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Nicotine

Learn about the dangers of tobacco products and nicotine addiction on the body and the mind, the risk factors, and how to quit.

Too many young people and adults use tobacco products, which can lead to chronic and deadly health effects. In addition, nicotine is a toxic and highly addictive substance that can lead to long-term dependence.

It’s true that nearly 40% fewer Americans smoke traditional cigarettes now than they did in 2000. However, the numbers of those puffing on regular and flavored cigars in that time jumped by 85.2%. In addition, use of smokeless tobacco hasn’t dropped much in two decades. And with nearly 13.3% of high schoolers still vaping — exposing them to an addictive chemical that can harm young brains and increase the likelihood of trying regular cigarettes — a new generation is at risk of becoming hooked on nicotine.

Quitting smoking is more important than ever.

A majority of youth and young adult e-cigarette users surveyed say they want to quit. This is Quitting can help 13-24 year-old vapers quit with free, anonymous daily text messages. Text DITCHVAPE to 88709 to enroll.

Parents who want resources to help their child quit can visit BecomeAnEX.org for information, a supportive community, and guiding text messages and emails.

Dangers of tobacco use and nicotine addiction

Despite the nation’s progress in bringing down youth smoking rates to an all-time low of 2.3% in 2021, tobacco use is still the leading cause of preventable death and disease in America. Smoking is the main cause of chronic obstructive pulmonary disease (COPD), a condition that includes emphysema and chronic bronchitis and makes it hard to breathe.

In addition to the ways smoking cigarettes can harm our lungs, tobacco products that are smoked, vaped, heated, or used in smokeless form can pose various other dangers to our physical and mental health, and to our environment from secondhand smoke and paper, plastic, and electronic waste. Here are some hazards of the most commonly marketed products:

Traditional tobacco products

  • Cigarettes: Smoking cigarettes can harm just about every part of the body and is the cause of roughly 30% of all cancer deaths. Tobacco smokes contain nearly 70 carcinogenic properties, and is why smokers die from cancer at twice the rates of nonsmokers and why heavy smokers die at four times the rate of nonsmokers. In addition to causing many other illnesses and conditions, smoking also raises the risk of heart diseases such as stroke, heart attack, vascular disease, and aneurysm. Young people who smoke have reported experiencing reduced quality of life
  • Cigars, little cigars, and cigarillos: In addition to being responsible for 9,000 premature deaths in people over age 35, cigar smoking is connected to higher risk of oral, esophageal, laryngeal, and lung cancers; heart disease; and gum disease and tooth loss.
  • Hookah and other flavored tobacco: Just because hookah, or flavored tobacco smoked through a water pipe, is enjoyed in a social setting doesn’t make it less dangerous: one hour of hookah produces the smoke of 100 or more cigarettes. And hookah use can lead to nicotine dependence.

Smokeless tobacco such as chew, snuff, and dissolvable tobacco: A main danger of these products is they can lead to nicotine dependence. In addition, they can cause precancerous oral lesions, and oral, esophageal, and pancreatic cancers and may contribute to the risk of heart disease. Children who ingest these products can be poisoned.

E-cigarettes, vapes, and heated tobacco devices: Vaping nicotine frequently puts people over age 18 at nearly 2.5 times higher odds of having a diagnosis of depression compared to never users, according to a study of 30,000 e-cigarette users. The same study found vaping users are also more apt to report having poor mental health in the past month. Researchers think trace metals in vape liquid might be worsening the mental health of vaping users. Other research shows that using nicotine, including through a vape, is associated with higher levels of ADHD and anxiety symptoms.

The Food and Drug Administration allowed Philip Morris International to claim in advertising that its heated tobacco product, IQOS, reduces adult smokers’ exposure to the harmful chemicals of combustible cigarettes. But the FDA said this is the case only if they completely transition away from traditional cigarettes to such a product, which operates by placing a tobacco stick into a device that’s heated to create an inhalable aerosol. And, the agency made clear, the product is not a “safe” tobacco product.

