Vaping and Nicotine Addiction in Adolescents

The market for e-cigarettes and tobacco products continues to expand, despite regulations and bans at the federal and local levels attempting to eliminate them in the region. 

In Latin America, this industry mobilized USD 150 million in 2021 and is forecast to reach USD 260 million by 2027.

Adolescents are the population group that is consuming these electronic nicotine delivery system (ENDS) devices the most. In a regional survey conducted in five countries with 6,550 children and adolescents, with an average age of 14, 27.8% said they had already used e-cigarettes. 

The 2022 Annual National Youth Tobacco Survey found that, in the United States, more than three million middle and high school students use some tobacco product, with e-cigarettes being the most commonly used. These young tobacco users do not experiment with it for “fun” on weekends, but are regular consumers, 10 days or more per month.

In Latin America, Brazil, Argentina, Mexico, Panama, Uruguay, and Venezuela have banned e-cigarettes, and other countries have raised their tobacco taxes or have raised the age limit for buying them, in order to limit their use. However, in the absence of strict enforcement of these regulations, e-cigarettes continue to circulate and to be consumed.

This consumption is extremely harmful for the entire population, especially for adolescents, at a critical stage when the brain and the body in general are still developing.

Electronic cigarettes (e-cigarettes) are highly engineered drug delivery devices that create and maintain addiction. Early e-cigarettes did not deliver nicotine as efficiently as cigarettes because the freebase nicotine (the nicotine originally in vape liquids) was too strong and therefore difficult to inhale. 

This situation changed with the 2015 introduction of Juul products, from Juul Labs, Inc., which added benzoic acid to nicotine e-liquid to reduce pH levels and form protonated nicotine. Protonated nicotine increases the addictive potential by facilitating the inhalation of amounts of nicotine that are difficult to achieve for inexperienced users, who have never consumed traditional cigarettes or the old electronic cigarettes.

When an adolescent inhales e-cigarette vapors combined with nicotine, the drug is rapidly absorbed through the blood vessels lining the lungs. It takes about ten seconds to reach the brain. 

In the brain, nicotine binds to acetylcholine receptors on neurons, releasing dopamine, which causes feelings of pleasure and alters the brain circuits involved in learning, stress, and self-control, leading to addiction and dependence.

Adolescents and young adults are particularly susceptible to these chemical processes and to addiction to nicotine receptors due to their greater brain plasticity, since the full development of the brain is only complete around age 25.

The cycle of tobacco addiction is similar to addition to other drugs; the more the brain and body get used to nicotine, the harder it is to give it up. When vaping is stopped, nicotine levels in the bloodstream drop, which can cause unpleasant sensations, physical symptoms, and a strong desire to vape. This is defined as nicotine addiction.

Marina Picciotto, a neuroscientist and researcher at Yale, offers a clear example. A student sitting in a noisy classroom, with traffic noise coming in through the window, needs to be able to divert their attention away from the distracting sounds to understand what the teacher is saying. 

“Brains not exposed to nicotine learn to decrease connections, and refinement within the brain can happen efficiently,” explains Picciotto. “But when you flood the system with nicotine, this refinement doesn’t happen as efficiently.” 

The appearance of e-cigarettes 15 years ago reversed the trend that had been achieved: a reduction in youth tobacco consumption and tobacco use in general. With its relentless search for new markets, the vaping products industry has once again increased consumption among adolescents, and this use is now starting at younger ages. 

Adolescents are completely unaware that this consumption will turn them into addicts. As Nii Addy, a neurobiologist at Yale University, explains, “nicotine, alcohol, heroin, or any drug of abuse works by hijacking the brain’s reward system.”

This story was produced using content from the original study and from other medical research, as well as health and public health sources, highlighted in related links throughout the article.