. Manufacturers often claim that such mixtures even contain "vitamins" or are "lighter" on the body.

"This is purely marketing. There is no evidence that inhaling any “vitamins” in this form provides benefits. Instead, we often don't even know exactly what substances are in these liquids. And they are often harmful," says Maryana Dreval.

She explains that e-cigarette liquids are often manufactured without proper quality control.

"A person thinks they are in control: choosing the flavor, mixing the liquids. But in reality, this is also an addiction, and it often forms unnoticed," the specialist adds.

IQOS and hookahs: "less harmful" doesn't mean safe

Another popular myth is that hookahs and tobacco heating systems are a "better alternative" to regular cigarettes.

"Hookah is also smoking. During one session, a person can receive a dose of nicotine comparable to a pack of cigarettes or even more," the doctor emphasizes.

As for tobacco heating systems—like IQOS or glo—according to medics, they also emit toxic substances.

"Yes, there is no combustion process like in a regular cigarette. But when heated, phenols, heavy metals, and other harmful substances are still released. It's impossible to say it's safe or harmless," says Maryana Dreval.

Smoking and cancer: a link long proven

Doctors emphasize: regardless of the form of consumption, nicotine and tobacco products are linked to the risk of developing oncological diseases.

"When we talk about smoking, it's not just lung cancer. It's also oral cancer, esophageal cancer, and other oncological diseases. And this has long been proven by evidence-based medicine," the specialist explains.

In addition to oncology, smoking affects the cardiovascular system, lungs, and nervous system.

"We are not scaring, but explaining"

According to Maryana Dreval, it is not prohibition or fear that works best, but an honest explanation of the consequences.

"Our approach is not to intimidate. We try to explain exactly how these products affect the body and why addiction forms so quickly," she says.

That is why a series of preventive initiatives for children, students, and adults are being implemented in the Lviv region. In particular, the "Nicotine and Tobacco Free School" project has already reached over 11,000 students in seven districts of the region.

"Children are starting to talk about it themselves. They record videos, TikToks, and discuss the topic among themselves. And this means they are becoming more aware," the doctor says.

Doctors emphasize: the problem with modern nicotine products today lies not only in the addiction itself but also in the fact that society still often underestimates their danger.

"There is no such thing as safe nicotine. It's just the form, smell, and packaging that change," summarizes Maryana Dreval.

Read also: In Lviv, everyone is invited to free examinations, doctor consultations, and outdoor activities.

As a reminder, according to the Global Youth Tobacco Survey (GYTS), nearly one in five Ukrainian teenagers uses e-cigarettes, and the average age of the first smoking attempt is decreasing. The Ministry of Health also reported that the popularity of traditional cigarettes among young people is gradually falling, but instead, the use of vapes and other nicotine products is growing rapidly. The WHO emphasizes: e-cigarettes are not a safe alternative to smoking, and manufacturers often target their advertising specifically at children and teenagers.