A note before we begin: When we use the word "tobacco" on this page, we are referring to commercial tobacco products manufactured and sold by the tobacco industry that are designed to create addiction. This is different from traditional tobacco, which holds deep cultural, ceremonial, and spiritual significance for many Native and Indigenous communities and is used in a sacred, intentional way. These are not the same thing. To learn more about traditional practices and Native and Indigenous well-being, visit our Native & Indigenous Youth page.

What is Tobacco?

Tobacco is a plant that contains nicotine, a highly addictive chemical that stimulates the brain and causes dependency. Just as cannabis is a drug class, tobacco is a drug class. Commercial tobacco products come in many forms, but they all have one thing in common: they contain and deliver harmful chemicals, including nicotine. 

Nicotine is a toxic substance — the addictive chemical found in all commercial tobacco products. Historically, nicotine was sourced from the tobacco plant. Today, it's also produced synthetically in a lab. Regardless of its source, nicotine is harmful to the body and brain.

Commercial tobacco use is the single most preventable cause of disease, disability, and death in the United States. No commercial tobacco product is safe to use. And "safer" never means "safe."

In the United States alone, tobacco companies spend more than $8 billion each year on marketing, according to the Truth Initiative, much of it through price discounts and flavored products that appeal to many populations, including racial and ethnic minorities, LGBTQ+ individuals, women, youth, members of the military, and those with mental health conditions.

Two sources of nicotine

Plant-based nicotine Nicotine sourced from the tobacco plant. As the tobacco plant grows, it absorbs chemicals from soil and fertilizer, including cadmium, lead, and nitrates. During manufacturing, additional chemicals may be added to help nicotine absorb into the body more quickly. Plant-based nicotine is found in cigarettes, cigars, pipes, and many e-cigarettes and oral nicotine products.

Synthetic (lab-made) nicotine Synthetic nicotine is made in a laboratory. Tobacco companies often label products containing synthetic nicotine as "tobacco-free" or "tobacco-leaf free" — but this is misleading. These products still contain nicotine and are still classified as tobacco products. Synthetic nicotine is used in some e-cigarettes and oral products.

Important: "Tobacco-free" does not mean nicotine-free — and it doesn't mean safe.

Some brands also add nicotine salt (nic-salt) to products to reduce the harsh feeling of nicotine on the throat, which allows the body to absorb even higher levels of nicotine more quickly.

Types of commercialized tobacco products

Tobacco products come in many forms. All of them deliver nicotine and other harmful chemicals to the body.

  • E-cigarettes / vapes — electronic devices that heat a liquid into aerosol. Nicotine delivery can be very high (an example of a popular e-cigarette brand is Juul).
  • Nicotine pouches — small pouches placed between the lip and gum (examples of popular nicotine pouch brands include Zyn, on!, and Velo) contain 1.5–16 mg of nicotine per pouch — the equivalent of up to 4–5 cigarettes in a single pouch. (Source: Stanford REACH Lab)
  • Cigarettes — smoked tobacco; menthol varieties make nicotine more easily absorbed.
  • Cigars and cigarillos — available in many flavors; not regulated the same way as cigarettes. A large cigar can have as much nicotine as one pack of cigarettes, according to the American Cancer Society, and one cigarillo has as much nicotine as one to four cigarettes, according to the Mayo Clinic. 
  • Hookah tobacco — often used socially; a single session can produce as much smoke as several packs of cigarettes, according to the Centers for Disease Control and Prevention. 
  • Smokeless tobacco — snus, dip, and chewing tobacco placed in the mouth.
  • Oral tobacco products — includes gum, lozenges, toothpicks, and tablets. These can be mistaken for FDA-approved nicotine replacement therapy (NRT) but are sold as commercial tobacco products where tobacco products are sold.
  • Pipe tobacco — a loose-leaf, combustible product specifically designed to be smoked in a pipe, rather than rolled into cigarettes. On average one pipe bowl has as much nicotine as about 5 cigarettes, according to the Mayo Clinic.

If it's sold where tobacco products are sold, it IS a tobacco product.

Nicotine: It's a numbers game

The FDA does not regulate how much nicotine can be added to most tobacco products. This means nicotine levels vary widely and can be deceptively high.

The Federal Drug Administration (FDA) does not have rules about how much nicotine can be added to most tobacco products. This means nicotine levels vary widely and can be higher than they appear. For example: 

  • cigarettes: most have about 10-12 mg of nicotine 
  • e-cigarettes: most brands of disposable vapes contain extremely high levels of nicotine. 

 To determine how nicotine is in the e-cigarette, there are 2 numbers to know: 

  1. The e-liquid capacity of the pod/cartridge which is measured in milliliters (mL). The amount of e-liquid vapes contain can vary, anywhere from .7mL to 6.5mL.
  2. The nicotine strength of the e-liquid. It is a percentage (%) or whole number. 
    • If the e-liquid strength is a percent, convert it to a whole number. So, 5% would be 50 mg of nicotine / mL of e-liquid fluid.
    • If the e-liquid strength is a whole number, like 60, this means 60 mg of nicotine / mL of e-liquid OR 6%.
The danger of flavors

Flavors are one of the biggest reasons young people try tobacco products. Four out of five young adults who have ever used tobacco reported that their first product was flavored. (cite Truth Initiative here?)

