New research from Sweden reveals that adolescents using nicotine, through traditional cigarettes or e-products like e-cigarettes and pouches, are increasingly experiencing anxiety, depression, and related mental health symptoms, with girls notably more vulnerable.
Adolescents who use nicotine are more likely to report anxiety, depression and related mental health symptoms than their peers who do not, according to researchers at the University of Gothenburg. The Swedish team said the pattern showed up across traditional tobacco and newer products such as nicotine pouches and e-cigarettes, raising fresh concerns about how rapidly changing nicotine habits may affect young people’s mental health.
In one study of nearly 3,000 Swedish secondary school pupils, almost 80% of girls who used nicotine reported clinically relevant symptoms of anxiety. The researchers also followed about 1,500 teenagers in southern Sweden from lower secondary school through upper secondary school and found that depressive symptoms and suicidal thoughts were more common among those who smoked. Girls whose tobacco use increased over time were more likely to develop worse sleep problems, low mood, trouble concentrating and anxiety, suggesting that the risks may deepen as use becomes more frequent.
A larger preprint study posted on medRxiv, involving 166,989 adolescents, found that any use of tobacco and nicotine products, including nicotine pouches and e-cigarettes, was associated with generalised anxiety. The odds rose with more frequent use, with daily nicotine pouch use linked to a higher risk than never use, although the association was even stronger for daily e-cigarette use. The authors said the findings point to a dose-related pattern, but not proof that nicotine directly causes the symptoms.
Animal research published in Neuropharmacology offers one possible biological explanation. In rats, nicotine changed signalling in the amygdala, a brain region involved in stress and emotion, and those effects persisted after the drug had left the body. The University of Gothenburg researchers said the changes were most pronounced in female animals, echoing the pattern seen in their school-based studies. Another study in the journal Adolescence also found that both tobacco and tobacco-free nicotine products were linked with higher odds of anxiety or depression symptoms, with girls appearing especially vulnerable and dual use posing added risk for boys.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
