Advertising exposure and the appeal of emerging nicotine-containing products among people who have never used nicotine: findings from the Eurobarometer 2023
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Introduction Emerging nicotine-containing products, including heated tobacco products (HTPs) and nicotine pouches, have been growing in popularity in the European Union (EU). Advertising exposure impacts perceived product appeal and may contribute to product initiation. However, the current EU’s Tobacco Products Directive lacks a consistent framework for regulating these advertisements. This study examines how exposure to HTP and nicotine pouch advertisements influences their appeal among people who have never used nicotine.
Methods Data from the Special Eurobarometer 99.3 survey (May–June 2023) included 13 436 participants who have never used nicotine across 27 EU Member States. We estimated the weighted prevalence of HTP and nicotine pouch advertising exposure and perceived appeal and ran multilevel Poisson regression models adjusting for sociodemographic factors.
Results 31.1% of participants reported HTP advertising exposure across the EU, with the highest levels reported in Romania (53.4%) and Slovakia (50.0%) and the lowest in Malta (13.6%). Nicotine pouch advertising exposure averaged 16.6%, peaking in Sweden (46.0%) and lowest in the Netherlands (5.0%) and Lithuania (7.7%). Product appeal remained low, with only 2.0% finding HTPs appealing and 1.3% finding nicotine pouches appealing. Exposed to HTP advertisements were 3.71 times more likely to find them appealing, while exposure to nicotine pouch advertisements increased perceived appeal of nicotine pouches by 5.78 times.
Conclusion Advertising exposure was associated with higher appeal of nicotine-containing products among people who have never used nicotine. Given the risk of initiation, EU-wide advertising restrictions could protect this group and limit the impact of these products on health.
Methods Data from the Special Eurobarometer 99.3 survey (May–June 2023) included 13 436 participants who have never used nicotine across 27 EU Member States. We estimated the weighted prevalence of HTP and nicotine pouch advertising exposure and perceived appeal and ran multilevel Poisson regression models adjusting for sociodemographic factors.
Results 31.1% of participants reported HTP advertising exposure across the EU, with the highest levels reported in Romania (53.4%) and Slovakia (50.0%) and the lowest in Malta (13.6%). Nicotine pouch advertising exposure averaged 16.6%, peaking in Sweden (46.0%) and lowest in the Netherlands (5.0%) and Lithuania (7.7%). Product appeal remained low, with only 2.0% finding HTPs appealing and 1.3% finding nicotine pouches appealing. Exposed to HTP advertisements were 3.71 times more likely to find them appealing, while exposure to nicotine pouch advertisements increased perceived appeal of nicotine pouches by 5.78 times.
Conclusion Advertising exposure was associated with higher appeal of nicotine-containing products among people who have never used nicotine. Given the risk of initiation, EU-wide advertising restrictions could protect this group and limit the impact of these products on health.
Date Issued
2025-09-06
Date Acceptance
2025-09-05
Citation
Tobacco Control, 2025
ISSN
0964-4563
Publisher
BMJ
Journal / Book Title
Tobacco Control
Copyright Statement
Copyright © Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group. This is the author’s accepted manuscript made available under a CC-BY licence in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy)
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40957677
PII: tc-2025-059522
Subjects
Advertising and Promotion
Non-cigarette tobacco products
Prevention
Public opinion
Public policy
Publication Status
Published online
Coverage Spatial
England
Date Publish Online
2025-09-16