Introduction:
Europe faces a significant challenge with tobacco-related mortality, accounting for over 700,000 deaths annually. Alongside the persistent prevalence of smoking in some countries, the emergence of novel nicotine and tobacco products such as e-cigarettes and heated tobacco products (HTPs) has added complexity, leading to a landscape of dual and poly-product use and posing new challenges for public health policies and regulations.

Objective:
This study aimed to analyse the prevalence and patterns of dual and poly-use of both conventional and novel nicotine and tobacco products in Europe, with a focus on understanding the associated regulatory challenges. It also sought to offer evidence-based recommendations for comprehensive tobacco control policies to tackle increasing dual- and poly-product use.

Material and Methods:
A narrative review of recent studies was conducted, focusing on the prevalence of smoking and dual and poly-use of tobacco products across European countries by geographic regions. The study also reviewed current tobacco control policies, regulatory environments, and the impact of novel products on the market.

Results:
The results revealed a varying prevalence of smoking across Europe, with the highest percentages in the Central and Eastern regions. Novel products are gaining popularity, leading to a high prevalence of e-cigarette users and HTP users engaging in dual use, especially in Western and Northern European regions. The study identified regulatory gaps that could be strengthened to prevent the tobacco industry from exploiting marketing opportunities and highlighted the need for stricter controls on packaging, labelling, advertising, and taxation of products.

Conclusions:
The growing market for novel nicotine and tobacco products threatens existing tobacco control measures and adds complexity to the public health landscape. Implementing comprehensive, evidence-based policies that encompass all novel products is critical to reducing overall and dual and poly-product use. The findings call for Europe-wide monitoring, extended smoking bans, cessation support, and enforcement of advertising and taxation policies to safeguard population health and reduce the burden of non-communicable diseases.