Flavors aren't just appealing. They're harmful. When flavoring chemicals are heated, they transform into new compounds linked to tissue inflammation and suppressed immune function. Cinnamon, mint, and menthol are among the most chemically dangerous. Tobacco companies also use terms like "ice," "frost," "chill," and "freeze" to disguise menthol, a flavor that makes tobacco products more addictive.

"Banana ice" isn't just appealing. It's addicting.

Is one tobacco product safer than another?

This is a question many teens ask. Here's the honest answer:

When someone asks, "Is vaping safer than cigarettes?" a better question is: "Is this a safe product to use?" The answer is always no.

Tobacco companies sometimes compare their products to cigarettes, one of the most researched causes of disease and death in history. That's not a high bar. No matter what tobacco product is being discussed, none of them are safe. Whether it's a nicotine pouch, an e-cigarette, or a cigarette, each delivers a toxic substance to your body.

Due to the high levels of nicotine found in tobacco, and youth reporting dual-use (meaning a person uses two or more tobacco products), nicotine toxicity/poisoning is a medical emergency, and is a serious risk of using high-nicotine products. Signs include: 

  • Nausea and vomiting
  • Dizziness and headache
  • Stomach pain and confusion
  • Abnormal heart rhythms
  • Shaking, facial twitching, staring blankly, or fainting (signs of seizure-like activity, per the FDA)

If you or someone you know experiences these symptoms, stop using immediately and contact a doctor or trusted adult.

Nicotine Pouches: What to Know About the Risks

Nicotine pouches are often marketed as clean, discreet, and “spit-free.” But that doesn’t mean they’re harmless. They sit directly in the mouth and deliver nicotine through the gums, and can affect multiple systems in the body. They can:  

  • Damage your gums and mouth– Placing pouches against the gums can lead to irritation, mouth sores, gum disease, and gum recession, which causes long-term damage to oral tissue. 
  •  Disrupt your digestive system– Swallowed nicotine and saliva can contribute to nausea, bloating, stomach discomfort, and heartburn. 
  • Trigger frequent hiccups (“niccups”)– Nicotine can irritate the diaphragm, causing repeated hiccups, a common side effect reported by pouch users. 
  • Contribute to bad breath– Ongoing gum irritation and bacterial buildup in the mouth may lead to persistent bad breath. 

What you can do

  • Educate yourself

    Learn the facts about what tobacco and nicotine products actually contain and how they affect your body.

  • Talk about it

    Start open, honest conversations with trusted friends, family members, or a school counselor about the risks of tobacco and nicotine.

    Download Guide

  • Say no

    Practice strategies to resist peer pressure and avoid tobacco products of all kinds.

  • Seek help

    If you or someone you know is using tobacco, help is available.

Why It Matters

Tobacco and nicotine products are designed to create addiction, and they're effective at it. The adolescent brain is especially vulnerable. Nicotine changes how the brain develops and wires itself, increasing the risk of lifelong dependency. These aren't just short-term concerns. The damage tobacco causes shows up both today and years from now.

  • Brain Impact

    Your brain doesn't fully develop until around age 25. This means teens and young adults are at significantly higher risk of becoming addicted to nicotine than adults. Nicotine acts on the brain's reward system — creating intense cravings that make it very hard to stop.

    Nicotine can disrupt normal brain development, making it harder to:

    • Remember information

    • Focus and pay attention

    • Learn new things

    • Manage emotions and impulse control

    Nicotine can also worsen mental health conditions, including anxiety and depression.

    How nicotine travels to the brain matters:

    • When smoked or vaped, chemicals are inhaled into the lungs, where the heart pumps them rapidly to the brain and the rest of the body.

    • With oral products like nicotine pouches, chemicals are absorbed through the gums and the lining of the mouth, traveling to the brain through the mucosal membrane. This creates a slower, steadier delivery, but one that is just as harmful and easier to use discreetly.

  • Physical Health Impact

    Nicotine and tobacco chemicals affect nearly every organ system in the body — both immediately and over time.

    Cardiovascular effects:

    • Raises heart rate and blood pressure

    • Narrows blood vessels, reducing blood flow to the brain and organs

    • Causes blood to clot faster, increasing the risk of heart attack, heart disease, stroke, and circulation problems

    Gastrointestinal effects:

    • Nausea, vomiting, diarrhea, and indigestion

    Neurological effects:

    • Dizziness, headache, anxiety, nervousness

    Sleep effects:

    • Insomnia and disrupted sleep patterns

    Other physical harms:

    • Increases risk of many types of cancer

    • Raises blood glucose, increasing risk for diabetes Damages gums and causes tooth decay

    • Secondhand smoke and secondhand aerosol are also dangerous to those around you, including pets

    Note for teens and dual users: Many teens also consume high amounts of caffeine. Nicotine and caffeine used together compound stress on the cardiovascular system, increasing risk of heart-related effects.

