The proliferation of new tobacco products in society threaten to reverse years of progress made toward ending nicotine addiction. This Truth Initiative Impact Series will explore the evolution of Big Tobacco into Big Nicotine. In addition to discussing the tactics the industry is taking to expand nicotine use and addiction, panelists will also discuss what actions must be taken to protect this next generation and society from a lifetime of nicotine addiction.

Big Tobacco has morphed into Big Nicotine. Faced with declines in cigarette use – the youth smoking rate dropped from nearly 23% in 2000 to an all-time low oral nicotine pouches and lozenges and the heated tobacco device IQOS. Companies have also begun to use synthetic nicotine – created in a laboratory and not derived from tobacco –raising regulatory challenges and health concerns. Alongside this proliferation of products, many with high nicotine concentrations, tobacco use (including cigarettes) is pervasive in popular culture, putting young people at risk for a lifetime of addiction.

Youth nicotine use in any form is unsafe. Nicotine is harmful to developing brains, and young nicotine users are more likely to become addicted, have more difficulty quitting, and may be at higher risk for addiction to other substances in the future. Dual use of e-cigarettes and cigarettes is also common among young people.
Many of these newer products contain high nicotine concentrations, which is not restricted in the U.S. For example, nicotine levels in some e-cigarettes match or exceed levels found in combustible cigarettes, and the average nicotine concentration in e-cigarettes sold in the U.S. doubled in just the five years between 2013 and 2018.
The tobacco industry continues to cultivate influence with the general public, thought leaders, the scientific community and policy makers, lobbying against policies that strengthen tobacco control efforts, seeking publication in scientific journals and running million-dollar “advertorial” content campaigns across national media outlets aimed to influence the public about the health dangers of its products.
In addition to the physical health effects of tobacco, nicotine can negatively affect mental health by amplifying anxiety symptoms and feelings of depression and stress. Many young people have turned to nicotine to deal with these feelings, unaware that it may be making them feel worse – a serious concern amid a worsening youth mental health crisis.