A recent study revealed that adolescents who exclusively vape may have nicotine exposure levels comparable to those who smoke tobacco.

In the study, published in JAMA Network Open, researchers recruited 364 participants aged 16 to 19 years from Canada, England, and the United States, who provided urine samples to measure nicotine metabolites

The researchers found no statistically significant differences in total nicotine equivalents (TNE-2) among the adolescents who exclusively vaped (3.10 nmol/mg creatinine), exclusively smoked (3.78 nmol/mg creatinine), or engaged in dual use (6.07 nmol/mg creatinine). All groups that vaped or smoked had significantly higher TNE-2 concentrations compared with those who reported no use (0.19 nmol/mg creatinine, P < .001).

Among the 73 adolescents who exclusively vaped, those using products with nicotine salts exhibited higher TNE-2 concentrations (10.78 nmol/mg creatinine) compared with those using nonsalt products (2.72 nmol/mg creatinine, P = .03).

Lead study author David Hammond, PhD, of the School of Public Health Sciences at the University of Waterloo, and his colleagues noted: "Vaping was associated with similar nicotine exposure as smoking among adolescents," suggesting potential implications for understanding dependence and long-term vaping patterns.

Conducted between September 2019 and January 2022, the study included analyses performed in early 2023. The participants completed questionnaires regarding their smoking and vaping habits and self-collected urine samples. The researchers aimed to assess differences in nicotine exposure based on smoking and vaping status, country of residence, and characteristics of the last vaping product used.

Notably, adolescents using vaping products with nicotine concentrations above 20 mg/mL didn't show statistically significantly differences in TNE-2 levels compared with those using products with 20 mg/mL or less. This finding suggested that nicotine concentration alone may not be the sole factor influencing nicotine exposure.

The researchers emphasized the importance of understanding nicotine exposure among adolescents, particularly as vaping becomes increasingly popular. They raised concerns about the potential for addiction and long-term health effects, stating that "these findings suggest that nicotine intake is similar among adolescents who vape and adolescents who smoke."

The researchers underscored the need for continued research into the effects of vaping on youth and the implications for public health policies aimed at reducing nicotine exposure among adolescents.

Full disclosures are available in the study.