Vaping and your brain: What to know

Many people are curious as to how vaping impacts the brain. As a researcher who studies the psychology behind smoking, I share that curiosity.

Vaping is the process of inhaling an aerosol that contains nicotine, flavoring and other chemicals. Vaping is relatively new compared to smoking, so there's a lot we're still learning. However, vapes often contain an ingredient we know plenty about: nicotine. We can use this information to help us understand how vaping impacts the brain.

Here is what my team is learning about vaping and how it affects brain health and development.

How does vaping impact the brain? 

Nicotine is a highly addictive substance. When you vape, the nicotine you inhale can dysregulate activity in several parts of the brain. This can make nicotine more desirable. 

The brain functions that nicotine affects include:

• Reward processes: These are a central component of the brain’s motivational systems. The motivational systems guide behavior toward positive outcomes or away from negative ones.
• Executive function: This set of cognitive processes is essential for controlling and managing thoughts, actions and emotions.

When nicotine hits the brain, it produces effects that are similar to those produced by other rewards like food, sex and social connection. Nicotine can “hijack” the brain mechanisms that support reward and executive functions and bias them toward nicotine and nicotine-associated cues. This means that through repeated exposures, the brain learns that certain cues, such as vape logos and even the shape of a vape device, are associated with nicotine.   

The associations between these cues and nicotine can be so strong that they lead to addiction. 

My team is using brain imaging to study why some people are more affected by drug cues – like pictures of vapes or people vaping – than others.

What parts of the brain are affected by nicotine?

Nicotine primarily impacts the brain regions involved in reward processing and cognitive control. These areas are crucial for regulating emotion, motivation and impulses.

In our studies, we showed that there are large individual differences in the effects of nicotine on the brain. Some individuals have stronger brain responses to these nicotine-related cues than to non-drug-related rewards. For them, resisting the lure of nicotine is more difficult. These individuals tend to compulsively use nicotine when exposed to nicotine-related cues. They are also more likely to relapse when they try to quit.

Our team is developing tools to identify people who are sensitive to nicotine-related cues. These screening tools will help us develop more successful, personalized smoking cessation treatments.

Does vaping impact mental health? 

There is a complex relationship between nicotine use and mental health.

Nicotine addiction is often seen in those with other behavioral or mental health conditions such as:

• attention-deficit/hyperactivity disorder (ADHD)
• anxiety disorders
• depression 
• other substance use disorders

Some individuals with mental health concerns might use nicotine as a form of “self-medication” to find temporary relief from their symptoms. However, nicotine withdrawal can worsen anxiety and depression symptoms. 

Our studies and clinical trials show that quitting smoking improves mental health symptoms.

Are there any brain development risks specific to youth and young adults who vape? 

The human brain continues to mature until a person is in their mid-20s. The prefrontal cortex – the part of the brain responsible for functions like impulse control – develops significantly during adolescence and young adulthood. 

Using nicotine while the brain is still developing can have long-lasting effects because it dysregulates activity in the brain’s neuronal circuits. These circuits control: 

• attention 
• impulse control 
• mood   
• reward sensitivity

Youth and young adults who use nicotine products may also be more vulnerable to:

• nicotine dependence
• mental health problems
• use of other addictive substances  

For these reasons, youth and young adults should avoid using nicotine, including vape products.

In late 2019, the legal age for purchasing nicotine products increased from 18 to 21 to reduce nicotine use among young adults.

Can quitting vaping improve brain function, or is the damage permanent?

Our team studied this by showing nicotine-related photos to people who currently smoke, used to smoke and have never smoked. Then, we measured their brain response to these images. Our results found that neither non-smokers nor former smokers felt motivated to smoke after viewing these images compared to current smokers.

This means it is possible to reverse nicotine’s effects on the brain. However, it is common for former smokers to relapse even after long periods of not smoking. Specific environments, emotional states or cues can suddenly trigger a craving that, if not managed, can lead to relapse. That is why nicotine addiction is considered a chronic relapsing disease that often requires multiple quit attempts. 

What resources can help you quit vaping?

If you want to quit smoking or vaping, you don’t need to do it alone.

MD Anderson’s Tobacco Research and Treatment Program provides evidence-based smoking cessation treatments to every MD Anderson patient and employee.

Additionally, This is Quitting provides free, anonymous text support for people ages 13-24 who want to quit vaping.

Request an appointment at MD Anderson online or call 1-877-632-6789.

Jason Robinson, Ph.D., a professor in the Department of Behavioral Science, and Jennifer Cofer, executive director of MD Anderson’s EndTobacco® program, also contributed reporting to this story.