    Lung Impact

    Tobacco products, whether smoked, vaped, or used in other inhaled forms, cause serious damage to the lungs.

    • Damages cilia, the hair-like structures in the airways that sweep out germs, dust, and particles

    • Irritates and inflames the airways

    • Triggers asthma flare-ups

    • Lowers the amount of oxygen in your bloodstream, causing shortness of breath

    • Weakens the lungs' ability to fight off infections

    • Can cause chronic obstructive pulmonary disease (COPD) and emphysema

  • Mental Health Impact

    Nicotine addiction and the disruption it causes to brain chemistry can have lasting effects on emotional well-being.

    • Nicotine use is strongly linked to increased anxiety and depression

    • Withdrawal from nicotine, even brief periods without it, causes irritability, restlessness, trouble concentrating, and intense cravings

    • Nicotine can make existing mental health conditions worse

    • The developing brain is particularly vulnerable to the mood-altering effects of nicotine

  • Social Impact

    Tobacco and nicotine use can affect relationships, school performance, and social life in ways that are easy to overlook at first.

    • Tobacco use is often framed as social, but peer pressure to participate can quickly turn into dependence

    • Nicotine addiction can affect focus, memory, and motivation, impacting academic performance

    • Use of tobacco products can create friction with family and caregivers

    • Students who use tobacco may face disciplinary actions at school

  • Financial Impact

    Tobacco products aren't cheap, and the addiction they create keeps the spending going.

    • Regular use of nicotine pouches, e-cigarettes, or cigarettes can cost hundreds to thousands of dollars per year

    • Disposable vapes and single-use products are particularly expensive relative to how quickly they're used up

    • Underage purchase or possession of tobacco products can result in fines and legal consequences

    • Money spent on tobacco products is money that could be invested in education, savings, or experiences that actually build your future

  • Environmental Impact

    Tobacco products cause damage well beyond the people who use them.

    • Discarded cigarette butts are one of the most common forms of litter worldwide and leach toxic chemicals into soil and water

    • E-cigarette devices, pods, and cartridges contribute to electronic waste

    • E-liquid spills and improperly disposed of devices release harmful chemicals into the environment

    • Many tobacco product components include plastics and metals that do not biodegrade

  • Extracurriculars & Athletics Impact

    For teens involved in sports, performing arts, or other activities, tobacco and nicotine can directly undermine performance and commitment.

    • Nicotine affects lung capacity and cardiovascular performance, making physical activity harder

    • The body's ability to heal and recover from injury is impaired

    • Fatigue and health issues can lead to missed practices, games, or auditions

    • Many athletic organizations test for tobacco/nicotine use and may have eligibility rules

Am I Addicted? (Hooked on Nicotine Checklist)  

If you answer yes to even one of these questions, it may indicate an increased dependency on nicotine. Talk with a trusted adult or healthcare provider. 

  1. Have you ever tried to quit, but couldn't? 
  2. Do you use tobacco now because it feels really hard to quit? 
  3. Have you ever felt like you were addicted to tobacco? 
  4. Do you ever have strong cravings to smoke, vape, or use tobacco? 
  5. Have you ever felt like you really needed a cigarette, vape, or tobacco product? 
  6. Is it hard to keep from using tobacco in places where you aren't supposed to, like school or work? 
  7. When you tried to stop, did you find it hard to concentrate because you couldn't use tobacco? 
  8. Did you feel more irritable because you couldn't use tobacco? 
  9. Did you feel a strong urge to use tobacco? 
  10. Did you feel nervous, restless, or anxious because you couldn't use tobacco? 

Source: National Cancer Institute / Hooked on Nicotine Checklist 

Resources to Quit or Learn More

Talk to your doctor. Your healthcare provider can connect you with nicotine cessation support appropriate for your age.

  • Quit Partner (Minnesota)

  • My Life, My Quit™ (Ages 13–17)

    • Text "Start My Quit" to 36072
    • Call 1-855-891-9989 to speak with a coach
    • Confidential. Built for teens.

  • Truth Initiative — Outsmart Nicotine

  • teen.smokefree.gov

    • Tools, tips, and support for teens who want to quit

  • National Alliance on Mental Illness (NAMI)

  • Wisconsin Quit Line

  • Substance Abuse and Mental Health Services Administration (SAMHSA)

Tobacco and nicotine use in adolescence is one of the most preventable health risks a young person can face. As a caregiver, staying informed, keeping conversations open and non-judgmental, and connecting your teen with the right resources can make a real difference. Visit the Confident Caregiver Page for tools to help you start the conversation.

This project is possible, fully or in part, as a result of grant funding recommended by the Opioid Epidemic Response Advisory Council (OERAC) and the Minnesota Department of Human Services. The views expressed in this publication do not necessarily reflect the official policies the Minnesota Department of Human services; nor mention of trade names, commercial practices, or organizations imply endorsement by the state of Minnesota.