Anushka Patel

Undergraduate Neuroscience Program

E-cigarettes have been at the forefront of discussion in the realm of public health in the country. Specifically, youth in America have been targeted by this phenomenon. In 2024, e-cigarettes were the most commonly used tobacco related product amongst United States middle school and high school students with 1.63 million students currently using these devices.¹ Students and young adults are targeted by vape companies through flashy advertising, various e-liquid flavors, and devices disguised to be everyday items such as USBs or pens.² For example, Juul Labs, a prominent producer of vapes, advertises its vapes to be sleek, rechargeable, and incorporated with nicotine salts, but the authenticity of those claims falls short with harmful concentrations of nicotine affecting American youth.³ Beyond the marketing strategies used on social media through influencer paid promotions, vapes inherently market false claims. Students have misconceptions that these e-cigarettes are not as harmful as combustible cigarettes as well as vapes aiding in stress relief. However, the harsh reality is that e-cigarettes can have short term and long-term impacts on the health of our future generations.

The delivery of nicotine has spanned a variety of devices over the past few generations. The most traditional cigarette model is the combustible cigarette, which is composed of tobacco leaves and other additives encased in cigarette paper. 4 The user ignites the paper and inhales the smoke from the burning tobacco taking in nicotine alongside carcinogenic compounds.⁴ To make the process more pleasing for users, tobacco companies began investing into e-cigarettes. E-cigarettes differ in their delivery system, ingredients, and flavorings. E-cigarettes or vaping devices often contain four different elements: cartridge, heating element, power source, and mouthpiece.⁵ By puffing into the vape, the cartridge containing the e-liquid is activated, and the liquid is heated resulting in an aerosol.⁵ The aerosol contains nicotine, heavy metals, various aldehydes, volatile organic compounds, alongside other harmful chemicals, which are inhaled by the individual.⁶ These chemicals interact within the body affecting our organ systems in a variety of ways.

Addiction is the phrase that follows the discussion surrounding the use of vapes. Nicotine is the primary reinforcing component of tobacco products driving the addiction.⁷ The brain inherently facilitates this addiction pathway. Nicotine is mediated through the activation of the mesolimbic reward circuitry, a neural pathway in the brain, and is associated with the release of dopamine which contributes to the addiction.⁸ After entering the body, nicotine activates the nicotinic acetylcholine receptors within the ventral tegmental area (VTA), a region also associated with reward and motivation.⁹ Dopaminergic projections then transport the signal from the VTA to a variety of brain areas such as the frontal cortex, hippocampus, amygdala influencing executive functions, reinforcement behavior, and memory.⁹ As the increase in dopamine influences the reward and pleasure of the individual, the brain will become dependent on nicotine, inciting the addiction.

Due to e-cigarettes’ newer entry into the U.S. markets in 2007, these devices have not been researched to the same degree as combustible cigarettes. However, there is evidence to show the harms of vaping on the brain. The toxicity of e-cigarette smoke was correlated to brain inflammatory responses in the blood brain barrier. A study conducted with the use of animal models provided evidence to suggest that the inflammation in the brain of mice exposed to the vape smoke also led to decreased cognitive spatial and memory function compared to the control group.¹⁰ In addition to changes in the blood brain barrier, functional MRI studies have been utilized to see a reduction of volume in the frontal cortex and thalamus as well as functional changes to the frontal cortex, thalamus, insula, and striatum.⁹ E-cigarette use can also play a role in prenatal development. Based on animal studies, the early nicotine exposure can lead to dopamine, serotonin and norepinephrine disorders in the forebrain and midbrain.⁹ Even with the progress that has been made in describing the correlations of vape smoke and use to neurological changes, there is a continued need to research the extent of the potential effects this habit could have on users.

With the toxicity associated with e-cigarette use, there is a continued need to make individuals more aware of these dangers. To combat the flashy marketing and propaganda pushed through social media, education and continued awareness through social medial campaigns and policy built to combat vape use have become the necessity to prevent our population and younger generations from succumbing to e-cigarette use. From an individual standpoint, this message can be further spread through supporting anti-vape initiatives and engaging in active conversations with peers and legislative representatives to advocate for policies regulating e-cigarette use in communities. Together with this educational push, there is continued need for research to enhance the current understanding of the long-term neurological effects of e-cigarette use.

References

1. Jamal A, Park-Lee, E, Birdsey J, et al. Tobacco product use among middle and high school students — National Youth Tobacco Survey, United States. MMWR Morb Mortal Wkly Rep. 2024;73(41):917–924.
2. Jones, K., & Salzman, G. A. (2020). The Vaping Epidemic in Adolescents opens a new website . Missouri Medicine, 117(1), 56.
3. Fraga, J. A. (2024, August 2). The dangers of Juuling - National Center for Health Research opens a new website . National Center for Health Research - The Voice For Prevention, Treatment and Policy.
4. Center for Tobacco Products. (2020). How are Non-Combusted Cigarettes, Sometimes Called Heat-Not-Burn Products, Different from E-Cigarettes and Cigarettes? opens a new website FDA.
5. National Institute on Drug Abuse . (2020, January 8). Vaping Devices (Electronic Cigarettes) DrugFacts opens a new website . National Institute on Drug Abuse; National Institute on Drug Abuse.
6. National Academies of Sciences, Engineering, and Medicine. (2018). Public Health Consequences of E-Cigarettes opens a new website (K. Stratton, L. Y. Kwan, & D. L. Eaton, Eds.). National Academies Press.
7. National Institute on Drug Abuse. (2022, May). How does tobacco deliver its effects? opens a new website National Institute on Drug Abuse.
8. Hamann, S. L., Kungskulniti, N., Charoenca, N., Kasemsup, V., Ruangkanchanasetr, S., & Jongkhajornpong, P. (2023). Electronic Cigarette Harms: Aggregate Evidence Shows Damage to Biological Systems opens a new website . International Journal of Environmental Research and Public Health, 20(19), 6808.
9. Wawryk-Gawda, E., Lis-Sochocka, M., Chylińska-Wrzos, P., Budzyńska, B., & Jodłowska-Jędrych, B. (2019). The Impact of Traditional Cigarettes and E-Cigarettes on the Brain opens a new website . Neuroscience of Nicotine, 25–32.
10. Prasedya, E. S., Ambana, Y., Martyasari, N. W. R., Aprizal, Y., Nurrijawati, & Sunarpi. (2020). Short-term E-cigarette toxicity effects on brain cognitive memory functions and inflammatory responses in mice opens a new website . Toxicological Research, 36(3), 267–273.