Nicotine and Tobacco

Why Is Nicotine Unsafe for Kids, Teens, and Young Adults?

• Nicotine is an addictive drug in e-cigarettes, regular cigarettes, cigars, and other tobacco products.
• Nicotine can harm the developing adolescent brain. The brain keeps developing until about age 25.
• Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control.
• Each time a new memory is created or a new skill is learned, stronger connections – or synapses – are built between brain cells. Young people’s brains build synapses faster than adult brains. Nicotine changes the way these synapses are formed.
• Using nicotine in adolescence may also increase risk for future addiction to other drugs.

Tobacco

Tobacco smoke increases a user’s risk of cancer, emphysema, bronchial disorders, and cardiovascular disease. The mortality rate associated with tobacco addiction is staggering. Tobacco use killed approximately 100 million people during the 20th century.

Smoking leads to disease and disability and harms nearly every organ of the body.

• Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis.
• Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.
• Smoking is a known cause of erectile dysfunction in males.

Smoking is the leading cause of preventable death.

• Worldwide, tobacco use causes more than 7 million deaths per year. If the pattern of smoking all over the globe doesn’t change, more than 8 million people a year will die from diseases related to tobacco use by 2030.
• Cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including more than 41,000 deaths resulting from secondhand smoke exposure. This is about one in five deaths annually, or 1,300 deaths every day.
• On average, smokers die 10 years earlier than nonsmokers.

Costs and Expenditures

·         The tobacco industry spends billions of dollars each year on cigarette and smokeless tobacco advertising and promotions.

·         Smoking costs the United States billions of dollars each year.

·         State spending on tobacco prevention and control does not meet CDC-recommended levels.

·         Thousands of young people start smoking cigarettes every day.

Youth use of tobacco products in any form is unsafe.

Preventing tobacco product use among youth is critical to ending the tobacco epidemic in the United States.

• Tobacco product use is started and established primarily during adolescence.
  • Nearly 9 out of 10 cigarette smokers first try cigarette smoking by age 18, and 98% first try smoking by age 26.
• Flavorings in tobacco products can make them more appealing to youth.
• Recent increases in the use of e-cigarettes is driving increases in tobacco product use among youth.

Estimates of Current Tobacco Use Among Youth

Electronic cigarettes (E-cigarettes)

Current (past 30 day) use of e-cigarettes has increased among middle and high school students.

 

Tobacco Product Use Among High School Students – 2018

Cigarettes, Cigars and Smokeless Tobacco

• From 2011 to 2018, current (past 30 day) cigarette and cigar smoking and smokeless tobacco use went down among middle and high school students.

Hookah

• From 2011 to 2018, current use of hookahs did not change in a meaningful way among middle school students and high school students.

Many young people use two or more tobacco products.

• In 2018, about 2 of every 100 middle school students (2.4%) and about 11 of every 100 high school students (11.3%) reported current use of two or more tobacco products in the past 30 days.

Youth who use multiple tobacco products are at higher risk for developing nicotine dependence and might be more likely to continue using tobacco into adulthood.

Factors Associated With Youth Tobacco Product Use

Factors associated with youth tobacco product use include the following:

• Social and physical environments
  • The way mass media show tobacco product use as a normal activity can make young people want to try these products.
  • Youth are more likely to use tobacco products if they see people their age using these products.
  • High school athletes are more likely to use smokeless tobacco than those of the same age who are not athletes.
  • Young people may be more likely to use tobacco products if a parent uses these products.
• Biological and genetic factors
  • There is evidence that youth may be sensitive to nicotine and that teens can feel dependent on nicotine sooner than adults.
  • Genetic factors may make quitting smoking harder for young people.
  • A mother’s smoking during pregnancy may increase the likelihood that her children will become regular smokers.
• Mental health: There is a strong relationship between youth smoking and depression, anxiety, and stress.
• Personal views: When young people expect positive things from smoking, such as coping with stress better or losing weight, they are more likely to smoke.

• Other influences that affect youth tobacco use include:
  • Lower socioeconomic status, including lower income or education
  • Not knowing how to say “no” to tobacco product use
  • Lack of support or involvement from parents
  • Accessibility, availability, and price of tobacco products
  • Doing poorly in school
  • Low self-image or self-esteem
  • Seeing tobacco product advertising in stores, on television, the Internet, in movies, or in magazines and newspapers

Smokeless Tobacco: Health Effects

Smokeless tobacco is associated with many health problems. Using smokeless tobacco:

• Can lead to nicotine addiction
• Causes cancer of the mouth, esophagus (the passage that connects the throat to the stomach), and pancreas (a gland that helps with digestion and maintaining proper blood sugar levels)
• Is associated with diseases of the mouth
• Can increase risks for early delivery and stillbirth when used during pregnancy
• Can cause nicotine poisoning in children
• May increase the risk for death from heart disease and stroke

Using smokeless products can cause serious health problems. Protect your health; don’t start. If you do use them, quit.

