By Nadine Cohen
E-Cigarette use in teenagers and young adults is at an all-time high. According to a study done by the Centers for Disease Control and Prevention in 2018, more than 3.6 million U.S. middle and high school students used e-cigarettes in the past 30 days, including 4.9 percent of middle school students and 20.8 percent of high school students.
Electronic nicotine delivery systems are marketed under a variety of names, most commonly electronic cigarettes and e-cigarettes. The flavors, designs, and marketing of e-cigarettes all combine to appeal to teenagers and result in normalizing the products, creating a false sense that the nicotine and tobacco product used in them is “harmless.”
While original e-cigarettes more closely resembled traditional cigarettes, newer models are made to resemble common objects such as a USB flash drive, pen or flashlight. This design methodology also helps to promote a false sense of security for teens who do not associate it with conventional cigarettes. To that note, in one study published by the American Journal of Preventive Medicine, those who used flavored e-cigarettes were much more likely to continue to use the products, compared to those who used tobacco-flavored ones.
Since 2011, the growth in e-cigarette use is due to a significant increase in the advertising of these products in areas frequented by teens such as television, movies, video games, social media and the internet. According to one study published in Pediatrics, the Journal of the American Academy of Pediatrics, 80 percent of U.S. youth age 12 to 17 years were exposed to an average of 13 e-cigarette advertisements over a one-year period.
There is also an ease of access for teenagers. While many states in recent years have created laws restricting the sale of e-cigarettes, there are no federal regulations limiting the sale of them over the internet. Therefore, anyone of any age can purchase these products online.
Exposing the developing adolescent brain to nicotine has real consequences, as the adolescent brain has not fully matured. The chemical exposures change the way the brain works, affecting connections in the brain, and thus potentially impacting “executive functioning” or decision-making, and other processes and connections in the brain. Exposure to nicotine at a younger age increases the likelihood of addiction to nicotine and other dangerous substances in the future.
E-cigarettes and regular cigarettes deliver nicotine, which activate and stimulate receptors in the brain, triggering the release of a powerful neurochemical substance called dopamine. This stimulates the brain’s “reward system” and pleasure centers, leading to a cycle of addiction to the dangerous and addictive substance.
Nicotine also stimulates the adrenal glands to release the hormone epinephrine (adrenaline). This increases heart rate and blood pressure and therefore, overtime, impacts the cardiovascular system throughout the body.
Since e-cigarettes are not regulated, there are unpredictable levels of nicotine found in them and therefore cannot be used as a consistent aide in cessation. Many studies have found no association between e-cigarette use and successful cessation of conventional cigarette use.
The dramatic increase of e-cigarette use by teens in recent years is a serious concern. It is now the most commonly used form of tobacco in the United States. This should serve as a call to action for schools, government, health care providers and parents to take proactive steps to educate youth on the dangers of e-cigarette use and work to reduce its use in this vulnerable population.
Nadine Cohen, internal and adolescent medicine specialist at CareMount Medical’s Thornwood office, sees both adult and adolescent patients ages 12 years and older. She has privileges at Northern Westchester Hospital. For additional information about CareMount Medical and its specialties, visit www.caremountmedical.com.
