AP RESEARCH PAPER

KATHERINE KWON

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Katherine Kwon

Clouded Cognition: The Effects of Nicotine

Vaping on Adolescent’s Lives

Word Count: 4,900 words

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The reports on adolescents turning towards e-cigarettes have become clear in recent

years, as many teens are starting to turn to vapes to help them in various aspects of their lives.

With an abundant amount of advertisements promoting the use of e-cigarettes over cigarettes,

adolescents begin to develop a distorted view of e-cigarettes and believe that they are a

significantly healthier alternative (Tobore, et al). However, these incorrect viewpoints on

e-cigarettes become even more clear when observing how they affect individuals in different

areas of life.

Additionally, as advertisements constantly promote e-cigarettes over time, peer pressure

begins to play a significant role in the prominent use of these substances. As young adolescents

from across the globe become influenced by companies’ promotional tactics, many individuals

will go and spread the word to those around them, in attempts to come across as ‘carefree’ and

‘easygoing’ to others. One important factor to point out within these adolescents is that their

social groups will generally have more positive norms and opinions about e-cigarettes than

cigarettes because of the numerous commercials and advertisements vaping companies put out

that compare e-cigarette and cigarette products against one another (Piombo).

With more and more individuals negatively using word of mouth to promote e-cigarette

use, many of these adolescents will not truly realize the effects that e-cigarettes have until they

experience physical effects. Observing a select group of adolescents who began to vape at an

early age shed light on the direct correlation between mental health issues and nicotine use

(Livingston, et al). Subsequently, it was hypothesized that older adolescents who use vapes tend

to have significantly lower self-esteem compared to those who do not consume nicotine.

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Although this was later deemed as false, happiness and vaping continued to reveal a direct link

with one another (Janjua, et al). Furthermore, chemicals used in nicotine-based products were

found to have caused several health issues, such as cancer, cardiovascular disease, and acute lung

injury.

Additionally, many parents show concern with their children who use e-cigarettes when

their academic performance begins to decline. Many adults have academic concerns about their

children, as it has a significant impact on their future, and many parents depend on their children

to take care of them later on in life. With this growing fear, many schools have implemented a

school security system to help these staff members and authorities detect potential nicotine use

within their building, in hopes of reducing this problem. This academic decline not only affects

the children’s parents but also the teachers, as it causes numerous disruptions in the classroom

and other peers’ performances to decline (Rock). This leads me into my research question, how

does the frequent use of e-cigarettes affect the attention span of adolescents and impact them in

various life settings?

Cognitive Development:

To examine the rising rates and prevalence of vaping among adolescents, understanding

the relationship between cognitive development and vaping is crucial. Exploring the direct links

can allow people to understand the drastic changes that vaping has on cognitive development.

Therefore, these links will allow individuals to see the effects that an impaired cognition has on

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their academic performance, overall well-being, and the way it alters the way one may present

themselves.

Karem H. Alzoubi reveals the behavioral changes that individuals experience that are

caused by nicotine use and sheds light on vaping’s adverse effects on memory functions,

learning, and academic performance. Alzoubi's study established a direct, harmful link with

e-cigarettes when she "found that ECIG use could potentially play a role in maladjustments of

young adults such as poor learning and academic performance, increased aggressive and

impulsive behavior, poor sleep quality, attention deficits, impaired memory, and cognition, and

increased depression and suicidal ideation” (Alzoubi, et al).

As it becomes evident that infusing nicotine into one’s body exposes multiple threats to

an individual’s cognitive development, it becomes crucial to create personalized techniques for

these adolescents to protect their cognitive well-being. Recognizing the detrimental effects

e-cigarettes have on cognitive development and function, government policies and intervention

must go beyond traditional methods, as it is currently insufficient in reducing the massive vaping

rates in recent years.

History:

The historical development and increase of the vaping issue reveals the many

contributing factors to this dramatic rise over recent years. This unfortunate rapid growth has

educated the general public about the concerning rise among adolescents with the use of

e-cigarettes and the beginning of nicotine addiction.

