Initially, electronic nicotine delivery systems were not marketed to target teenagers. However, their sleek design and soothing fruity flavors had a consequential appeal to youth. For example, the first highly popularized e-cigarette by JUUL gained traction in 2015. Shaped like a USB drive and mango flavored, JUUL and similar e-cigarette brands quickly became the cool new gadget that proliferated on social media to a substantial network of teenagers.
Unfortunately, the brain does not fully develop until 25 years old, and adolescence is matched with exclusive behavioral changes — including risk-taking and peer associations — to understand the transition to independence. During maturation, structural and functional reorganization of gray matter and white matter, which make up the cells of the nervous system and neurochemical systems, renders the brain acutely sensitive to new experiences. Plasticity, an experience-dependent ability by the brain to reorganize itself through external stimuli, occurs in the developing prefrontal cortex — the part of the brain responsible for executive performance and decision-making.
The unique neuroplasticity of the adolescent brain explains its vulnerability to nicotine addiction. Specifically, nicotine consumption rewires the brain by altering the functioning of synapses in the prefrontal cortex that underlie cognitive function: When nicotine enters the blood system through the lungs, it reaches the brain in just 10–20 seconds where it binds to the target nicotinic acetylcholine receptors. It then participates in cholinergic signaling, an essential process to cognitive function. As a result, the adolescent brain becomes more sensitive to long-lasting changes in nicotine binding and brain function, leading to impaired cognitive processing.
While marketed as an aid to cease smoking cigarettes as a “safer” alternative, e-cigarettes are not subject to FDA regulation and foreshadow serious subsequent addictions. Research indicates that among youth who have never smoked a cigarette, recent vapers are more likely to smoke cigarettes in the future. These results contribute to the evidence supporting that vaping is the strongest link to cigarette smoking among youth. So, how much “safer” really is vaping compared to cigarettes?
Nicotine creates adverse effects on cardiovascular and lung systems, and a continued history of smoking during teenage years predicts cognitive impairment later in life. Several studies also show that nicotine consumption during adolescence also has long-lasting effects on emotional behavior and is associated with a later risk of developing mental disorders including depressive disorder, panic disorder, addiction to other substances, personality disorders, and academic problems.
“Exacerbated by the recent increase in electronic cigarette popularity and its rapidly evolving market, the nicotine epidemic has developed into one of the largest global public health crises with millions of users.”
This poses a significant issue as the demographic of e-cigarette users has been dominated by adolescents. Entering the marketplace in 2007, vaping has been the most common form of nicotine consumption among youth since 2014. Exacerbated by the recent increase in electronic cigarette popularity and its rapidly evolving market, the nicotine epidemic has developed into one of the largest global public health crises with millions of users. As tobacco claims the leading cause of preventable death again this past year, how can electronic nicotine delivery systems be marketed away from the youth population? How will government agencies and public health services address the widespread teenage addiction to vaping?
