E-cigarettes may promote illicit drug use and addiction

PUBLIC RELEASE DATE: 3-Sep-2014

Contact: Karin Eskenazi
Columbia University Medical Center
E-cigarettes may promote illicit drug use and addiction
Nicotine, no matter the source, may function as a gateway to marijuana and cocaine

NEW YORK, NY (September 3, 2014)—Like conventional cigarettes, electronic cigarettes (or e-cigarettes) may function as a "gateway drug"—a drug that lowers the threshold for addiction to other substances, such as marijuana and cocaine—according to the 120th Shattuck lecture, presented to the Massachusetts Medical Society by Columbia researchers Denise and Eric Kandel and published today in the online edition of the New England Journal of Medicine.

"While e-cigarettes do eliminate some of the health effects associated with combustible tobacco, they are pure nicotine-delivery devices," said co-author Denise B. Kandel, PhD, professor of sociomedical sciences (in psychiatry), Department of Psychiatry and Mailman School of Public Health, at Columbia University Medical Center (CUMC).

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they found that when mice are exposed to nicotine, it alters their brain biochemically and induces activation of a reward-related gene. As a result, nicotine primes the animals' subsequent response to cocaine, providing a molecular basis for nicotine as a gateway drug for cocaine.

Dr. Denise Kandel's further analysis of 2004 epidemiologic data from a large, longitudinal sample suggested that nicotine also primes human brains to respond to cocaine. She found that the rate of cocaine dependence was highest among users who started using cocaine after having smoked cigarettes. "Our findings provided a biologic basis for the sequence of drug use observed in people," said Dr. Eric Kandel. "One drug alters the brain's circuitry in a way that enhances the effects of a subsequent drug."

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"E-cigarettes have the same physiological effects on the brain and may pose the same risk of addiction to other drugs as regular cigarettes, especially in adolescence during a critical period of brain development. We don't yet know whether e-cigarettes will prove to be a gateway to the use of conventional cigarettes and illicit drugs, but that's certainly a possibility. Nicotine clearly acts as a gateway drug on the brain, and this effect is likely to occur whether the exposure comes from smoking cigarettes, passive tobacco smoke, or e-cigarettes."

Studies show that the typical e-cigarette user is a long-term smoker who has been unable to stop smoking. However, the researchers point out that e-cigarette use is increasing exponentially among adolescents and young adults.

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