Vanessa Cezarita Cordeiro's research points out the escalating use of e-cigarettes as the

most used tobacco product among American youth. She highlights that “as the young brain is

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still developing up until the age of 30, nicotine can also affect the formation of synapses,

tampering with the “wiring” of the brain and setting a teenager up for a lifetime of addictive

tendencies and potentially impacting mood, attention span and learning” (Cordeiro). In regards to

this dilemma, she urges to place bans on flavored e-cigarettes and increase the purchasing age of

these products.

Similarly with how vaping has become increasingly more prevalent over the years,

Carolyn Ann Stalgaitis’s research reveals the powerful influence social groups have on vaping

and identifies specific groups of adolescents needed to be targeted for future prevention

programs. Her study recognized that “rates almost doubled from 2017 (11.0% of 12th graders) to

2018 (20.9%), the largest substance use increase ever observed in the 44-year history of the

national Monitoring the Future study” (Stalgaitas, et al). To try and alleviate this alarming trend,

she and her team advocate for ways that healthcare providers can implement to reduce this

growing percentage of e-cigarette usage.

There has been a growing discussion on whether or not e-cigarettes negatively affect

other main aspects of life, in addition to solely just their attention span and brain development.

By understanding the direct correlation that e-cigarettes and vaping at a young age had on these

individuals, researchers could conduct qualitative research to deepen their understanding of other

aspects of life that vaping affects. This approach would not only create effective strategies and

methods to address this complex matter, but it would also shed light on the true harms vaping has

on one’s overall health and aid in developing personal strategies to assist these individuals.

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Data Collection & Analysis Steps/Justifications:

For my original research, I chose to do a qualitative research approach with coding and

content analysis for my method of research. This method was most suitable for my study, as it

primarily analyzes previous studies and findings related to my research question. As my question

dives deep into the topic of frequent e-cigarette use affecting adolescents’ attention spans and

impacting them in various life settings, a qualitative approach seemed most appropriate for my

study to explore these behaviors and analyze the individual experiences.

The data collection process must begin with a clear, concise research question, in order to

move on further with my research. In my instance, my final research question crafted was “how

does the frequent use of e-cigarettes affect the attention span of adolescents and impact them in

various life settings?”. With my research question being centered on both attention span and

different life settings, it directly targets my chosen area of study. Additionally, ensuring that I

derived focused and clear objectives from my chosen research question helped narrow down the

scope, which helped me find data specific to my question.

To further obtain information relevant to my research question, it was essential for me to

gather secondary data sources, primarily from MackinVia and Google Scholar. Sources that came

from academic websites were used throughout my entire research process because it ensures that

my data came from reliable databases that have been peer-reviewed, which guarantees its

reliability. Subsequently, I would refine the chosen sources to ensure that I highlighted key terms

directly related to my research question, which affirmed that my sources were focused on the

information I wanted to obtain from my research question. Since I had specific areas I wanted to

study, such as attention span and numerous life settings, my key words consisted of

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‘adolescents’, ‘attention deficits’, ‘behavioral effects’, ‘long-term’, ‘consequences’,

‘impairment’, and ‘interaction’. These terms were general enough to gather fixed pieces of

information, but precise enough to directly find answers to my chosen inquiry question. In other

words, my sources were chosen based on their level of credibility because I wanted my data

collection to be accurate and be a suitable analysis of my chosen research question and topic.

Subsequently, I created a document to organize the collected sources and file them by date to

properly show my data collection progress. Additionally, this document would contain

information on the research method chosen, life aspects it affected of an individual, any

quantitative data pieces for specifics, and the underlying reason as to why these adolescents

resorted to vaping. This allowed me to grasp a general, overall understanding of what each

source’s main points were, in order for quick analysis and to help me separate these sources into

themes for my coding process.

Furthermore, I made sure to have strict ethical considerations in place during the

selection of which data sources were going to be finalized in my final steps of research. These

ethical considerations consisted of identity concealment, which involved no exposure of age,

name, birthdate, and location. Ensuring that I was not only respecting the original data

contributors, but also having academic integrity during this process, I made sure that my chosen

sources met the ethical standards I had set and continuously maintained user confidentiality and

privacy.

