Novel nicotine and tobacco products in pediatric age: a joint position paper

Electronic nicotine delivery systems (ENDS), heated tobacco products (HTP), and nicotine pouches have rapidly gained popularity among adolescents, driven by appealing flavors, targeted marketing strategies, and widespread misperceptions of reduced harm. This joint position paper, endorsed by the Italian Society of Pediatrics (SIP) and the Italian Pediatric Respiratory Society (SIMRI), considers current evidence on patterns of youth use and outlines potential prevention strategies. We examine industry tactics, including social-media influencer campaigns and product design features that disproportionately attract adolescents, and discuss the influence of peer, family, and environmental factors on product uptake. Parents and caregivers play a pivotal role through open dialogue, modeling nicotine-free behaviors, and monitoring access. Pediatricians and primary-care providers should incorporate routine screening for all nicotine products into well-child visits, deliver brief motivational counseling, and connect families with cessation resources tailored to teens. Continuous surveillance of youth consumption patterns and systematic evaluation of intervention effectiveness will ensure strategies remain responsive to evolving product designs and marketing practices. Through coordinated policy changes, healthcare support, community action, and education, it is possible to prevent nicotine initiation among adolescents and foster a generation free from smoke and vaping addiction.