New research finds connections between nicotine use, anxiety, depression, and other symptoms
Nearly 80% of nicotine-using girls in one study reported clinically relevant anxiety symptoms.
Researchers found mental health concerns among teens who used both traditional tobacco and newer nicotine products.
The studies found associations, but researchers say they cannot yet determine whether nicotine directly causes mental health problems.
Nicotine use among teenagers has changed in recent years, with products ranging from traditional tobacco to e-cigarettes and tobacco-free nicotine pouches. Now, three studies from the University of Gothenburg are raising questions about how nicotine use may be connected to mental health during adolescence.
The research found that adolescents who use nicotine were more likely to report symptoms of anxiety, depression, and other mental health concerns than those who did not use nicotine. The differences appeared particularly pronounced among girls.
Importantly, the researchers say the findings do not establish a cause-and-effect relationship. Other factors including stress, socioeconomic circumstances, alcohol use, other substance use, and individual vulnerability may influence both nicotine use and mental health.
How the research worked
The findings come from several studies that looked at the relationship from different angles. In one, researchers surveyed nearly 3,000 Swedish high school students about nicotine use and mental health symptoms.
Another study followed approximately 1,500 adolescents in southern Sweden over time, tracking them from lower secondary school through high school. This allowed researchers to examine how changes in tobacco use corresponded with changes in mental health and other symptoms.
The researchers also conducted experiments involving rats to explore what nicotine might do in the brain. They focused on the amygdala, a brain region involved in emotional regulation and responses to stress.
Together, the questionnaire studies, long-term follow-up, and animal experiments provided several types of evidence to examine the potential connection.
What the findings could mean
The results showed some notable differences. In the study of nearly 3,000 students, almost 80% of girls who used nicotine reported clinically relevant anxiety symptoms. The associations appeared with both traditional tobacco products and tobacco-free nicotine products, including nicotine pouches and e-cigarettes.
Among the adolescents followed over time, depressive symptoms and suicidal thoughts were more common among those who smoked. Girls who increased their tobacco use were also more likely to experience worsening sleep problems, anxiety, low mood, and concentration difficulties.
We see clear differences between girls and boys, with girls who smoke appearing to be particularly vulnerable, researcher Johanna Andersson said in a news release. At the same time, we need a better understanding of how nicotine pouches affect mental health, especially among adolescent girls, where the use of nicotine pouches has increased so rapidly.
The animal research may offer a possible biological explanation: nicotine altered communication between neurons and caused lasting changes in brain activity, with the strongest effects seen in female rats.
Still, the researchers stress that more work is needed. The findings raise questions about nicotine's effects on the developing brain and whether adolescent girls may be particularly sensitive, but they don't prove that nicotine itself causes mental health problems.
One of the key findings is that we see similar patterns across several different studies using different types of data. However, we still cannot determine cause and effect. The animal studies demonstrate biological changes in the brain that could contribute to increased vulnerability to anxiety and stress-related symptoms, researcher Louise Adermark said in the release.
Posted: 2026-08-17 15:47:16
















