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Objective. To determine the trends in the structure and assess medical, social and clinical aspects of the consumption of tobacco and nicotine-containing products among adolescents aged 1417. Material and methods. During the study, 352 adolescents aged 14 to 18 years studying in urban (n = 202) and rural (n = 150) schools of Yaroslavl region were surveyed in 20202021. Statistical processing of the data was carried out using computer programs "Statistica" v.10.0. Results. The survey of teenagers revealed a fairly high prevalence not only of active tobacco smoking (tried 37 %, actively smoked 30 % of adolescents), but also the use of "new" nicotine-containing products (vape, hookah, electronic cigarettes, snus, snuff) (tried 38 %, actively used 7 % of teenagers). The structure of active tobacco use and NRTI use was found to differ by the place of residence. Active tobacco use accounted for 46.7 % of rural adolescents and 19.8 % of urban residents (p 0,01). Conclusions. In modern adolescents, along with tobacco smoking, a negative trend has been detected to increase the use of nicotine-containing products, especially hookah. This substantiates the need to improve educational anti-nicotine programs, to introduce a system of regular regional monitoring of the prevalence of traditional and new nicotine-containing products use among children and adolescents in order to make quick and effective decisions.