There is evidence that adolescents who are exposed to nicotine may become addicted more rapidly, and at lower or more intermittent levels of consumption than adults.1-3 Evidence suggests that nicotine exposure during adolescence, a time during which the brain undergoes rapid development, may have a long-term negative impact on higher cognitive function.4,5 The US Surgeon General’s 2014 report on the health consequences of smoking noted that ‘the evidence is already sufficient to provide appropriately cautious messages to … adolescents about the use of nicotine-containing products such as smokeless tobacco and electronic cigarettes, and newer forms of nicotine-containing tobacco products, as alternatives to smoking’.4 The 2016 report similarly concludes that ‘nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain’.6
Aside from nicotine exposure, several studies with adolescents have found increased respiratory symptoms among e-cigarette experimenters.7 There is evidence that adolescents who use e-cigarettes experience increased cough and wheeze, and adolescents with asthma may be more likely to have an increase in respiratory symptoms and exacerbations compared with adolescents who do not use the products.8 Vaping is also associated with increased chronic bronchitic symptoms among adolescents.9 Another study reported significantly greater toxicant and carcinogen exposure in adolescent e-cigarette users compared with non-users.10
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1. McNeill AD. The development of dependence on smoking in children. British Journal of Addiction, 1991; 86(5):589–92. Available from: https://www.ncbi.nlm.nih.gov/pubmed/1859924
2. O'Loughlin J, DiFranza J, Tyndale RF, Meshefedjian G, McMillan-Davey E, et al. Nicotine-dependence symptoms are associated with smoking frequency in adolescents. American Journal of Preventive Medicine, 2003; 25(3):219–25. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14507528
3. Doubeni CA, Reed G, and Difranza JR. Early course of nicotine dependence in adolescent smokers. Pediatrics, 2010; 125(6):1127–33. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20439592
4. U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Available from: http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf.
5. England LJ, Bunnell RE, Pechacek TF, Tong VT, and McAfee TA. Nicotine and the developing human: a neglected element in the electronic cigarette debate. American Journal of Preventive Medicine, 2015; 49(2):286–93. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25794473
6. US Department of Health and Human Services. E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2016. Available from: https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/index.htm.
7. McNeill A, Brose LS, Calder R, Bauld L, and Robson D. Evidence review of e-cigarettes and heated tobacco products 2018: A report commissioned by Public Health England. Public Health England, London: Public Health England, 2018. Available from: https://www.gov.uk/government/publications/e-cigarettes-and-heated-tobacco-products-evidence-review.
8. National Academies of Sciences Engineering and Medicine. Public health consequences of e-cigarettes. The National Academies Press, Washington, DC 2018. Available from: http://nationalacademies.org/hmd/Reports/2018/public-health-consequences-of-e-cigarettes.aspx.
9. McConnell R, Barrington-Trimis JL, Wang K, Urman R, Hong H, et al. Electronic-cigarette use and respiratory symptoms in adolescents. American Journal of Respiratory and Critical Care Medicine, 2017; 195(8):1043–9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27806211
10. Rubinstein ML, Delucchi K, Benowitz NL, and Ramo DE. Adolescent exposure to toxic volatile organic chemicals from e-cigarettes. Pediatrics, 2018. Available from: http://pediatrics.aappublications.org/content/pediatrics/early/2018/03/01/peds.2017-3557.full.pdf