Although I did focus on maintaining user confidentiality and privacy throughout this

process, as I mentioned before, my research utilized a content analysis methodology. In other

words, this type of study I chose primarily relied on preexisting data and findings from other

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researchers using pre-existing literature reviews, rather than conducting my primary research

with human participants. My chosen methodological approach and data collection process not

only ensured gathering reliable information that directly addressed my research question, but it

also guaranteed the confidentiality of the human participants that might have been used in any

previous research I gathered during my literature review. Therefore, this analysis of preexisting

research from other researchers helped provide me insight into the impact of using e-cigarettes

on adolescents’ attention spans in various life settings and situations.

In order to effectively analyze the data collected using the steps listed above, a coding

method was used, as previously mentioned. With this process, each source was later reviewed

again to determine which specific life aspects I wanted to focus on during this research process,

which ultimately ended up being social, physical, mental, and academic. This was because the

data collection process enabled me to see that the most recurring themes analyzed in my chosen

sources were those four life aspects. After gathering these finalized major life aspects that

e-cigarettes affect, I focused on gathering different solutions to combat this prominent issue

growing and a chart was later created to organize these findings into the listed life aspects above.

This chart would allow me to get a quick, visual representation and understanding of the true

extent that vaping affects these individuals in several different aspects of life, which then led me

to try and find solutions catered specifically to these adolescents that I focused on during my

gap. In this chart separated into my main themes, I tallied the frequency of how many times a

social, physical, mental, and academic characteristic of my sources were mentioned. Although

this was my overall chart of all the four aspects, I made four additional separate charts organized

for the specific theme chosen. This better helped me understand and organize the direct effects of

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e-cigarettes on a social, physical, mental, or academic part of one’s life in four distinct charts

while also having a broad, general understanding of all of these aspects into one chart.

During the final steps of finalizing my research and data pieces, triangulation was crucial

as it allowed me to further validate the information collected during the research process. Being

able to cross-reference the sources I gathered during the data collection process helped in

increasing the reliability of the chosen findings. Furthermore, triangulation helps remove any

potential biases that occurred during any previous researcher’s data collection that I observed in

my literature, which allowed me to confirm other researchers’ conclusions. This was because it

focused on gathering any key insights and points from several different sources, perspectives,

and methodologies during the entire research process.

The qualitative data analysis approach I had for my study involved a systematic process

that I had to conduct to review and synthesize the gathered data from my chosen sources.

Therefore, each source was examined to ensure that they aligned with my specific themes and

patterns in alignment with the impact of frequent e-cigarette use on adolescents’ lives. To

elaborate more on this concept, my analysis process involved the coding of the data and grouping

based on recurring themes, trends, and patterns that were identified within my coded data to

better understand the correlation between nicotine and young individuals. More specifically, the

separated themes I chose were social, physical, mental, and academic aspects of an individual’s

life that I decided to focus on. Subsequently, the coded data was synthesized to better answer my

chosen research question, as I now had a deeper understanding of my collected data findings.

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Social:

In regards to the escalating rise in e-cigarette use over the years, Rebecca D. Jones

highlights the detrimental effects that early exposure to nicotine has during brain development

and the long-term cognitive consequences individuals may face. Jones pointed out patterns she

saw in adolescents that were being targeted, as "advertisements influence perceptions of

e-cigarettes leading users and nonusers alike to cite e-cigarette use as a healthier alternative to

smoking combustible cigarettes and reporting that they believe e-cigarettes contain fewer

chemicals, less nicotine, and less smoke than their combustible counterparts” (Jones).

Similarly, Catherine E. Dubé and her collaborators provide insight into how there has

been an increase in nicotine labels in vape devices, as "the introduction of a device called a “pod

mod” containing a form of nicotine estimated to be 2 to 10 times more concentrated than nicotine

found in other vape liquids” (Dubé, et al). Their study involved 90 students and highlighted

negative social influences and peer pressure that drastically encouraged the use of e-cigarettes

and nicotine-infused products.

Physical:

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Lyzwinski and her partners highlighted the respiratory issues that come along with the

use of e-cigarettes, including asthma and bronchitis. Additionally, those who reported having

used nicotine or e-cigarette products were at a large disadvantage during the peak of COVID-19,

as “the odds of getting COVID were also five times greater in teenage vapers relative to their

non-vaping counterparts” (Lyzwinski, et al). Not only were they more likely to get this virus, but

Lyzwinski’s study also emphasized that they “found a rise in arterial blood pressure and heart

rate in young adult vapers using JUUL, but not in e-cigarettes without nicotine.

