Children who begin using tobacco at 9 to 10 years old have significantly smaller brain area and volume than non-users within two years, according to a study published this month in JAMA Network Open [1].
The stunted brain development, observed on structural MRI by researchers at the University of Nebraska Medical Center in Omaha, corresponded in the study with subpar cognitive abilities.
And both sets of effects applied to vaping with electronic cigarettes as well as smoking with conventional “nicotine delivery systems.”
Lead author Hongying (Daisy) Dai, PhD, senior author Ali Khan, MD, MPH, MBA, and colleagues found 116 children in the longitudinal Adolescent Brain and Cognitive Development (ABCD) study who reported ever having used tobacco products.
Among these 116, some 80 said their smoke of choice was e-cigarettes or regular cigarettes.
A surprising number of these 9- and 10-year-olds said they’d instead—or also—used cigars (reported by 10 participants), smokeless tobacco (12 participants), hookahs (7 participants), pipes (5 participants) and/or nicotine replacement (8 participants).
Vaping vs. Smoking Only Substitutes One Set of Toxins for Another
After controlling for confounders, the team found the 116 “tobacco ever” users consistently scored lower than non-users in picture-vocabulary tests and crystalized cognition, which reflects previously acquired language-comprehension skills.
At two-year follow-up, the users also had significantly lower whole-brain measures not only in cortical area and volume but also in multiple regions across frontal, parietal and temporal lobes.
From these findings Dai and co-authors urge healthcare policy influencers to treat youths at risk of getting hooked on e-cigarettes and tobacco products as “a priority population in tobacco prevention.”
Addressing the inclusion of e-cigarettes in their introduction, the authors point out that companies often market these “alternative tobacco products” as safer and less detectable by parents’ sense of smell than combustible cigarettes.
“These marketing strategies could lower harm perception and increase curiosity among adolescents, making inroads to tobacco use among substance-naive children,” Dai and colleagues warn. “Youth nicotine use can lead to addiction and harm the developing brain, impairing learning, memory and attention, and causing impulsivity, irritability, anxiety and poor decision-making.”
What’s more, they note, e-cigarette aerosols and liquids have been found to contain neurotoxic chemicals, particles and free radicals—poor substitutes for the familiar chemical cocktail spicing old-school smokes.
Smaller, Lower-Volume Cortexes in Tweens an Avoidable Harm
In their discussion, Dai et al. point out that the total cortical area in healthy children continues to grow into early adolescence.
“Because the associative cortex (ie, frontal, parietal and temporal cortices) is essential for higher order cognition and continues development into early adolescence,” they add, “the decreased cortical surface area and cortical volume exhibited by tobacco-ever users during this critical development period may be of concern.”
The researchers’ primary conclusions:
Results of this cohort study suggest that initiation of tobacco use in late childhood at 9 to 10 years of age is associated with inferior cognitive performance and brain development with sustained effects at the two-year follow-up. Electronic cigarettes and smokeless tobacco products should not be treated as harm reduction alternatives for youth. Comprehensive intervention strategies and tobacco control policies are needed to prevent tobacco initiation.”
The study is available in full for free.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.