Background <p>For pulmonologists it is relevant that tobacco control measures in Germany have so far been insufficiently implemented, which is reflected in a persistently high prevalence of smoking. At the same time, new products such as e‑cigarettes, heated tobacco products and shishas are becoming increasingly more popular, particularly among young people. Cannabis, legalized under certain conditions since 2024, is most often consumed in combination with tobacco. Patterns of co-use are increasingly observed, for example the use of both cigarettes and e‑cigarettes or of tobacco and cannabis.</p> Research question <p>What are the prevalence and trends in the use of inhaled tobacco and nicotine products as well as cannabis in Germany and how do these differ between age groups?</p> Material and methods <p>A narrative review of representative population surveys on current prevalence rates and trends is presented.</p> Results <p>The prevalence of cigarette smoking has remained around 29% in recent years. Among persons 18–25 years old it declined from approximately 44% (2008) to about 25% (2023). The prevalence of heated tobacco products, e‑cigarettes and shishas is ≤ 4% in the general population and between 4% and 14% among adolescents, depending on the product. Among persons 14–17 years old e‑cigarette use recently increased to nearly 14% (2023/2024). Cannabis use remains low among persons 12–14 years old (around 2%), has recently decreased to about 5% among those 15–17 years old and reaches more than 11% among young adults. The co-use of multiple products is widespread.</p> Conclusion <p>Germany continues to show a&#xa0;high prevalence of smoking. New products are gaining importance, particularly among young people. For pneumology, this underscores the need for a thorough history taking and targeted counselling, including systematic screening. More consistent tobacco control measures, stricter regulation of new products and preventive behavioral approaches are required.</p>