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tobacco, a known carcinogen that contains nicotine and is sprayed in the growing process with numerous chemicals. Tar is another major component of smoking and occurs when the tobacco is burned or smoked. Tar is a sticky black liquid that sticks to cells in the lung tissue and allows the other carcinogens in the cigarette to stick to it and accumuof adults who have been daily smokers at some point reported trying their first cigarette by age 18 years (ALA, 2017). Currently, 15.5% of American adults smoke (Jamal et al., 2018). According to the U.S. Surgeon General, the developing adolescent brain is particularly vulnerable to the negative effects of exposure to nicotine, including “addiction, priming for use of other addictive substances, reduced impulse control, deficits in attention and cognition, and mood disorders” (U.S. Department of Health and Human Services [DHHS], 2016, p. vii). Youth are at higher risk for becoming dependent on nicotine than adults (CDC, 2017). Tobacco is considered by many to be a “gateway drug” that opens the door to using illicit drugs. This theory, known as the Gateway Hypothesis, is not universally accepted because there are discrepancies about whether tobacco, alcohol, or marijuana is the initial “gateway” drug that leads to the use of illicit drugs. Electronic Cigarettes Use of electronic cigarettes (e-cigarettes) and hookahs have increased significantly among high school students. According to the National Institute on Drug Abuse (NIDA) (2018), e-cigarettes (also known as electronic nicotine delivery systems, e-cigs, e-hookahs, hookah pens, late in that site. Its amount varies from 1 to 15 mg per cigarette, most of which is in the last third of the cigarette. Nicotine, which is among the most addictive substances, increases the release of acetylcholine neurotransmitters that suppress the appetite, enhance pleasure, and assist in relaxation. Each cigarette contains 8 to 20 mg of nicotine, of which 1 mg is absorbed. The drug acts within seconds of being inhaled (ALA, 2017).
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