Doctor explains: Why the illusion of ‘safe nicotine’ is fuelling a new youth addiction crisis

What began as a public health effort to move smokers away from combustible cigarettes has evolved into a new challenge for health authorities worldwide: the rapid rise of vaping devices, nicotine pouches and flavoured oral nicotine products among adolescents and young adults.

The World Health Organisation (WHO) and public health agencies across multiple countries have repeatedly warned that sleek designs, sweet flavours, influencer marketing and social media-driven branding are helping nicotine products reach a generation that might otherwise never have picked up a cigarette.

At the same time, growing evidence suggests that nicotine exposure during adolescence can alter brain development, affect attention and mood regulation, and increase the risk of long-term dependence.

While many young users view vaping as a cleaner or safer alternative to smoking, doctors say this perception often masks the highly addictive nature of modern nicotine products, some of which can deliver nicotine concentrations comparable to or even higher than traditional cigarettes.

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Firstpost spoke with Dr Praveen Gupta, Chairman of the Marengo Asia International Institute of Neuro and Spine (MAIINS), about the rise of new-age nicotine products, the impact of nicotine on the developing brain, and why experts warn that many young users may be falling into addiction under the mistaken belief that smoke-free products are safe.

Dr Gupta: We are witnessing a clear shift from traditional cigarettes to vapes, nicotine pouches and flavoured oral nicotine products among young people. Clinically, we increasingly see young adults who have never smoked conventional cigarettes but have become heavily nicotine-dependent through these newer devices.

A major reason is perception. Many teenagers and young adults associate vaping with being cleaner, cooler and even wellness-friendly because there is no smoke or tobacco smell. Attractive branding has made nicotine appear modern, socially acceptable and relatively harmless. That perception lowers caution, encourages experimentation and normalises addiction among users who often underestimate the long-term health consequences.

Adding to the concern is the way many of these products are marketed. Sweet flavours, colourful packaging, sleek technology-inspired designs and influencer-driven social media campaigns closely mirror youth consumer culture. The messaging resembles lifestyle branding rather than a discussion about addiction risks, making experimentation psychologically appealing and socially acceptable for adolescents.

Many young users argue that vaping is safer because it is not smoking. What are the biggest misconceptions surrounding these products?

Dr Gupta: The most common misconception is that vaping or nicotine pouches are safe simply because they are not cigarettes. That is incorrect.

Nicotine itself is highly addictive and affects the brain, cardiovascular system, sleep, mood and concentration. Many users do not realise how quickly dependence can develop, particularly among adolescents whose brains are still developing.

The absence of smoke does not mean the absence of harm. Medical professionals are increasingly concerned about cardiovascular stress, lung inflammation, exposure to high nicotine concentrations and the unknown long-term consequences of repeatedly inhaling or consuming chemical compounds found in these products.

Many modern vaping devices deliver extremely high doses of nicotine in a single session. Because these products are relatively new, we still do not fully understand the chronic health consequences that may emerge over decades of use.

Why are young people becoming more psychologically vulnerable to these new-age nicotine habits?

Dr Gupta: Today's young people live in an environment of constant stimulation, competition and digital validation. Nicotine is increasingly being used not as an act of rebellion but as a coping mechanism.

We see strong links between nicotine use and stress, performance pressure, gaming culture, nightlife, loneliness, anxiety and the desire for social acceptance. Many adolescents use nicotine products to regulate emotions, improve concentration, manage stress or feel connected to their peer groups.

As a result, dependence often develops on two levels. There is the physical addiction to nicotine, but there is also emotional dependence, where users begin relying on nicotine for confidence, focus, comfort or a sense of belonging.

Young users frequently exhibit patterns associated with stress, sleep disturbances, irritability, impulsiveness and reduced emotional resilience. Many struggle to manage boredom, loneliness or uncomfortable emotions without nicotine stimulation.

From a neurological perspective, how concerning is nicotine exposure during adolescence?

Dr Gupta: It is extremely concerning because adolescence is a critical period for brain development.

Nicotine affects attention, impulse control, memory, emotional regulation and the brain's reward pathways. Exposure during these formative years can create stronger addiction patterns and increase the likelihood of anxiety disorders and future substance dependence.

The developing brain is far more vulnerable to nicotine than the adult brain, which means early exposure can have consequences that extend well into adulthood.

If current trends continue, are we at risk of creating a generation addicted to nicotine under the illusion of smoke-free safety?

Dr Gupta: That is one of the biggest concerns within the medical community.

If this trend continues unchecked, we could see an entire generation developing nicotine dependence based on the mistaken belief that smoke-free means risk-free. Social reinforcement, attractive marketing and the normalisation of vaping as a stress-relief tool are making nicotine use appear harmless and socially acceptable.

The danger is that addiction often develops quietly. What begins as occasional social use can gradually influence mood, focus, sleep patterns, stress responses and emotional wellbeing. By the time users recognise that cravings have taken hold, quitting is often far more difficult than they expected.

What interventions are urgently needed from policymakers, schools and families?

Dr Gupta: Stronger regulation of flavouring, advertising, influencer promotions, online sales and youth accessibility is becoming increasingly important.

Equally important is education. Parents and teachers need to move beyond fear-based messaging and have open, evidence-based conversations with young people. Public health campaigns must clearly communicate that modern nicotine products can be highly addictive and carry significant health risks.

The goal should not simply be preventing experimentation but helping young people understand that nicotine dependence today often arrives in a much more attractive and socially acceptable package than it did a generation ago.