Addiction to Smokeless Tobacco

• Smokeless tobacco contains nicotine, which is highly addictive.
• Because young people who use smokeless tobacco can become addicted to nicotine, they may be more likely to also become cigarette smokers.

Smokeless Tobacco and Cancer

• Many smokeless tobacco products contain cancer-causing chemicals.
  • The most harmful chemicals are tobacco-specific nitrosamines, which form during the growing, curing, fermenting, and aging of tobacco. The amount of these chemicals varies by product.
  • The higher the levels of these chemicals, the greater the risk for cancer.
  • Other chemicals found in tobacco can also cause cancer. These include:
    • A radioactive element (polonium-210) found in tobacco fertilizer
    • Chemicals formed when tobacco is cured with heat (polynuclear aromatic hydrocarbons—also known as polycyclic aromatic hydrocarbons)
    • Harmful metals (arsenic, beryllium, cadmium, chromium, cobalt, lead, nickel, mercury)
• Smokeless tobacco causes cancer of the mouth, esophagus, and pancreas.

 

Smokeless Tobacco and Oral Disease

• Smokeless tobacco can cause white or gray patches inside the mouth (leukoplakia) that can lead to cancer.
• Smokeless tobacco can cause gum disease, tooth decay, and tooth loss.

Reproductive and Developmental Risks

• Using smokeless tobacco during pregnancy can increase the risk for early delivery and stillbirth.
• Nicotine in smokeless tobacco products that are used during pregnancy can affect how a baby’s brain develops before birth.

Other Risks

• Using smokeless tobacco increases the risk for death from heart disease and stroke.
• Smokeless tobacco can cause nicotine poisoning in children.
• Additional research is needed to examine long-term effects of newer smokeless tobacco products, such as dissolvables and U.S. snus.

Reducing Youth Tobacco Product Use

National, state, and local program activities have been shown to reduce and prevent youth tobacco product use when implemented together. These activities include:

• Higher costs for tobacco products (for example, through increased taxes)
• Prohibiting smoking in indoor areas of workplaces and public places
• Raising the minimum age of sale for tobacco products to 21 years
• TV and radio commercials, posters, and other media messages aimed at kids and teens in order to counter tobacco product ads
• Community programs and school and college policies that encourage tobacco-free places and lifestyles
• Community programs that lower tobacco advertising, promotions, and help make tobacco products less easily available

Some social and environmental factors are related to lower smoking levels among youth. Among these are:

• Being part of a religious group or tradition
• Racial/ethnic pride and strong racial identity
• Higher academic achievement

It is important to keep working to prevent and reduce the use of all forms of tobacco product use among youth.

Tobacco Industry Marketing

Cigarette and smokeless tobacco companies spend billions of dollars each year to market their products.

Marketing to Specific Populations

Youth and Young Adults

Scientific evidence shows that tobacco company advertising and promotion influences young people to start using tobacco.

• Adolescents who are exposed to cigarette advertising often find the ads appealing.
• Tobacco ads make smoking appear to be appealing, which can increase adolescents’ desire to smoke.

Women

Women are also targeted by the tobacco industry, and tobacco companies continue to produce brands specifically for women. Marketing toward women is dominated by themes of social desirability, empowerment, and independence, which are conveyed by advertisements featuring slim, attractive, and athletic models.

Racial/Ethnic Communities

Advertisement and promotion of certain tobacco products appear to be targeted to members of racial/minority communities.

• Marketing to Hispanics and American Indians/Alaska Natives has included advertising and promotion of cigarette brands with names such as Rio, Dorado, and American Spirit.
• The tobacco industry has targeted African American communities in its advertisements and promotional efforts for menthol cigarettes. Strategies include:
  • Campaigns that use urban culture and language to promote menthol cigarettes
  • Tobacco-sponsored hip-hop bar nights with samples of specialty menthol cigarettes
  • Targeted direct-mail promotions

• Tobacco companies’ marketing to Asian Americans has included:
  • Sponsorship of Chinese and Vietnamese New Year festivals and other activities related to Asian/Pacific American Heritage Month
  • Heavy billboard and in-store advertisements in predominantly urban Asian American communities
  • Financial and in-kind contributions to community organizations
  • Support of Asian American business associations