E Cigarette-The impact of e-cigarettes on the developing brains of young individuals is a growing concern

E-cigarettes: The impact of e-cigarettes on the developing brains

• Introduction

An e-cigarette, also known as an electronic cigarette or vape, is a device that simulates the experience of smoking tobacco. It is designed to deliver nicotine or other substances to the user in the form of an aerosol, commonly called vapor. E-cigarettes are battery-powered and typically consist of a heating element, a cartridge or tank to hold the e-liquid (also known as vape juice), and a mouthpiece through which the vapor is inhaled. 

The impact of e-cigarettes on the developing brains of young individuals is a growing concern. Nicotine, a highly addictive substance found in many e-cigarettes, can have profound effects on the developing brain. During adolescence, the brain undergoes critical structural and functional changes, including synaptic pruning, myelination, and the development of brain circuits involved in decision-making and impulse control. Nicotine exposure during this sensitive period can disrupt these processes, leading to long-term cognitive and behavioral consequences. Studies suggest that nicotine exposure in adolescence can impair working memory, attention, and cognitive flexibility. It can also alter the development of the prefrontal cortex, which plays a crucial role in decision-making and impulse control.

Furthermore, nicotine can affect the reward pathways in the brain, increasing the vulnerability to addiction and substance abuse. There is also evidence linking adolescent nicotine exposure to an increased risk of mental health issues, including anxiety and depression. Given the potential harmful effects, it is crucial to prioritize prevention efforts, educate young individuals about the risks of e-cigarettes, and implement strict regulations to protect their developing brains. E-cigarettes are tobacco products that deliver nicotine. Nicotine is a highly addictive substance, and many of today’s youth who are using e-cigarettes could become tomorrow’s cigarette smokers. Nicotine exposure can also harm brain development in ways that may affect the health and mental health of our kids. 

• Background

Electronic cigarettes, or e-cigarettes, were introduced in the early 2000s as a potential alternative to traditional tobacco cigarettes. They are battery-operated devices that heat a liquid (e-liquid) to produce an aerosol, which users inhale. E-cigarettes were initially marketed as a safer and less harmful alternative to smoking, with the potential to aid in smoking cessation. However, concerns about the health risks and safety of e-cigarettes have arisen over time. Research has indicated that e-cigarette aerosols can contain harmful substances, including nicotine and various chemicals. The popularity of e-cigarettes, particularly among young people, has raised public health concerns and prompted increased scrutiny and regulation of these products.

Most e-cigarettes contain nicotine, which can cause addiction and can harm the developing adolescent brain. Compared with older adults, the brain of youth and young adults is more vulnerable to the negative consequences of nicotine exposure. The effects include addiction, priming for use of other addictive substances, reduced impulse control, deficits in attention and cognition, and mood disorders. Furthermore, fetal exposure to nicotine during pregnancy can result in multiple adverse consequences, including sudden infant death syndrome, altered corpus callosum, auditory processing deficits, effects on behaviors and obesity, and deficits in attention and cognition. Ingestion of e-cigarette liquids containing nicotine can also cause acute toxicity and possibly death if the contents of refill cartridges or bottles containing nicotine are consumed. E-cigarette companies appear to be using many of the advertising tactics the tobacco industry used to persuade a new generation of young people to use their products.

• Discussion

The use of products containing nicotine poses dangers to youth, pregnant women, and fetuses. The use of products containing nicotine in any form among youth, including in e-cigarettes, is unsafe.

Furthermore, fetal exposure to nicotine during pregnancy can result in multiple adverse consequences, including sudden infant death syndrome, altered corpus callosum, auditory processing deficits, effects on behaviors and obesity, and deficits in attention and cognition. Ingestion of e-cigarette liquids containing nicotine can also cause acute toxicity and possibly death if the contents of refill cartridges or bottles containing nicotine are consumed.

• Health Risks of E-Cigarettes in adolescents and youth

E-cigarette use in adolescents and youth carries significant health risks. They are at risk of nicotine addiction, which can impact brain development. E-cigarettes can impair lung development, leading to respiratory issues and decreased lung function. They may serve as a gateway to smoking traditional cigarettes, increasing the risk of tobacco-related diseases. E-cigarette use has been associated with negative behavioral and cognitive outcomes. Accidental ingestion of liquid nicotine can be dangerous. Prevention efforts, including education and regulation, are crucial to protect the health of adolescents and youth from the harms of e-cigarettes.

• Legal Framework in India

In 2019, the Indian government introduced an ordinance called "The Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage, and Advertisement) Ordinance, 2019." This ordinance prohibited the production, manufacturing, import, export, sale, distribution, and advertisement of electronic cigarettes in India.

Under the ordinance, the term "electronic cigarette" includes all forms of electronic nicotine delivery systems (ENDS), heat-not-burn products, e-hookahs, and similar devices. The ban covers both the devices themselves and the components used in their manufacture.

The ordinance also made the storage of electronic cigarettes illegal. Existing stocks of e-cigarettes were required to be declared and disposed of within a specified time frame. Violations of the ordinance can lead to penalties, including imprisonment and fines.

• Conclusion

The most commonly cited reasons for using e-cigarettes among both youth and young adults are curiosity, flavoring/taste, and low perceived harm compared to other tobacco products. The use of e-cigarettes as an aid to quit conventional cigarettes is not reported as a primary reason for use among youth and young adults.

E-cigarette use among youth and young adults is associated with the use of other tobacco products, including conventional cigarettes. Because most tobacco use is established during adolescence, actions to prevent our nation’s young people from the potential of a lifetime of nicotine addiction are critical.

Compared with older adults, the brain of youth and young adults is more vulnerable to the negative consequences of nicotine exposure. The effects include addiction, priming for use of other addictive substances, reduced impulse control, deficits in attention and cognition, and mood disorders.

E-cigarette aerosol is not harmless. It can contain harmful and potentially harmful constituents, including nicotine. Nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain.

• Way Forward

Action can be taken at the national, state, local, tribal, and territorial levels to address e-cigarette use among youth and young adults. Actions could include incorporating e-cigarettes into smoke free policies, preventing access to e-cigarettes by youth, price and tax policies, retail licensure, regulation of e-cigarette marketing likely to attract youth, and educational initiatives targeting youth and young adults.

Although we continue to learn more about e-cigarettes with each passing day, we currently know enough to take action to protect our nation’s young people from being harmed by these products. Increasing awareness among adolescents about the harms of e-cigarettes is urgently required through comprehensive tobacco-prevention programs. More research is needed to examine the role of flavors in increasing acceptability of e-cigarettes and how it affects perceived harmfulness of tobacco products.

• Reference

1. WHO Tobacco: E-cigarettes https://www.who.int/news-room/questions-and-answers/item/tobacco-e-cigarettes.
2. Adolescents and E-cigarettes in India: A Qualitative Study of Perceptions and Practices https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9810289/.
3. Over 60 Percent Youth Are Susceptible To E-Cigarettes In India: Study https://zeenews.india.com/health/over-60-percent-youth-are-susceptible-to-e-cigarettes-inindia-study-2621989.
4. E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General 2016 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Office of the Surgeon Genera.
5. LifeFirst: Impact of a school-based tobacco and supari cessation intervention among adolescent students in Mumbai, India Upendra Bhojani1, Amiti Varma1, Pragati B. Hebbar1, Gauri Mandal2 , Himanshu Gupte3.

Regards and Thanks

Dr. (Prof)Rajendra T. Nanavare

Chest Physician and 

Ex Medical Superintendent GTB hospital Sewri Mumbai