Being a teen today isn’t easy. Between school, part-time jobs, social media, activities, friends, and figuring out plans for college, trade school, or entering the workforce, a lot is happening. On top of all that, there has been a rise in teen vaping in the past few years and more recently, a rise in the use of nicotine pouches.

At first glance, the fruity flavors and colorful packaging might seem harmless, but there’s a much bigger story underneath. How is all this nicotine affecting young people’s mental health? Let’s dive in and find out.

Did you know? Even before the COVID-19 pandemic, 70% of young people said anxiety and depression were major problems among peers, according to a study by the Pew Research Center.

In the 2021–2022 CDC Youth Risk Behavior Survey, teens ages 12–17 reported troubling mental health concerns: 21% experienced symptoms of anxiety in the past two weeks, 40% reported persistent feelings of sadness or hopelessness in the past year, and 20% seriously considered suicide. It’s clear that stress and anxiety affect many young people.

While teens are already facing growing mental health challenges, they are also navigating the public health concern that comes with the increase of nicotine products in the community.

According to the 2024 National Youth Tobacco Survey, more than 1.63 million youth (7.9% of high school and 3.5% of middle school students) currently use e-cigarettes, and of young people who currently use a tobacco product, more than 1 in 3 used more than one type of product (E-Cigarette Use Among Youth | Smoking and Tobacco Use | CDC).

You can learn more about the rise of teen vaping in North Carolina in WRAL’s Documentary: Gen V: Teen Vaping in North Carolina explores the rise of teen vaping.

Results from the Annual National Youth Tobacco Survey | FDA

The good news is that e-cigarette use has decreased among high school students. However, concerningly, there has been an increase among middle school students. It is widely known that nicotine harms the developing brain, making young people more vulnerable to addiction.

What many people don’t realize is the possible connection between nicotine use and mental health challenges. Research is ongoing and there is not yet direct evidence that nicotine causes mental illness, but numerous studies show that nicotine use can increase and worsen symptoms of anxiety, depression, and other mental health challenges.

Youth continue using other nicotine products for the same reasons. Unfortunately, while they may begin using nicotine to alleviate symptoms, it has been found that nicotine use can actually increase and worsen symptoms of depression and anxiety, and has also been linked to heightened symptoms of ADHD.

In fact, surveys show that 45% of young people who vape believe it is acceptable to vape for stress relief, though that misunderstanding is likely due to the cycle of nicotine withdrawal and addiction. When someone stops using nicotine, withdrawal symptoms such as irritability, anxiety, and depression can occur.

Using nicotine products temporarily relieves these symptoms of withdrawal, but only for a short time. Because symptoms ease up, using nicotine again is falsely seen as “helping” or “relieving stress.” In actuality, the person is trapped in a cycle of use, withdrawal, increased use, and withdrawal and use again, which is the cycle of addiction. What may feel “helpful” is actually causing an increase of harm.

Because this harmful messaging is so present in youths’ lives, it is crucial that adults demonstrate healthy coping strategies for managing mental health challenges. Some proven self-help strategies include regular exercise, relaxation techniques, proper nutrition, and healthy sleep habits. Engaging in hobbies and activities can also be an effective way to manage stress without turning to tobacco products.

It is important to talk openly with young people about mental health and substance use, assure them that professional help is available, and help them access care. Youth need a trusted adult: someone who is encouraging, consistently present, and listens and supports them. This can make a huge difference in a young person’s life.

It is essential that caregivers have regular conversations about mental health and substance use. An easy way to start is using everyday opportunities to prompt conversations, for example, when watching a movie or reading a book. Using these strategies and fostering bonds with our children strengthens resilience and supports healthy brain development, allowing them to better handle stress.