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In a matter of years, e-cigarettes have spread across the country and into the hands of nearly four million adolescents, according to the National Youth Tobacco Survey. Despite their meteoric rise in popularity, research into the world of vaping is a bald spot that Yale scientists are racing to rectify.

For researchers at the Yale Tobacco Center for Regulatory Science, the similarities between cigarettes and e-cigarettes are helpful for closing this knowledge gap. According to co-leader of the Center Suchitra Krishnan-Sarin, both products contain the addictive chemical nicotine, which in high-enough doses, can prove to be harmful to the brains of young children and teenagers.

“The teen brain is very sensitive to the effects of nicotine,” she said. “During adolescence, the brain is growing and maturing and developing connectivity. Nicotinic receptors are one of the primary regulators of many of these pathways. If you use nicotine, you are altering your pathways and processes related to cognition and memory, your response to rewards, and also your anxiety and depression pathways.”

Even though there is still more research to be done, her advice for teens is simple: Do not start vaping.

“There are certain people who may genetically be predisposed to having an addictive nature or addictive behavior,” she said. “If they use the addictive substances, there is a greater possibility that this might not just be a one-time use but that they may develop addiction faster.”

Since both cigarettes and their electric counterparts contain nicotine, those who may want to quit vaping may find success by utilizing the same techniques that cigarette smokers use to quit smoking, she said. For example, since most smokers are used to bringing cigarettes to their mouths, Krishnan-Sarin recommended replacing this hand-to-mouth habit with a different activity that can stimulate the body in a similar way. This can take the form of chewing gum or eating carrots.

But Director of Yale’s play4REAL Lab Kimberly Hieftje believes that similarities stop at the chemical level: For this new generation of smokers, more high-tech solutions may prove to be more effective at convincing people not to smoke. Her team at the Yale Center for Health & Learning Games has developed several video games to prevent early addiction to smoking and other harmful substances.

In one game called Invite Only VR, players use virtual reality to navigate through social situations and avoid peer pressure related to vaping. Hieftje said that these new techniques are more appropriate for today’s adolescents because they provide a safe space for children to practice social skills.

“For instance, they can practice refusing peers in simulated high-risk situations involving social pressure,” she said. “We focus heavily on teaching about nicotine addiction, as this is a serious concern with the current generation and the increased use of e-cigarettes.”

While prevention and cessation are both hot topics in tobacco research, actually determining what makes e-cigarettes so popular will take more time and effort, Krishnan-Sarin said. One principal concern among researchers is the ethics of studying adolescents.

“I couldn’t bring a young person into a lab and just give them nicotine for the heck of it and say ‘Hey, let’s see what happens.’ That wouldn’t be right, and I wouldn’t do it in a human,” she said.

Rat trials, on the other hand, show interesting results, according to Krishnan-Sarin. Young rats are more sensitive to nicotine than adult rats, and also have a lower tolerance to the substance. This means that mature animals have the potential to consume more nicotine without the harmful effects. As researchers continue to study e-cigarettes, they will rely on animal trials and cigarette studies to support their findings, she said.

In a University of Michigan survey measuring adolescent drug addiction, researchers reported a 10 percent increase in e-cigarette use among high school seniors in 2018 alone.

Matt Kristoffersen | matthew.kristoffersen@yale.edu