Teens, Smoking and Mental Health

Young people with mental health concerns are four times more likely to smoke than their peers, this increases further for young people who also use alcohol or drugs. 

Cigarettes are smoked by over 1 billion people worldwide. Most Adult smokers began smoking early. 90% of smokers were smoking before their 18th birthday, with another 5% beginning before they reach their 26th birthday. If you are not smoking by your 18th birthday, you have a really good chance of not taking up the habit at all, and that’s great news. 

How Does Nicotine Work in Teenage Brains?

Nicotine is a stimulant and it activates an area located in the middle of a young person’s brain. Nicotine stimulates a neurotransmitter called acetylcholine that is responsible for many activities and functions in our bodies. This includes our heart rates, the way that we move our muscles and also our cognition, particularly the part that affects the way we pay attention to our surroundings. 

Nicotine then causes a chemical called dopamine to be released in a nearby area of the brain. This part of the brain is involved in reward and it is involved in other addictive behaviours. Illegal street drugs, like cocaine and amphetamines also increase dopamine in this area of the brain. The teenage brain is not able to tell the difference between a safe reward and a toxic reward; it just knows that it likes what is happening and most importantly wants more of it. 

How Do Teens Become Addicted to Tobacco?

The younger you are when you try your first cigarette, the more likely you are to become addicted to cigarette smoking and tobacco products. Children and teenagers who have parents who smoke are also more likely to try smoking. Young people with peers who smoke regularly are also more likely to try smoking. 

Nicotine is absorbed into the bloodstream through the lungs. The lungs are a very large area that provides an effective route for the nicotine to be quickly and easily absorbed. Tobacco smoke is the fastest and most rewarding way of getting nicotine into our brain. 

The quicker the nicotine can get to the brain, the more addictive the cigarette becomes.

Cigarettes Get Nicotine to the Brain in Lightning Speed

A cigarette is cleverly designed to get nicotine to reach your brain as fast as it can. The designers and manufacturers of cigarettes want teens to smoke earlier and smoke more often. This is because young smokers are often smokers for life and that makes a fantastic business model for the cigarette manufacturing giants. 

Chemicals are added to the tobacco plant to help the speed that nicotine can be absorbed. Some of these chemicals are dangerous. Ammonia is often added. Most people can recognise the smell of ammonia, particularly when it is used in public bathrooms for cleaning. 

Vanilla, cocoa and honey are also added to take away the nasty tastes of the chemicals. Cocoa is also known to widen our airways – it’s a bronchodilator which helps to get more tobacco into young people’s lungs quickly, which in turn gets more nicotine into the brain. 

Quick Fact : Did you know that tobacco smoke is made up of over 500 different gases, including hydrogen cyanide? 

How Does It Feel To Smoke a Cigarette?

Young people who have their first cigarette may feel dizzy, woozy or like they are going to be sick. They may also feel anxious and a little shaky.

When young people move past the initial discomfort, they may find that cigarettes make them feel sharper, more alert, quicker and in a better mood because of nicotine’s stimulant qualities. 

However, this honeymoon period does not last for long. The body soon gets used to the amount of nicotine that it is experiencing and the improvements in concentration and performance reduce and then stop. This is very similar to the tolerance that builds up in alcohol or drug use, in something that we understand leads to addiction. 

Smoking Habits in Teens

A coffee and a cigarette? A cigarette between assignments? It doesn’t take long for our brains to do something that scientists call ‘pairing’.  Pairing means that our brains get used to the clues of doing things together and that reinforces the reward patterns in the brain. 

Teens Smoke More Cigarettes More Often

The effects of nicotine last for about two hours in a teens body. That means that every two hours or so, the teenage brain gives out a signal to let the body know that it needs another hit of nicotine. That is because the young persons body starts to enter withdrawals. Withdrawal is something that we often associate with street drug use, however the same process happens with cigarette smoking. 

Quick Fact: Researchers use the amount of time from waking up in the morning to reaching for your first cigarette as a way to measure how addicted you are to smoking. The morning cigarette or time from waking to smoking is a really good place to start cutting down, by increasing the amount of time between waking and have it the first smoke of the day. 

Withdrawal Symptoms From Cigarette Smoking in Teens

Teens and young people may feel restless, withdrawn, agitated, have a low mood, unable to concentrate, pacing, and anxious as the effects of the last cigarette wear off. The easiest way for the brain to get back to feeling ‘normal’ is to have another cigarette. This is the process of physical and psychological addiction. 

Nicotine and Teens 

Nicotine is not as harmful as the other ingredients in cigarettes. Nicotine patches, gums and other nicotine replacement products can really help Teens with the withdrawals and cravings that follow attempts to quit smoking. 

One in two smokers will die from a smoking related condition. We also know that smokers who start smoking early are at increasingly high risk of addiction. 

Smoking and Mental Health in Teens 

Smoking is linked to mental health in teenagers and young people. We know that young people with mental health concerns are more likely to smoke than their peers. We also know that teenage smokers have higher rates of anxiety and depression and are more likely to experience severe episodes of psychosis. 

Top Tips To Quit Teen Smoking

1) Nicotine replacement therapy is an accessible way that teens can tackle quitting. There are eight types of nicotine replacement therapies available to help teens quit. Nicotine replacement therapies are often more effective if you use two different types at the same time. Maybe, gum and a patch together or an inhalator and a gum. It’s important to work out how much Nicotine that you will need to stave off the cravings. This will be based on how many cigarettes you have most recently been smoking. The nicotine in your patches or gums should match the levels of nicotine that you have been smoking. 

2) Remember that nicotine gum is chewed differently to regular chewing gum. You need to chew the gum until you taste the flavour and then rest the gum on the side of your mouth, leaning the gum on the inside of your cheek. This is because the nicotine is absorbed through the cheeks and the back of the lips. 

3) Parents can join and make Family Quit Plan. Children of parents who do not smoke, are less likely to smoke themselves. Children are also less likely to be harmed by second hand smoke. 

4) Take some advice from your pharmacist or family doctor. People who stop smoking with help are more likely to stay stopped. 

5) Medications are available to help people to stop smoking. Your Child and Adolescent psychiatrist will be able to advise you on the types of medication that are available. 

6) Switch to electronic cigarettes or E-cigarettes, both have been effective at helping young people reduce the harm before quitting. About 40% of people who quit use an e-cigarette. 

Helping to reduce the exposure of children and teenagers to smoking is something that we can all play a part in to prevent the next generation of long term smokers and move to a smoke free society.



Fiona Yassin is the International Clinical Director of The Wave Clinic. Fiona is a UK Registered Adolescent and Family Psychotherapist and Clinical Supervisor (Licence number #361609 NCP/ICP), further trained in the specialty of Eating Disorders and Borderline Personality Disorder Treatment. Fiona is trained in FBT (Family Based Therapy), CBTE for eating disorders, FREED (King’s College, London), EMDR for eating disorders (EMDRIA) and has a Post-Graduate Diploma in Neuroscience and Trauma from the University of Tennessee, Knoxville.

Fiona works with international families and family offices from the UK, Dubai, Kuwait, Singapore and Malaysia. Fiona can be contacted by email on fiona@thewaveclinic.com.