How vaping affects young brainsTechnology | Rita Giordano 3 Dec 2019
Pulmonary harm isn't the only thing alarming pediatricians about their young patients and vaping. There also is the damage the practice might be doing to their brains.
A growing body of research suggests nicotine is a potent gateway drug to other substances, as well as other troubling behaviors, especially in the high doses delivered by many e-cigarettes.
Researchers and clinicians increasingly say they are seeing an increase in attention difficulties, irritability, volatility, even aggression and addiction, in young vapers whose brains are still forming.
"We have this burgeoning evidence base that nicotine exposure, especially early on, might increase your brain's risk of getting addicted to not only nicotine but other substances like marijuana, alcohol, and cocaine," said Brian Jenssen, a faculty member at the Children's Hospital of Philadelphia's PolicyLab.
"We know nicotine (use through e-cigarettes) is not only impacting the parts of the brain to do with addiction. It's impacting other parts of the brain, too, and we're seeing effects we haven't seen with cigarette smokers," said Sharon Levy, director of the adolescent substance use and addiction program at Boston Children's Hospital. "We're seeing lots of kids who have problems with attention, concentration, and a lot of behavioral dysregulation. We've seen it with marijuana addiction. We've seen it with opioid addiction. We have not seen it with cigarettes."
And the likelihood is we'll be seeing more of these problems, given the rapid growth of vaping among young people. According to research published last month in the New England Journal of Medicine, the prevalence of e-cigarette use among students in the eighth, 10th, and 12th grades have more than doubled from 2017 to 2019.
The ever-growing implications are troubling.
Nicotine is highly addictive - any smoker who has tried to quit cigarettes can attest to that. However, research has found the younger an adolescent starts using nicotine, the more likely he or she will continue into adulthood, even more so than users of other addictive substances.
Adolescence into young adulthood is a critical time for brain development. Studies suggest nicotine alters chemical pathways in the brain and boosts dopamine, a neurotransmitter associated with reward-seeking, pleasure, and the risk for various addictions.
An analysis of more than 20 studies recently published in JAMA Pediatrics found that youth with a history of vaping were 3.5 times more likely than those who do not vape to become marijuana users.
Other research has found people who use nicotine are more likely to try other substances.
Meanwhile, a landmark study by Columbia University medical school researchers found that mice given nicotine in their water over a period of time showed addiction-related gene changes and increased vulnerability to cocaine dependence.
Denise Kandel, a professor of sociomedical sciences in psychiatry at Columbia's Irving Medical Center and a lead author on the study, said the team has also found that alcohol and cannabinoids seem to have gateway-like relationships to cocaine use in mouse studies.
It's not yet known if all the same changes take place in humans, but because adolescents' brains are still forming, young people are likely to be especially susceptible to the gateway effect.
For the young, nicotine is the most likely gateway. Adolescent alcohol consumption rates have decreased in recent years. The prevalence of tobacco use is greater than marijuana use, Kandel said, and the decreases in young people smoking combustible cigarettes have been undone by the "explosive increase" in vaping.
"Whatever its source, nicotine is nicotine," Kandel said. "It will adversely affect the brains of adolescents and increase their susceptibility to the reward effects of other drugs."
The research is shocking given the super-doses of nicotine adolescents are getting from e-cigarettes like Juul, a popular brand among young people. One Juul pod has as much nicotine as a pack of cigarettes and young vapers tend not to partake sparingly.
"Many of these kids are using one, two, three pods a day," Jenssen said.
Ironically, Jenssen said, it's not unusual for these youngsters, priced out of their vaping habit, to start turning to conventional cigarettes - the very products e-cigarettes were marketed as an alternative to.
The Philadelphia Inquirer (TNS)