Youth nicotine policy often begins with a straightforward objective: prevent young people from starting to use nicotine. The harder question is how.
Smoking, vaping and nicotine pouch use are sometimes grouped together in prevention strategies because they all involve nicotine. Yet young people may encounter these products in different settings, perceive them differently and respond to different social influences. If the reasons for use vary, a single prevention strategy may miss some of the factors that matter most.
New research from Finland provides useful evidence on this question.
Published in the Journal of Health Psychology in 2026, Daniel J. Phipps, Keegan Knittle, Martin S. Hagger and Kyra Hamilton compared beliefs and behaviours relating to cigarettes, nicotine vapes and nicotine pouches among 1,194 people aged 15 to 25 living in Finland. The researchers examined factors including attitudes, health literacy, socioeconomic status, perceived behavioural control and the influence of friends and family.
Their findings suggest there are common influences across nicotine products, but important differences as well.
For policymakers, that distinction deserves attention.
Enjoyment May Matter More Than Perceptions of Harm
One of the study’s most striking findings concerns attitudes.
The researchers distinguished between “affective attitudes”, which concern whether using a product is perceived as enjoyable or emotionally rewarding, and “instrumental attitudes”, which include beliefs about issues such as risk and safety.
Across smoking, vaping and nicotine pouch use, affective attitudes were the strongest correlate of intentions, reported addiction and past behaviour. Instrumental attitudes generally showed much smaller effects or no statistically significant relationship with these outcomes.
This matters because much public-health communication around nicotine products understandably focuses on health consequences.
In the Finnish study, participants did recognise differences in harm. Cigarettes were perceived as the least healthy of the three behaviours. Vapes and nicotine pouches were regarded as less harmful than cigarettes, while pouches were perceived as less harmful than vapes. Yet those instrumental attitudes did not appear to be the main factor associated with whether participants intended to use the products or reported using them.
The authors therefore raise an important question for intervention design. If enjoyment and emotional expectations are more closely associated with behaviour than health-risk perceptions, information campaigns centred primarily on risk may have limited influence on some young people’s decisions.
That does not mean health education is unimportant. The study found that higher health literacy was associated with lower intentions across all three nicotine behaviours. It does suggest, however, that providing information about health risks may be only one part of effective prevention.
Friends Matter
The social environment also appears important.
Participants perceived nicotine pouches as the most accepted of the three behaviours among both friends and family. Pouch use was also perceived as the most common behaviour among friends, followed by vaping and then smoking.
Across the models, friend-related norms were generally more relevant to nicotine behaviour than family-related norms. The relationship was particularly pronounced for cigarette smoking, where friend subjective norms showed stronger effects than for vaping or pouch use, especially in relation to reported addiction.
This provides a useful reminder that youth nicotine behaviour occurs within social environments.
Regulators frequently concentrate on product availability, packaging, advertising and health warnings. Those measures can matter, but young people’s perceptions of what their peers consider normal or acceptable may also shape behaviour.
That suggests prevention programmes may need to engage more directly with social norms rather than assuming that communicating individual health risks will be sufficient.
Nicotine Pouches Show a Distinct Pattern
The findings on nicotine pouches deserve particular attention because the category is relatively new in many markets.
Within this sample, pouch use was reported more frequently during the previous month than smoking or vaping. Participants also reported the highest intentions and addiction scores for nicotine pouches, although these results should not be interpreted as national prevalence estimates because the sample was not designed to be representative of all Finnish young people.
Gender differences were also much clearer for pouches.
Being male was a stronger predictor of pouch-related intentions, past use and reported addiction than it was for either vaping or smoking. Male participants viewed nicotine pouch use as more enjoyable and socially acceptable than female participants did.
The researchers conclude that prevention strategies should consider both shared and product-specific determinants.
That is an important policy point. Treating every nicotine product as though young people interact with it in exactly the same way may overlook differences that could determine whether an intervention succeeds.
Health Literacy Still Has a Role
The study also examined health literacy, defined broadly around people’s ability to find, understand and use health-related information.