Risk factors

Avoiding use of tobacco products is the best way to prevent nicotine dependence and to prevent the transition from vaping nicotine to traditional smoking. Knowing the risk factors can help you stop a friend or family member from using nicotine or make a plan to quit. In general, more men than women use all tobacco products. Here are some other specific risk factors for use of certain products:

Traditional tobacco

  • Most people who smoke regularly begin when they’re young: Nearly nine of out 10 adults who become daily smokers first try smoking by age 18, and 99% try smoking by age 26.
  • People are more likely to smoke if they are living with mental health and substance use issues, have attained lower rates of education, or live below the poverty line.

Smokeless tobacco

  • Males are far more likely to use smokeless tobacco products than females, and more white men use these products than other ethnic groups.
  • Younger people, especially in the age bracket of 25-44 years, are more likely than other age groups to use these products.
  • An estimated 12.8% of military personnel use smokeless tobacco, which is more often used by people living in the South and Midwest.

E-cigarettes, vapes, and emerging tobacco products

  • Among adults who vape, nearly 90% were current or former smokers.
  • Among youths and young adults (aged 18-24 years) who vape — the group for which vaping is most popular — 40% had not been regular cigarette smokers.
  • Among youths, flavored vapes hold the most appeal: In 2021, nearly 86% of high schoolers and 79% of middle schoolers who said they used an e-cigarette in the past 30 days reported that it was flavored.

How to quit

If you smoke or vape, chances are you want to quit. (Nearly 70% of smokers say they want to stop, and more than half of young vapers surveyed recently said they wanted to quit.) The good news is you don’t have to go “cold turkey,” a method that’s not very successful anyway. Take advantage of the many available and effective quit medications, therapies, resources, and digital tools:

  • Medications. Start by exploring the many FDA-approved medications that aid in quitting. By reducing withdrawal symptoms, these nicotine replacement therapies have been shown to improve quit rates by 50% to 70%. They come over the counter or by prescription in the form of gums, lozenges, patches, inhalers, nasal sprays, and tablets. You can also get a prescription for FDA-approved medications that may help you quit, such as varenicline (marketed as Chantix) or bupropion SR (sustained release).
  • Counseling and coaching. Medication combined with counseling and coaching interventions from health care and help line professionals can increase your success in quitting smoking. Call 1-800-QUIT-NOW for free coaching or get free online resources through gov/quit and SmokeFree.gov.
  • Family and social support. Another effective way to quit is to let friends and family know you’re trying to quit, and ask for their support. If you’re a parent, learn about the vaping and nicotine products that appeal to kids such as flavored vapes and nicotine pouches, lozenges, and synthetics, and discuss why they should avoid or stop using them.
  • Other resources. Experts also suggest distracting yourself from nicotine cravings, which can fade, by grabbing a healthy snack, getting some exercise, or disrupting the habits or triggers that spark the urge to smoke. Also rely on printed self-help materials to assist in quitting.
  • Digital tools. Studies show that web-based platforms where you can share messages, stories and discussions with other former smokers are effective cessation tools. A study of the Truth Initiative-Mayo Clinic’s BecomeAnEx digital program demonstrated that online participants were less likely to be smoking three months after enrollment. Text message programs such as This is Quitting increase by nearly 40% the chances that a young person will quit vaping. Urge youths you know who vape to join the free service by texting DITCHVAPE to 88709 enroll and start receiving messages from peers stopping use of e-cigarettes.

Talk to your kids about preventing or quitting tobacco and nicotine products. 

https://startyourrecovery.org/who/parents

Many thanks to the Truth Initiative for helping source, review, and edit the content on this page.

