Troubling trend: Move over cigarettes and vape pens, teens are reaching for a new form of nicotine
BOSTON -- Last August, the Food and Drug Administration issued a Warning Letter to the manufacturer of KraveNic nicotine gummies and shortly thereafter those unauthorized tobacco products were pulled from the market.
End of story for nicotine gummies. At least for now.
But not for other oral nicotine formulations. From lozenges to gums to pouches meant to be jammed in the mouth like chaw, nicotine has found its way into a variety of discrete delivery systems -- and a new study finds kids gravitating towards these products.
The study, which appears in the journal Pediatrics, surveyed some 3,500 high school students in Southern California.
“What we found is that more than three percent of teens had tried these types of products,” said Adam Leventhal, PhD, one of the study authors. “One of the key reasons they’re using these products is they like the flavors. An additional thing is they can use these products discreetly.”
Leventhal, Director of the University of Southern California Institute for Addiction Science, said oral nicotine products ranked second only to vaping among students they sampled.
“Typically, when we think of nicotine and oral nicotine products we’re thinking about a medication -- nicotine gum -- to help you quit smoking,” Leventhal said. “But this new bent of commercial nicotine products that are not being sold to help people quit, but merely as a recreational form of nicotine, this is definitely new.”
And that raises the new and troubling possibility of a crisis similar to teen vaping.
“It really all comes down to the point that nicotine is an addictive substance,” said Sharon Levy, MD, MPH, Director of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital. “How addictive it is depends on the way it’s being used. Generally speaking, products that you eat or suck on will get into your brain more slowly.”
That’s opposed to smoking and vaping -- which deliver quick, high bursts of nicotine, she said.
But Levy said there’s no guarantee manufacturers aren’t altering the oral products in some way to enhance nicotine delivery.
“We really don’t know what sorts of manipulations might be going on behind the scenes for these oral products because they’re not regulated.” she said. “Even if their addictive potential is low we still don’t want children using nicotine.”
The adolescent brain, Levy said, is particularly vulnerable to the effects of nicotine.
“In low doses, it can help people concentrate,” she said. “In higher doses it can actually be a little bit disruptive.”
Long-term nicotine use in adolescence can result in trouble learning and paying attention. And while science has yet to catch up to oral nicotine products, it’s possible, Leventhal said, that, like vaping, oral nicotine could invite subsequent cigarette use.
That would be a shame, said Matthew Myers, President of the Campaign for Tobacco-Free Kids.
“Just as we saw what was, by any definition, historic progress in reducing cigarette use (in children), E-cigarettes came on the market in flavors that appeal to kids -- and now there are a wide variety of products like flavored gummies,” said Myers. “They threaten to undermine, literally, decades of progress.”
It is possible the FDA could order other oral nicotine formulations off the market -- pending review of their marketing applications. But, in the meantime, they are easily accessible to kids, Myers said.
“Kids will pick these products up, not understanding that there’s any threat whatsoever, begin using them and then not be able to quit,” Myers said. “And we will see an explosion of these products just as we saw with the explosion of flavored e-cigarettes.”
This is a developing story. Check back for updates as more information becomes available.
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