Cardiopulmonary risk is also compounded in dual e-cigarette and cigarette smokers” (Lyzwinski,

et al).

Adding onto Lyzwinski’s findings, Livingston and her colleagues found several oral

health difficulties that individuals faced after relying too much on nicotine and even finding

dependence on this drug. Although Livingston did state that e-cigarettes are a slightly healthier

alternative to traditional cigarettes, e-cigarettes still pose several problems to one’s overall health

and well-being. One of the more severe issues concerned with e-cigarettes is their uncertain

chemical concentration, as the “lack of consistency and regulation could place adolescents at

heightened risk of addiction or other harm resulting from exposure to toxins that may be present

in the vaping solution” (Livingston, et al). Inconsistent concentrations in e-cigarette products

being sold to the general public causes young individuals to be misinformed about the actual

nicotine concentration levels in a product.

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Mental:

Susanne Pallo's studies highlight how “both studies show that people who smoke and

vape – regardless of age – were most likely to report struggling with mental function. Behind

that group, people who only vape or only smoke reported mental fog at similar rates, which were

significantly higher than those reported by people who don’t smoke or vape” (Pallo). These

findings talk about how crucial it is to address threats posed by nicotine to individuals'

well-being, especially from a young age.

Furthermore, Emily Henderson expresses how “adolescence is a critical period for brain

development, especially for higher-order mental function, which means tweens and teens may be

more susceptible to nicotine-induced brain changes” (Henderson). This raises discussions about

when prevention programs should be implemented before it is too late to reverse nicotine has on

one’s cognitive development.

In addition to the cognitive drawbacks individuals undergo, Nicholas D. Wignall and

Harriet de Wit focused on discovering nicotine's influence on the attention spans between healthy

nonsmokers and unhealthy smokers. Furthermore, Barr used a modified signal detection task and

mentioned “that these enhancing effects of nicotine are complicated by possible preexisting

conditions affecting cognition, including nicotine withdrawal or disease-related impairments. It

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is less clear whether nicotine also improves cognitive performance in healthy nonsmokers, and

whether it affects only certain specific cognitive functions” (Wignall, Wit).

Academic:

In response to academic performance, Melanie Eyssen introduces the 'Sentry Plus for

Education' detection system to be implemented in schools to help identify the usage of vapes.

This proposed system "assists schools in implementing appropriate disciplinary actions. This

deterrence factor can contribute to a reduction in the prevalence of vaping and smoking within

the school community” (Eyssen). The urgency of the necessity of this system was stressed

heavily as it can work towards limiting the prevalence of vaping.

Discussing the effects vapes have on an individual’s mind, Dr. Joshua E. Danley's

contributions emphasize the concerning impact that vaping has on mood, attention, span, and

learning. He also provides insight into the misconceptions surrounding e-cigarette vs traditional

cigarette safety, in which he tries to convey that “the young brain is still developing up until the

age of 30, nicotine can also affect the formation of synapses, tampering with the “wiring” of the

brain and setting a teenager up for a lifetime of addictive tendencies and potentially impacting…

learning” (Danley).

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Overall, frequent e-cigarette use among adolescents has an influential impact on

numerous developmental aspects of one’s life. Therefore, future implications for social

interactions, physical health, mental well-being, and academic success of an individual begin to

revolve in conversations in recent years. By addressing these varying aspects, individuals can

come up with different strategies to support these adolescents' well-being.

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This qualitative study has revealed several findings about the direct effects e-cigarettes

have on different aspects of adolescents' lives. Furthermore, these important findings have future

implications for interventions or policy creations to be made by officials, in addition to new

knowledge that was discovered about the horrific dangers of e-cigarettes.

Throughout the research process, I explored the many effects that e-cigarettes had on the

overall well-being of an individual, which also included the disheartening reality of how

tremendous peer pressure from others negatively harms adolescent e-cigarette usage.

Specifically, research conducted by Rebecca D. Jones and Catherine E. Dubé highlighted the

dangerous impact of marketing tactics and peer pressure that adolescents faced, which resulted in

these individuals turning to e-cigarette use. As e-cigarette use has become more normalized in