Though marketed as healthier alternatives to the traditional cigarette, popular e-cigarettes, vape pens, and nicotine pouches are all potently addictive and deceptively harmful—especially for teens and adolescents, who are becoming hooked on nicotine products at alarming levels, according to SMH Comprehensive Lung Care Center Program Leader Amie J. Miller, APRN.
The growing problem can be explained in three simple truths:
1) E-cigs and vapes are full of superheated toxic substances
When someone takes a puff on an e-cig or vape pen, the liquid nicotine solution inside is rapidly superheated into the vapor they inhale. But each puff contains far more than water and nicotine.
Many of these nicotine solutions contain high levels of carcinogenic chemicals, such as formaldehyde and acrolein, as well as heavy metals, including nickel, tin and lead, which are all pulled into the lungs alongside the addictive nicotine.
Still, respiratory health professionals are seeing an alarming uptick in the number of people, particularly children in middle school and high school, picking up the habit.
“It’s an epidemic,” Miller says.
2) Nicotine is much more harmful than previously known.
“Nicotine is particularly toxic for younger populations,” Miller says, noting significant effects on brain development and mental health.
Studies have shown that nicotine can impair brain development even into the mid-20s and can intensify symptoms of depression and anxiety, as well as increase stress levels, despite often being portrayed as a stress reliever.
“Nicotine hijacks the brain’s stress response,” says Miller, “creating a chemical trap that mimics anxiety relief while actually fueling it.” It does so by triggering the release of both dopamine, which feels good, and cortisol, the body’s primary stress regulator, which activates your “fight or flight” response. So instead of calming your nerves, nicotine actually keeps your body in a state of heightened physiological stress, thinking more nicotine is the only answer.
Young people are also experiencing serious cardiovascular issues from nicotine use, which raises blood pressure and damages blood vessels, all while increasing general risk of heart disease.
3) Tobacco companies continue to target teens and students.
“The tobacco industry understands nicotine’s cycle of dependency and continues to prey on our youth,” says Miller. “They are continually developing products that are appealing to young people and finding new ways to get our kids addicted to nicotine, therefore ensuring customers for life.”
These products include:
- High-tech "smart vapes.” Complete with games, digital screens, and animations, one third of all youth report using a smart vape, making it the top seller.
- Flavored disposable e-cigarettes. Use of disposable e-cigarettes is widespread among teens, driven by fruit-, candy-, and dessert-flavored products.
- Oral nicotine pouches. No smoke, no vapor, and easy to conceal, 2024 saw flavored oral nicotine pouch sales increase more rapidly than any other nicotine product.
Nicotine products have also grown stronger. Many vapes and e-cigs contain nicotine equivalent to an entire pack of traditional cigarettes but are much easier to consume. And the new oral pouches contain extremely high levels of nicotine.
Dependence then develops quickly, and withdrawal symptoms like irritability, anxiety, dysphoria, and impaired concentration make quitting difficult. Early exposure only increases this addiction risk.
“And kids have totally jumped on board,” Miller says.
A Silver Lining to the Smoke Cloud
The good news is that many of these negative health effects can be reversed.
Quitting nicotine can reduce depression and anxiety symptoms as effectively as taking antidepressants and is one of the most effective ways for anyone to improve long-term mental wellness. Anxiety levels drop within weeks and the shift in mental clarity is significant.
And according to a recent survey, 67% of young adults plan to quit nicotine in 2026.
“But unless policy makers step in,” Miller says, “the tobacco industry will continue to use our kids as human guinea pigs and exposing entire generations to the dangers of nicotine addiction, and it’s not going to be pretty.”
Until then, parents need to ensure children and teens understand the dangers of nicotine abuse and addiction.
Ready to Quit Nicotine?
Look below for more information, Sarasota Memorial services, community resources and programs helping people quit tobacco every day.
Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, KY, and has been tobacco-free since 2019.