Sources

Association Between e-Cigarette Use and Depression in the Behavioral Risk Factor Surveillance System, 2016-2017, JAMA Network Open

Consumption of Combustible and Smokeless Tobacco - United States, 2000-2015, Morbidity and Mortality Weekly Report 2016 and Cigars: Facts, Stats and Regulations, Truth Initiative

Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration and Smokeless Tobacco: Facts, Stats, and Regulations, Truth Initiative

Teen Use of Illicit Drugs Decreased in 2021, As the COVID-19 Pandemic Continued, University of Michigan

Are E-Cigarettes Less Harmful Than Cigarettes? Truth Initiative

Emerging Tobacco Products, Truth Initiative

Quitting E-Cigarettes: Quit Attempts and Quit Intentions Among Youth and Young Adults, Preventive Medicine Reports

Monitoring the Future National Survey Results on Drug Use 1975-2021: 2021 Overview Key Findings on Adolescent Drug Use, University of Michigan

Smoking & Tobacco Use, Fast facts, Centers for Disease Control and Prevention (CDC)

Chronic Obstructive Pulmonary Disease (COPD), CDC

National Institute on Drug Abuse, Tobacco, Nicotine, and E-Cigarettes Research Report: What Are the Physical Health Consequences of Tobacco Use? National Institute on Drug Abuse (NIDA)

Mortality and Economic Costs From Regular Cigar Use in the United States, American Public Health Association

Tobacco Product Use Among Adults — United States, 2019, Morbidity and Mortality Weekly Report, U.S. Department of Health and Human Services, CDC

Smoking and Tobacco Use, Cigars, CDC

Flavored Tobacco Product Use in Youth and Adults: Findings From the First Wave of the PATH Study (2013-2014), American Journal of Preventive Medicine; Hookah is the Most Popular Flavored Tobacco Product Among Youth, Truth Initiative; and How Healthy are Hookahs? YouTube video

Smokeless Tobacco: Health Effects, CDC

Smokeless Tobacco: Facts, Stats, and Regulations, Truth Initiative

Association Between e-Cigarette Use and Depression in the Behavioral Risk Factor Surveillance System, 2016-2017, JAMA Network Open

Psychological Risk Factors for Alcohol, Cannabis, and Various Tobacco Use among Young Adults: A Longitudinal Analysis, Substance Use & Misuse and 3 Ways Vaping Affects Mental Health, Truth Initiative

FDA Authorizes Marketing of IQOS Tobacco Heating System with ‘Reduced Exposure’ Information, Food and Drug Administration

Tobacco, Nicotine, and E-Cigarettes Research Report: Are There Gender Differences In Tobacco Smoking? NIDA

Smoking and Tobacco Use, Youth and Tobacco Use, CDC

Smoking and Tobacco Use, Tobacco Use and Quitting Among Individuals With Behavioral Health Conditions, CDC

Smoking and Tobacco Use, Cigarette Smoking and Tobacco Use Among People of Low Socioeconomic Status, CDC

Smokeless Tobacco: Facts, Stats, and Regulations, Truth Initiative

E-Cigarettes: Facts, Stats and Regulations, Truth Initiative

Electronic Cigarettes: What’s the Bottom Line, CDC infographic

Youth and Tobacco Use, CDC

Smoking Cessation — The Role of Healthcare Professionals and Health Systems, CDC

More Than Half of Young People Consider Quitting Vaping in 2022, New Survey Finds, Truth Initiative

What You Need to Know to Quit Smoking, Truth Initiative and Read This Before Trying to Quit Smoking, Truth Initiative

Nicotine Replacement Therapy for Smoking Cessation, Cochrane Database of Systematic Reviews

Nicotine Replacement Therapy: An Overview, International Journal of Health Sciences

What You Need to Know to Quit Smoking, Truth Initiative

Tobacco, Nicotine, and E-Cigarettes Research Report: What are Treatments for Tobacco Dependence? National Institute on Drug Abuse

Vaping Prevention and Quit Resources: Top Tips for Parents and Schools, Truth Initiative

Tips For Quitting, CDC

Health‐Care Interventions to Promote and Assist Tobacco Cessation: A Review of Efficacy, Effectiveness and Affordability for Use in National Guideline Development, Addiction

A Multirelational Social Network Analysis of an Online Health Community for Smoking Cessation, Journal of Medical Internet Research

Effectiveness of a Vaping Cessation Text Message Program Among Young Adult e-Cigarette Users: A Randomized Clinical Trial, JAMA Internal Medicine