Series: Nicotine in a New Generation—Part 1 of a Two-Part Series
By Tishe Daini
Exam season hits harder than a ton of bricks. In class, your heavy-lidded eyes fight through a fog of stress and anxiety, burdened by the weight of sleepless nights. You can’t handle it much longer— you crave some sort of temporary escape.
A moment of relief.
Noticing your exhausted state, a friend approaches you.
“What’s wrong?” they ask.
You mutter your worries, explaining the pressures creeping up on you. After listening, they discreetly pull a sleek, brightly coloured device from their pocket.
You instantly recognize it.
It’s a vape.
“Here, I feel you. Take a hit of this. It’ll calm you down,” they say with a reassuring smile.
You hesitate, but desperation and peer pressure cloud your judgement.
Your first inhale burns, sending you into a fit of dry coughing. Yet, moments later, a brief wave of relief washes over. For a moment, your lingering worries seem distant.
A month passes. Not a day goes by without reaching for a vape. Puff after puff, the initial feeling fades. Instead of stopping however, you endlessly chase it, vaping more in search of something that’s already slipped away.
“Instead of stopping, you endlessly chase it, vaping more in search of something that’s already slipped away.”
The Changing Landscape of Nicotine
This depiction seems dramatized, but it is a legitimate concern for teenagers who begin recreational use of e-cigarettes (vapes) and other nicotine delivery systems.
Admittedly, a surface-level look into adolescent nicotine consumption might initially suggest a positive trend of decreasing exposure since fewer teens are opting for traditional combustible cigarettes. And while this statistic highlights the extensive work done by concerned groups to improve educational awareness on smoking dangers and protective regulation, it critically overlooks the pressing youth health concerns posed by emerging nicotine products.
In fact, the scale of this problem is becoming increasingly difficult to ignore. The World Health Organization (WHO) now estimates that at least 40 million children aged 13 – 15 worldwide use tobacco products, with more young people choosing to use e-cigarettes, nicotine pouches, and other nicotine products (WHO, 2026).
This is significant because these modern-day nicotine devices are relatively new additions to consumer markets in comparison to tobacco cigarettes that have been mass produced since the 19th century!
Consequently, there is limited research on the long-term health effects on young people that opt for these devices.
So, without fully understanding the risks, teen users of these novel products are essentially going in blind, entrusting their lives in the hands of the nicotine industry.
This risky youth experimentation of nicotine delivery systems therefore presents a multi-faceted public health concern shaped by nicotine’s psychological and physiological effects, adolescents’ unique susceptibilities, and exploitative industry practices that could leave lasting consequences for a generation of young people.
How Nicotine Affects the Brain and Body
Nicotine is a harmful chemical compound and stimulant found in e-cigarettes, nicotine pouches, and other similar products. Its primary danger is the debilitating cycle of dependence it triggers in users.
When nicotine enters the body, it engages with nicotinic acetylcholine receptors (nAChRs) in a few seconds. These interactions send signals to the reward area of the brain, stimulating the release of dopamine which generates short-lived feelings of pleasure, relaxation, and an improved mood. Hence, every time nicotine is used, dopamine levels surge.
However, nicotine is cleared out from the body rather quickly, causing a steep decline in dopamine levels. This results in an insatiable craving for more nicotine. Crucially though, if one gives in and continues use, their neuronal receptors undergo harmful adaptive changes. Over time, these changes contribute to a stronger need for nicotinic stimulation to achieve the reward of smoking or vaping—trapping users in an addictive cycle (Truth Initiative, 2026).
Worst of all, long-term nicotine dependence can indirectly facilitate physiological harm. This is because many nicotine devices on the consumer market contain toxic chemicals and metals that can harm the lungs and other essential organs.
According to the American Lung Association (ALA), chemicals found in e-cigarettes include carcinogens such as acetaldehyde, acrolein, which can cause irreversible lung damage, and diethylene glycol, a toxic chemical also used in antifreeze (ALA, 2026). As a result, when you consider both the risk of addiction and the potentially poisonous chemicals found in nicotine devices, it becomes evident that nicotine is not a substance to be taken lightly.
Why Adolescents are Especially Vulnerable
There are unique neurobiological, social, and environmental risk factors that influence teen nicotine initiation. Teenagers regularly deal with academic stress, social anxiety, and a whole host of pressures that present nicotine as a tempting coping mechanism. However, their developing brains are what makes them especially susceptible to nicotine’s effects.
As noted by the National Institute of Mental Health (NIMH), the brain does not fully develop until the mid–to-late 20s, while the prefrontal cortex is one of the last areas to mature (NIMH, 2023). The prefrontal cortex is relevant because it impacts judgement, decision-making, and self-control. In adolescents, its ongoing development could contribute to an increased susceptibility to impulsive decisions like consuming nicotine.
Crucially, this neural vulnerability could not only contribute to teen nicotine use but also compound its negative health effects. Exemplifying this is a report from the Centers for Disease Control and Prevention (CDC) stating that nicotine exposure during adolescence can “harm the parts of the brain that control attention, learning, mood, and impulse control” (CDC, 2025). Given that essential neural connections are actively formed in the brain during adolescence, nicotine exposure could adversely affect these neurological processes.
Hence, teens currently face a paradox where their developing brains may increase their susceptibility to initiating nicotine use, while that same developmental stage makes nicotine exposure particularly concerning.
