13 Vaping Nicotine and the Developing Brain

The History of Vaping

Tobacco and nicotine consumption has occurred for thousands of years. The many methods of nicotine use include smoking, chewing, sniffing, and most recently, vaping. The traditional cigarette was invented in the early 1800s, but its harmful effects weren’t discovered until the late 1940s (CDC, 2015). The realization of these negative effects motivated Chinese pharmacist Hon Lik to invent the e-cigarette as a safer, healthier alternative form of nicotine consumption. (Choucair, 2022).

The e-cigarette quickly became a non-medical method of quitting tobacco smoking, and advertising for the devices boomed (Choucair, 2022). This advertising caused many to believe, and still believe, that e-cigarettes are safer and better-tasting than cigarettes. While e-cigarettes can serve as a necessary stepping stone for people who want to quit smoking, e-cigarettes have also become a drug use practice of their own. Many young people use e-cigarettes but have never picked up a traditional cigarette.

The long-standing issue regarding the use of tobacco products among young people still exists today. The e-cigarette, although invented in 2003, did not become the most-used tobacco product among adolescents until 2014 (CDC, 2021a). Adolescent e-cigarette use has continued to grow since 2014. In 2019, 25.5% of 12th graders, 19.9% of 10th graders, and 9.6% of 8th graders reported vaping in the past 30 days (CDC, 2021b). The high rates of e-cigarette use among adolescents pushed the Food and Drug Administration (FDA) to implement anti-vape strategies in 2018. This ultimately led to an increase in the tobacco-product purchasing age from 18 to 21 in 2019 (Choucair, 2022).

Electronic e-cigarette devices, either disposable or rechargeable, heat a nicotine-containing liquid in order for the user to inhale the aerosol (CDC, 2022). This liquid contains high levels of nicotine, ultrafine metal particles, and potentially dangerous flavoring chemicals (CDC, 2022). Tanks and “mod” forms of e-cigarettes present unique risks because the composition of the liquid can be “modified” to contain a higher percentage of toxic chemicals. The batteries of these devices can also be replaced with stronger batteries that heat liquids to higher temperatures and produce more potent vapor (Laucks & Salzman, 2020). Rechargeable e-cigarettes often contain removable, flavored pods that contain more nicotine than a pack of cigarettes (Prochaska et al., 2021). E-cigarette technology is also found in the form of hookah and vape pens used to inhale THC (Choucair, 2022). To learn more about the effects of THC on the adolescent brain, visit this chapter.

Nicotine and the Brain

Research shows that adolescents may possess a higher risk for nicotine dependence due to their brain’s lack of maturity (Ferkol et al., 2018). Research on adolescent nicotine dependence through vaping remains limited. Still, the idea that nicotine from e-cigarettes causes addiction is supported by the fact that 90% of current cigarette smokers started smoking before they turned 18 (Ferkol et al., 2018). Frequent nicotine exposure affects the brain to a point where it needs the drug to function normally. If the nicotine use stops, it can cause withdrawal symptoms (Ferkol et al., 2018).

Nicotine affects the reward pathway of the brain by binding to neuron receptors and causing the release of dopamine (Herman & Tarran, 2020). Frequent exposure to nicotine can damage the receptors, leading to the cycle of craving that causes addiction (Herman & Tarran, 2020). The longer a person vapes nicotine products, the more nicotine receptors are created on neurons, and increasing the number of receptors increases the strength of cravings (Herman & Tarran, 2020). Quitting vaping may cause withdrawal symptoms because of the brain’s difficulty producing dopamine without nicotine (Herman & Tarran, 2020). When use stops, nicotine receptors slowly decrease, allowing brain structure to return to normal (Herman & Tarran, 2020). However, this process is more difficult for adolescent vapers because the reward pathway in the prefrontal cortex never fully developed before vape exposure (Goriounova & Mansvelder, 2012). Additionally, vape pods and vape liquids contain significantly more nicotine than a cigarette, contributing to a quicker onset of dependency compared to traditional cigarettes (Prochaska et al., 2021).

Other Cognitive Effects

Vaping increases levels of oxidative stress (Onojighofia, 2019). The developing brain of adolescents is more vulnerable to the effects of oxidative stress because of high oxygen consumption during development (Onojighofia, 2019). Research shows that oxidative stress contributes to sleep difficulty, cognitive impairments, aggressive behavior, difficulty paying attention, and mental health issues such as depression and suicide (Onojighofia, 2019).

Research on the long-term behavioral impacts of vaping continues to grow. The research shows that vaping can increase the risk of using other drugs throughout adulthood because nicotine increases brain sensitivity to other substances (Becker & Rice, 2021). Vaping can also affect short-term memory, and long-term inflammation caused by vaping may also impair memory functions (Prasedya et al., 2020).

The Role of Mental Health and Social Media

The rise in adolescent e-cigarette usage can be partly attributed to the increase in adolescent mental health disorders in the last ten years (Onojighofia, 2019). Mental health disorders have numerous negative implications on adolescents, including but not limited to poorer academic, social, and physical performance (Onojighofia, 2019). Adolescent vape use can also cause increased sensitivity to stress and negative emotions, which may contribute to mental health disorders even after vape use ends (Goriounova & Mansvelder, 2012).

Vape-normalizing content, peers who use vapes, and social media advertisements also contribute to adolescents’ use (Vogel et al., 2021). From 2019 to 2021, online time rose to over 5 hours for tweens and over 8 hours for teens (Moyer, 2022). This increased screen time increases exposure to vape content. Even brief exposure to influencers with vapes significantly increases adolescents’ chance of vaping (Vogel et al., 2021).

Conclusion

Throughout the 2010s, the e-cigarette industry boomed. By 2020, over 450 brands of rechargeable, disposable, or modified e-cigarettes were available (NIDA, 2020). Then in 2020, the FDA began regulating the sale of flavored vape cartridges marketed to minors and non-smokers (NIDA, 2020). As more dangerous effects of vaping emerge, the FDA should continue to regulate vape products to keep adolescents safe and healthy. In the US today, the sale of e-cigarettes to people under 21 is banned, and the FDA regulates every aspect of the creation, labeling, promotion, and sale of vapes (NIDA, 2020).

Vaping is a harmful behavior for adolescents. Nicotine addiction and other changes to the brain can result from adolescent vaping, and adolescents should learn about the effects that can occur. Social media and mental health contribute to the rise in adolescent vaping, and new legislation and information about the negative effects will hopefully lead to a decrease in adolescent vaping.

References

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Centers for Disease Control and Prevention. (2021a, September 30). Youth e-cigarette use remains serious public health concern amid COVID-19 pandemic. https://www.cdc.gov/media/releases/2021/p0930-e-cigarette.html

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