Youth Tobacco Survey in Nepal: Early Increase in Use of Harmful Substances Like Vape and Hookah

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A recent survey indicates that beyond traditional cigarette and tobacco use in Nepal, there is a rising trend among young teenagers experimenting with harmful substances such as marijuana, vape, and hookah at an early age.
The survey reveals that while the consumption of conventional tobacco products continues, the use of newer and harmful substances like e-cigarettes (vape), hookah, and sheesha is also increasing significantly among youth.
Medical experts have expressed concern over this situation and recommend the development of suitable policies to address it.
What Did the New Survey Find?
The Nepal Health Research Council (NHRC) has prepared the preliminary report of the Youth Tobacco Survey 2025.
The survey was conducted over nearly one year across 50 schools representing all seven provinces, covering over 3,000 students from grades 7 to 10, said researcher Kusum Shahi.
“Our aim is to understand tobacco use among school-aged students and to use these findings to develop appropriate policies,” said Namita Ghimire, acting member secretary of the council.
According to the preliminary report, 18.7% of teenagers attending educational institutions have used some form of tobacco product, including cigarettes, gutkha, and beedi, as well as hookah, sheesha, and e-cigarettes (vape).
For the 13 to 15-year age group, the usage rate stands at 17.5%.
PA
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17.5%Percentage of Users Aged 13–15 Years
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41.5%First Tobacco or Vape Use Before Age 10
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39,200Annual Tobacco-Related Deaths in Nepal
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NPR 4.5 BillionAnnual Economic Burden Due to Tobacco Use
Source: Nepal Health Research Council, Ministry of Health, World Health Organization
Rising Use of Vape
Within this age group, the use of new substances such as e-cigarettes (vape), hookah, and sheesha has doubled compared to traditional tobacco products.
A similar survey in 2011 revealed little change in traditional tobacco use since then; however, the addition of e-cigarettes, vape, sheesha, and hookah has made the overall situation more challenging.
“The key finding from our survey is the increasing trend in the use of these new tobacco products,” said researcher Kusum Shahi.
Another alarming fact is that approximately 41.5% of the surveyed students tried tobacco or vape products before the age of 10.
The survey further points out that easy availability and access have exacerbated the problem. Despite regulations forbidding the sale of tobacco products within 100 meters of schools, enforcement remains ineffective, and some parents still send their children to buy cigarettes or chewing tobacco.
Serious Health Impacts
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According to the World Health Organization, tobacco use leads to premature death, multiple diseases, imposes a high economic burden on community health, increases socioeconomic inequality, and hinders sustainable development goals.
A report published two years ago by WHO in collaboration with Nepal’s Ministry of Health states that approximately 39,200 people die annually in Nepal due to tobacco-related diseases.
The economic loss attributable to tobacco use exceeds NPR 4.5 billion annually.
Tobacco use is a major cause of non-communicable diseases such as cancer, diabetes, respiratory diseases, and heart diseases. Approximately one in four adults in Nepal consumes cigarettes or some form of smokeless tobacco.
Greater Impact on Younger Youth
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Experts say tobacco products have a more severe impact on younger people compared to adults.
Dr. Jagatjivan Ghimire, a pediatric pulmonologist at Kanti Children’s Hospital, expressed concern over the growing use of vape or e-cigarettes among teenagers, particularly in urban areas.
“Worldwide, the use of such substances has led to increasing cases of severe lung injury known as ‘vape-induced lung injury’ (VILI),” Dr. Ghimire explained.
“Similar cases are now emerging in Nepal. Continuous vape use at a young age can endanger lives and lead to serious respiratory complications ranging from chronic cough to pneumonia and ARDS (acute respiratory distress syndrome).”
He emphasized the necessity of targeted programs in schools and colleges to prevent access to these products.
“Our survey clearly shows these substances have a profoundly negative effect on young people,” he added.
It is important to raise awareness that not only traditional products like cigarettes and chewing tobacco but also vape/e-cigarettes, sheesha, and hookah are harmful, experts stress.
Though these products are often marketed as flavored and smoke-free, specialists note they contain addictive compounds like nicotine and other toxic chemicals.
The U.S. Centers for Disease Control and Prevention (CDC) warns that no tobacco product, including e-cigarettes and vape, is safe. The highest risks are for pregnant women, fetuses, and young populations.
E-cigarettes contain carcinogenic chemicals and fine particles that can reach deep into the lungs and cause serious harm.
The NHRC has said that the final report of the Youth Tobacco Survey in Nepal will be published soon, aiding the government in formulating effective policies.
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