USA: A new analysis published in the journal Addiction shows that nicotine consumption and addiction among young Americans has dropped significantly since 2012 - even though modern e-cigarettes now deliver nicotine more effectively than ever before, including via nicotine salts.
The researchers analysed data from over 170,000 high school students in the US and concluded that nicotine dependence symptoms in 2023 were at their lowest level in over a decade.
Addiction - but no epidemic
Addiction symptoms are still most prevalent among cigarette smokers. Among young people who exclusively use e-cigarettes, symptoms increased after 2017 - but overall addiction levels in the population are not increased. On the contrary:
"Our results directly contradict claims that e-cigarettes have created a new generation of nicotine-addicted youth," the researchers write.
Even if some users underreport addiction due to misconceptions, the data does not suggest a sustained increase.
Short-lived wave
E-cigarette consumption among young people increased rapidly in the years leading up to 2020, but declined just as quickly. This differs significantly from traditional tobacco smoking, which has historically been more difficult to reduce in younger age groups.
According to the researchers, it shows that young people vaping may be easier to manageprovided you act in a timely and targeted manner.
Also in Denmark - but staggered in time
In Denmark and the rest of the EU, the e-cigarette wave only took off around 2021-2022, as new products and nicotine salts became widely available. Nevertheless, figures from the Danish Health Authority's report Danes' smoking habitsthat Smoking among young people and adults continues to decline, while the use of e-cigarettes and smokeless nicotine products is increasing. The trend is in line with the Swedish picture, where overall nicotine consumption among young people is stable - but with a clear shift from cigarettes to snus and vaping. This suggests that product development is changing usage patterns, but not necessarily creating more addiction.
"Regulation with balance"
Researchers call for proportional regulation: less accessibility and lower appeal for young people without to undermine the role of e-cigarettes as a smoking cessation aid for adults. Rather than a total ban, they point to targeted measures such as advertising bans, plain packaging and limited visibility at points of sale. However, restricting nicotine levels per se can make products less effective for smoking cessation. The key lies in monitoring and flexible regulation that can be adjusted according to trends in use and addiction.
Despite more nicotine-efficient e-cigarettes, the analysis shows that addiction among young people has not increased, but rather decreased. This challenges the idea of a nicotine epidemic.
"Regulation focused on marketing and exposure - rather than broad bans - can protect youth without inhibiting adult users from quitting cigarettes." the researchers write in their analysis.