Higher health literacy was associated with lower intentions across smoking, vaping and pouch use. Its relationship with behaviour differed between categories, however. The protective association with past behaviour was particularly pronounced for vaping and weaker for nicotine pouch use.
The authors offer possible explanations but appropriately describe them as speculative.
For example, vaping has been the subject of substantial public-health messaging about potential risks, which may mean people with greater health literacy are better equipped to interpret that information. Information about nicotine pouches is newer and may be less widely understood.
More research is needed before drawing firm conclusions.
Still, the broader implication is useful. Effective health communication requires more than simply making information available. Policymakers need to understand whether intended audiences receive, understand and act on it.
Youth Prevention and Relative Risk Are Different Questions
The study also exposes a difficult issue for nicotine risk communication.
Young people should receive clear information that nicotine use carries risks and that people who do not currently use nicotine should not be encouraged to start. Strong safeguards against youth access and youth-oriented marketing remain appropriate.
At the same time, public-health communication should remain accurate about differences between nicotine products.
The Finnish participants already perceived cigarettes as more harmful than vaping and nicotine pouches. The study does not determine whether their estimates of relative risk were scientifically accurate, nor was it designed to establish the relative health risks of the three categories. Its purpose was to examine beliefs and their relationship with behaviour.
That distinction is important.
A prevention strategy intended to reduce youth uptake should not require communicating that all nicotine products carry identical risks if the evidence does not support that claim. Equally, communicating differences in relative risk should not become a message that nicotine use is harmless or desirable for young non-users.
These objectives require careful communication, particularly where the same information may reach both young people who have never used nicotine and adults who currently smoke.
What the Study Cannot Tell Us
The findings should be interpreted cautiously.
This was a cross-sectional study, meaning the researchers measured beliefs and behaviours at a particular point rather than following participants over time. It therefore cannot establish causation.
For example, positive attitudes may contribute to nicotine use, but experience using a product could also make attitudes more positive. The researchers explicitly acknowledge this problem.
The study also relied on self-reported behaviour. It did not account for differences in nicotine strength across products, which the authors identify as potentially relevant to both user experience and dependence.
There are limits to generalisability as well. Participants were recruited through an online panel in Finland, and the sample was not stratified beyond gender. Around 97% identified as Finnish, compared with a lower proportion in the wider population. Finland also has its own regulatory environment, including restrictions affecting some flavoured nicotine products. The authors therefore caution against treating the sample as representative of Finnish youth or automatically applying the findings to other countries.
These limitations do not make the research uninformative. They define what conclusions can reasonably be drawn from it.
Moving Beyond One-Size-Fits-All Prevention
The strongest policy lesson from the Finnish study is relatively modest but important.
Smoking, vaping and nicotine pouch use share some behavioural influences. Enjoyment-related attitudes and peer norms appear relevant across categories. Yet the strength of those relationships differs, and pouch use in particular displayed a distinctive gender pattern.
This suggests prevention policy may work better when it responds to the actual drivers of particular behaviours.
For GINN, this is consistent with a wider principle of evidence-based, risk-proportionate nicotine governance. Regulation should recognise differences between products where the evidence supports doing so, while remaining firm about preventing youth initiation.
That could mean stronger enforcement of age restrictions, responsible marketing standards, accurate risk communication and interventions designed around the social environments in which young people encounter nicotine. It also means evaluating whether interventions change behaviour rather than assuming that stronger warnings automatically produce better outcomes.
The Finnish research provides another reason to examine nicotine products in context.
Young people do not necessarily smoke cigarettes, vape or use nicotine pouches for precisely the same reasons. Prevention strategies should be capable of recognising those differences.
Better youth protection begins with understanding behaviour as it actually occurs.
Source
Phipps DJ, Knittle K, Hagger MS, Hamilton K. A comparative study of vape, pouch, and cigarette related beliefs and behaviors and their determinants in young Finnish people. Journal of Health Psychology. 2026.
