Adolescent brain maturation and smoking: What we know and where we’re headed

Abstract

Smoking is a leading cause of mortality and morbidity worldwide. Smoking initiation often occurs during adolescence. This paper reviews and synthesizes adolescent development and nicotine dependence literatures to provide an account of adolescent smoking from onset to compulsive use. We extend neurobiological models of adolescent risk-taking, that focus on the interplay between incentive processing and cognitive control brain systems, through incorporating psychosocial and contextual factors specific to smoking, to suggest that adolescents are more vulnerable than adults to cigarette use generally, but that individual differences exist placing some adolescents at increased risk for smoking. Upon smoking, adolescents are more likely to continue smoking due to the increased positive effects induced by nicotine during this period. Continued use during adolescence, may be best understood as reflecting drug-related changes to neural systems underlying incentive processing and cognitive control, resulting in decision-making that is biased towards continued smoking. Persistent changes following nicotine exposure that may underlie continued dependence are described. We highlight ways that interventions may benefit from a consideration of cognitive-neuroscience findings.

Increasing the Value of an Alternative Monetary Reinforcer Reduces Cigarette Choice in Adolescents

“…In particular, adolescents process salient incentives differently than adults, and have more trouble inhibiting responses. 36 The changing neurobiology of adolescents underscores the need for studying this population distinctly from adults, and creating a through body of knowledge specific to the variables that may differentially affect the smoking behavior of this vulnerable population.…”

Insight into the Potential Factors That Promote Tobacco Use in Vulnerable Populations

“…In adolescents, both the physical signs and negative affective states produced by withdrawal are lower than adults. Thus, it has been suggested that the strong rewarding effect of nicotine is a major contributing factor to enhanced tobacco use during adolescence [68][69][70][71]. In females, nicotine withdrawal produces an intense anxietylike behavior but similar physical signs as compared to males.…”

A Practitioner's Guide to Electronic Cigarettes in the Adolescent Population

“…Nicotine has deleterious effects on the developing brain, harming neurodevelopment in utero and may have effects on brain development in adolescence [23,24]. Adolescence is a critical period of brain development with normal neurobiological changes that allow for increased risk-taking and heightened reactivity to short-term rewards rather than long-term goals.…”

“…Adolescence is a critical period of brain development with normal neurobiological changes that allow for increased risk-taking and heightened reactivity to short-term rewards rather than long-term goals. In animal studies, nicotine has been associated with cellular damage as well as acute and persistent changes in different neurobiological pathways within the developing adolescent brain [24]. Behaviorally, adolescents have been found to be more sensitive to nicotine and more likely to demonstrate dependence than their adult counterparts even with relatively low amounts of nicotine exposure and more likely to have continued use into adulthood [23,24].…”

“…In animal studies, nicotine has been associated with cellular damage as well as acute and persistent changes in different neurobiological pathways within the developing adolescent brain [24]. Behaviorally, adolescents have been found to be more sensitive to nicotine and more likely to demonstrate dependence than their adult counterparts even with relatively low amounts of nicotine exposure and more likely to have continued use into adulthood [23,24]. In fact, 88% of adults who remain daily smokers started before the age of 18 years [23].…”