Although the prevalence of smoking has been steadily declining in high income countries over the past decades, a number of alternative and novel tobacco products have recently become popular among adolescents and young adults. These include roll-your-own tobacco, e-cigarettes, waterpipe and others. The role of these products as a gateway to regular smoking is still unclear, but their increasing popularity is a legitimate cause of concern, as adolescence is the period when most smokers take up smoking. This presentation will present evidence of the increased prevalence of alternative tobacco and nicotine products among youth using data from national and international surveys, such as the Global Youth Tobacco Survey, Eurobarometer, the UK Millennium Cohort study and others. There is wide variation in the prevalence of alternative tobacco products use among countries, which can be explained by the different tobacco control policies, price differentials between products, tobacco market characteristics and cultural factors. Tobacco control policies and regulations should be updated to effectively prevent uptake of tobacco use in any form among children and adolescents.