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Pediatrics. 2020 Feb 11. pii: e20191346. doi: 10.1542/peds.2019-1346. [Epub ahead of print]

The Effects of Nicotine on Development.

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Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois;
Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine and.
Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois.
Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Department of Pediatrics, Icahn School of Medicine at Mount Sinai and Kravis Children's Hospital, New York, New York.
Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire; and.
Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois.


Recently, there has been a significant increase in the use of noncombustible nicotine-containing products, including electronic cigarettes (e-cigarettes). Of increasing popularity are e-cigarettes that can deliver high doses of nicotine over short periods of time. These devices have led to a rise in nicotine addiction in adolescent users who were nonsmokers. Use of noncombustible nicotine products by pregnant mothers is also increasing and can expose the developing fetus to nicotine, a known teratogen. In addition, young children are frequently exposed to secondhand and thirdhand nicotine aerosols generated by e-cigarettes, with little understanding of the effects these exposures can have on health. With the advent of these new nicotine-delivery systems, many concerns have arisen regarding the short- and long-term health effects of nicotine on childhood health during all stages of development. Although health studies on nicotine exposure alone are limited, educating policy makers and health care providers on the potential health effects of noncombustible nicotine is needed because public acceptance of these products has become so widespread. Most studies evaluating the effects of nicotine on health have been undertaken in the context of smoke exposure. Nevertheless, in vitro and in vivo preclinical studies strongly indicate that nicotine exposure alone can adversely affect the nervous, respiratory, immune, and cardiovascular systems, particularly when exposure occurs during critical developmental periods. In this review, we have included both preclinical and clinical studies to identify age-related health effects of nicotine exposure alone, examining the mechanisms underlying these effects.


Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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