Nicotine and Tobacco as Substances of Abuse in Children and Adolescents

Pediatrics. 2017 Jan;139(1):e20163436. doi: 10.1542/peds.2016-3436.


Nicotine is the primary pharmacologic component of tobacco, and users of tobacco products seek out its effects. The highly addictive nature of nicotine is responsible for its widespread use and difficulty with quitting. This technical report focuses on nicotine and discusses the stages of use in progression to dependence on nicotine-containing products; the physiologic characteristics, neurobiology, metabolism, pharmacogenetics, and health effects of nicotine; and acute nicotine toxicity. Finally, some newer approaches to cessation are noted.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Brain / drug effects
  • Child
  • Cross-Sectional Studies
  • Electronic Nicotine Delivery Systems / adverse effects
  • Humans
  • Nervous System / drug effects
  • Receptors, Nicotinic / drug effects
  • Smoking / adverse effects*
  • Smoking / epidemiology*
  • Smoking Prevention
  • Tobacco Products / adverse effects
  • Tobacco Smoke Pollution / adverse effects
  • Tobacco Smoke Pollution / statistics & numerical data
  • Tobacco Use Disorder / epidemiology*
  • Tobacco Use Disorder / etiology*
  • Tobacco Use Disorder / prevention & control
  • United States
  • Up-Regulation / drug effects


  • Receptors, Nicotinic
  • Tobacco Smoke Pollution