Nicotine is very addictive, comparable to heroin or cocaine. Nicotine induces strong effects on the brain, which lead to considerable changes in the brain’s physiology such as stimulation in regions of the cortex associated with reward, pleasure and reducing anxietyWhen nicotine intake stops, there are withdrawal symptoms.
Various organizations are concerned that vaping might increase nicotine addiction and use among young people. These include the Centers for Disease Control and Prevention, the International Union Against Tuberculosis and Lung Disease, the American Academy of Pediatrics and the Food and Drug Administration. The World Health Organization raised concern about addiction for non-smokers from their use in July 2014. The National Institute on Drug Abusesaid they could maintain nicotine addiction in those who are attempting to quit.
It is not clear whether vaping will decrease or increase overall nicotine addiction. Information about the drug action of the nicotine in e cigarettes is limited, but the nicotine in e cigarettes is adequate to sustain nicotine dependence. The limited data suggests that the likelihood of abuse from e cigarettes could be smaller than traditional cigarettes A 2014 systematic review found that the concerns that e cigarettes could cause non-smokers to start smoking are unsubstantiated. No long-term studies have been done on the effectiveness of e cigarettes in treating tobacco addiction. Some evidence suggests that dual use of e cigarettes and traditional cigarettes may be associated with greater nicotine dependence.
A 2014 review found no evidence that they are used regularly by those who have never smoked, while another 2014 review has found that in studies up to a third of young people who have ever vaped have never smoked tobacco. The degree to which teens are using e cigarettes in ways the manufacturers did not intend, such as increasing the nicotine delivery, is unknown. The extent to which e cigarette use will lead to addiction or substance dependence in youth is unknown. Youthful experimentation with e cigarettes could lead to a lifelong addiction.
Smoking a traditional cigarette yields between 0.5 and 1.5 mg of nicotine, but the nicotine content of the cigarette is only weakly correlated with the levels of nicotine in the smoker's bloodstream. The amount of nicotine in the e cigarette aerosol varies widely either from puff-to-puff or among products of the same company In practice vapers tend to reach lower blood nicotine concentrations than smokers, particularly when the vapers are inexperienced or using earlier-generation devices. Nicotine in tobacco smoke is absorbed into the bloodstream rapidly, and e cigarette vapor is relatively slow in this regard. The concentration of nicotine in e liquid ranges up to 36 mg/mL. New EU regulations cap this at a maximum of 2% (20 mg/mL), but this is an arbitrary ceiling based on limited data. In practice the nicotine concentration in an e liquid is not a reliable guide to the amount of nicotine that reaches the bloodstream.