How the Nicotine Industry Targets Youth
Concerned public health organizations are not the only ones that are aware of adolescents’ neural susceptibility to nicotine. As it turns out, the industry pumping out these nicotine products has recognized these vulnerabilities, refining age-old tactics to lure in a younger customer base.
Aiming to dissociate from negative public perceptions of smoking, manufacturers are striving to create an increasingly marketable look for new nicotine devices, doing away with the raw, grimy presentation of traditional cigarettes for sleeker and more stylish high-tech products that teens may view as socially acceptable.
Crucially, an article from the Truth Initiative further reports that “e-cigarette brands frequently use youth-appealing imagery, bright colors, fun flavor descriptions, and toy-like packaging” to attract young people (Truth Initiative, 2026). These marketing strategies are significant because they combine elements of excitement with social buzz, offering an enticing product that appeals to the thrill-seeking tendencies of teenagers.
Additionally, social media advertising is the fast-evolving avenue for the nicotine industry’s youth targeting. On apps like Instagram and TikTok, brands offer subtle paid sponsorships to youth influencers and content creators to publicly use their nicotine products, exposing their young fanbases in the process. Another notable tactic highlighted in a piece from the Yale School of Medicine is “incentivized friend-tagging” in which e-cigarette companies encourage their followers to tag other social media accounts on brand posts to win free or discounted products (Backman, 2024).
Ultimately, these tactics all try to capitalize on common teen values such as identity formation, novelty-seeking, and social conformity, exploiting a younger consumer market.
A Public Health Dilemma
Despite understanding the deleterious long-term health effects of youth nicotine addiction, curbing this issue effectively still proves to be difficult due to the conflicting interests of adult nicotine consumers.
Nicotine products are not exclusively used by teenagers. In fact, a recent tobacco trends report from the WHO suggests that more than 86 million of the over 100 million e-cigarette users are adults (WHO, 2025).
A notable potential reason for this e-cigarette use is nicotine replacement therapy (NRT), which research has found to be a viable smoking cessation tool for adults (Beis et al., 2025).
Importantly, this presents a dilemma where suggested measures to prevent youth nicotine use such as price increases and capping the number of retail outlets, could unfairly restrict access to current smokers who are trying to use nicotine products as a tool for quitting.
This could in turn be viewed as an infringement on the broader population of adult consumers who are simply exercising their individual autonomy.
Conversely, a failure to impose strict access restrictions could result in further youth exposure and nicotine initiation, creating an ongoing public health concern for lawmakers.
Ultimately, what is needed is a balanced, multilayered approach combining efforts from government bodies, the nicotine industry, and public health/educational institutions to preserve the individual autonomy of adult consumers while protecting a generation of young people from the harmful, addictive effects of nicotine use.
“What is needed is a balanced, multilayered approach … to preserve the individual autonomy of adult consumers while protecting a generation of young people.”
In the second part of this Nicotine in a New Generation series, we will explore relevant potential solutions while offering unique insights from concerned healthcare professionals.
You do not want to miss it!
References and Further Readings
American Lung Association. (2026, June 2). What’s in an e-cigarette? https://www.lung.org/quit-smoking/e-cigarettes-vaping/whats-in-an-e-cigarette
Backman, I. (2024, November 22). How social media promotion of vaping targets teens. Yale School of Medicine. https://medicine.yale.edu/news-article/how-vaping-social-media-promotion-target-teens/
Beis, I., Dimou, A., Kotoulas, S.-C., & Pataka, A. (2025). Nicotine replacement therapy as a smoking cessation tool for adolescents: An update. Frontiers in Psychiatry, 16, 1525510. https://doi.org/10.3389/fpsyt.2025.1525510
Centers for Disease Control and Prevention. (2025, January 31). Health effects of vaping. https://www.cdc.gov/tobacco/e-cigarettes/health-effects.html
National Institute of Mental Health. (2023). The teen brain: 7 things to know. https://www.nimh.nih.gov/health/publications/the-teen-brain-7-things-to-know
Truth Initiative. (2026, February 19). Four marketing tactics e-cigarette companies use to target young people. https://truthinitiative.org/research-resources/tobacco-industry-marketing/4-marketing-tactics-e-cigarette-companies-use-target
Truth Initiative. (2026, April 6). Breaking the cycle of nicotine addiction and withdrawal. https://truthinitiative.org/research-resources/quitting-smoking-vaping/breaking-cycle-nicotine-addiction-and-withdrawal
World Health Organization. (2025, October 6). WHO tobacco trends report: 1 in 5 adults still addicted to tobacco. https://www.who.int/news/item/06-10-2025-who-tobacco-trends-report-1-in-5-adults-still-addicted-to-tobacco
World Health Organization. (2026, May 29). WHO urges governments to protect young people from addiction to tobacco and nicotine products. https://www.who.int/news/item/29-05-2026-who-urges-governments-to-protect-young-people-from-addiction-to-tobacco-and-nicotine-products
Acknowledgements
I would like to thank my research assistants, Yide-Abasi Essien and Leinad Delgado, for their contributions to this project. Their preliminary research and individual research summaries helped provide the foundation for my own investigation into youth nicotine use. They also took the time to review the completed piece and provide valuable feedback. I greatly appreciate their time, effort, and support throughout the research and writing process.
Leave a Reply