NICOTINE

Why Do Some Teens Start Smoking or Using Nicotine?

There are many social and emotional reasons why teens begin:

• They see parents or friends smoking, so they assume it’s normal.
• Smoking or vaping is shown in movies, TV, or social media, which can make it look glamorous or “cool.”
• A teen might feel more confident or feel like they “belong” to a group by doing what others are doing.
• For some, smoking is a form of rebellion — to show independence or upset parents.

Understanding these reasons is important because quitting nicotine is harder the more one becomes dependent on it.

The Dangers of Smoking and Tobacco Use

Smoking and tobacco use carry serious health risks — for both users and those around them.

Illnesses Caused by Smoking

Smoking can lead to:

• Chronic lung disease (like chronic bronchitis and emphysema)
• Coronary heart disease (heart attacks, clogged arteries)
• Stroke
• Cancers of many organs — including lungs, larynx (voice box), esophagus, mouth, bladder, cervix, pancreas, and kidneys
• Other issues such as reduced healing ability, weaker immune system, poor circulation

Burning tobacco produces a chemical mix. There are over 7,000 chemicals in cigarette smoke, and at least 69 of them are known to cause cancer.¹

Smokeless tobacco (chew, dip) and cigars are also dangerous. They can cause cancers of the mouth, throat, esophagus, and other organs.

The 2024 Surgeon General’s Report estimates more than 490,000 deaths are caused by cigarette smoking and exposure to secondhand tobacco smoke in the United States.²

Effects on Others: Secondhand Smoke and Pregnancy

Smoking doesn’t only hurt the user. Others exposed to tobacco smoke can also suffer health damage.

• In total, secondhand smoke is estimated to cause more than 19,000 deaths per year.³
• It’s also linked to stroke risk— increasing the risk by 20–30% for stroke or heart disease in nonsmokers.⁴
• Pregnant women who use tobacco risk low birth weight babies, preterm birth, or other complications.
• Babies and children exposed to secondhand smoke are more likely to have respiratory infections, asthma, ear infections, and sudden infant death syndrome (SIDS).⁵

In short: no amount of secondhand smoke is safe.

How Strong Is Nicotine?

Nicotine is extremely addictive. It changes the brain’s chemistry, creating cravings and withdrawal when someone tries to stop.

Because teens’ brains are still developing, nicotine can affect decision-making, impulse control, mood, and attention.

Some newer nicotine products deliver very high doses quickly — sometimes equal to or more than what you’d get from a pack of cigarettes — making addiction fast and strong.

Types of Nicotine Products

Here’s a list of common ways people use nicotine:

• Cigarettes – burned tobacco, inhaled
• Vapes / e-cigarettes – battery-powered devices that heat a nicotine liquid into aerosol
• Nicotine pouches – small, often flavored packets placed under the lip
• Chewing tobacco / dip / snuff – moist tobacco placed in the mouth, nicotine absorbed through gums
• Cigars / cigarillos / pipe tobacco – rolled or loose tobacco, inhaled or partially inhaled

If a product contains synthetic nicotine, it can be just as addictive and harmful, even if it is labeled “tobacco-free.”

Signs Someone Might Be Using Nicotine

Some signs to look for:

• Frequent stepping away from group / disappearing
• Sweet, fruity, candy-like smells in the air (from flavored vape liquids)
• Irritability, restlessness, or mood swings when away from the device
• New or worsening cough, sore throat, shortness of breath
• Spending more money or being secretive about purchases
• Trouble concentrating, changes in sleep, or mood
• Stains on fingers, lips, or teeth (for smoked or dipped tobacco)

These signs don’t prove use—but they can be clues that it’s time to talk and offer support.

Getting Help: Treatments for Nicotine Dependence

Quitting nicotine is possible. Many people try more than once before succeeding. Support and medical help improve the odds a lot.

Nicotine Replacement Therapy (NRT)

NRT gives controlled, smaller doses of nicotine to ease cravings and withdrawal. It doesn’t contain the harmful chemicals found in burned tobacco. Common options include:

• Patches (stick-on skin patches)
• Gum
• Lozenges
• Inhalers or nasal sprays (require a prescription or supervision)

These tools allow the user to gradually reduce nicotine intake until they can stop entirely.

Medications (Non-nicotine)

Doctors sometimes prescribe medicines that don’t contain nicotine but help with quitting:

• Bupropion (Zyban®) — helps reduce cravings and withdrawal symptoms
• Varenicline (Chantix®) — binds to nicotine receptors in the brain and lessens the effect of nicotine

These medications are usually more effective when used together with counseling or a support plan.

Counseling & Support

Having someone to talk to — a counselor, support group, quit coach — makes quitting much more likely to succeed. Behavioral therapy, goal setting, coping strategies, and reminders all help.

Resources often available include:

• Quitlines (in the U.S., 1-800-QUIT-NOW)
• Web programs that help you plan to quit or provide live support (smokefree.gov, or local equivalents)
• Text support programs
• Apps and peer support groups

Check out this article for even more information on how to help your teen quit nicotine use.

Final Thoughts & Key Takeaways

• Tobacco is a plant crop; nicotine is its addictive component.
• Smoking, chewing, or dipping delivers nicotine, along with thousands of other harmful chemicals.
• Smoking and tobacco use lead to serious health problems — cancer, lung disease, heart disease, stroke, and more.
• The impact extends beyond users: secondhand smoke causes thousands of deaths yearly and harms babies, children, and pregnant women.
• Quitting nicotine is challenging but possible, especially with tools like NRT, medicines, counseling, and support.