Study finds that caffeine consumption was associated with nicotine use onset among early adolescents

In a recent study published in the PLOS ONE Journal, researchers examined the contribution of caffeine to nicotine use onset during early adolescence.

Study: Possible role of caffeine in nicotine use onset among early adolescents: Evidence from the Young Mountaineer Health Study Cohort. Image Credit: VovaShevchuk/


Preventing nicotine usage among the young population is a critical population health concern. Caffeine intake during early adolescence could enhance the risk of nicotine use in the following months; however, the probability has not been extensively investigated and warrants further research.

In recent times, most adolescents regularly consume caffeinated products, such as coffee, tea, soda, energy drinks, and candy, with several products directly marketed toward them.

For young adolescents, the onset of caffeine use might be uniquely detrimental due to ongoing neurodevelopmental maturation coupled with increased social and educational demands.

Both caffeine and nicotine can increase dopamine secretion, and therefore, caffeine intake could probably enhance nicotine-induced psycho-stimulation.

About the study

In the study, researchers investigated whether caffeine usage at study initiation would predict a greater likelihood of nicotine onset at follow-up.

The team analyzed the Young Mountaineer Health Study (YHMS) data that were provided by 1,349 students (response rate of 81%) in sixth grade (mean student age of 12 years) across 20 schools providing middle-school level education in five counties located in the western regions of Virginia. Data were obtained from the autumn of 2020 to the spring season of the following year.

Data extraction included the product, type, and frequency of nicotine use. The team conducted a baseline evaluation between October and December 2020, during which 1,671 students attended school physically or in hybrid (offline/in-person and online/virtual) formats.

Children attending school exclusively virtually and those reporting prior nicotine usage were excluded from the analysis, limiting the sample size to 1,187 students.

The follow-up survey was conducted between April and May 2021. Multivariate logistic regression modeling was performed to calculate the odds ratios (ORs) adjusting for behavioral, social, and environmental variables impacting nicotine usage, including alcohol intake, peer substance use, and perceived nicotine accessibility.


Among the study participants, during the follow-up period, 8.10% documented prior nicotine use ≥1.0 times between study initiation and follow-up, among whom 5.0% used electronic nicotine delivery systems (ENDS) exclusively.

Further, 84% of nicotine users used ENDS ≥1.0 times, 28% had practiced cigarette smoking ≥1.0 times, and 20% consumed nicotine in other forms.

Concerning regular coffee intake, the highest prevalence rates of 70% and 51% were noted for caffeine-containing soda and tea, respectively.

The team found a significant association between caffeine intake and nicotine usage with OR values of 1.2 and 1.1 in models considering various forms of nicotine (such as ENDS, combustible cigarettes, smokeless tobacco, and alternative tobacco such as hookah) as a dichotomized outcome variable (model 1.0) and the use of ENDS exclusively as the study outcome (model 2.0), respectively.

Using the first model, for every decile point elevation in caffeine use, there was a 15% elevation in the chances of nicotine use onset among young adolescents.

Among covariates, the largest contribution was noted for the self-perceived parental responses to alcohol, tobacco, or other drugs (ATOD) use (OR, 1.2) and substance use by peers (OR, 1.2).

In model 2.0, ENDS use probability rose by 13.0% per point elevation in caffeine usage. The covariates that contributed the most to the observations were the perceived parental reactions to the use of alcohol, tobacco, or other drugs (OR, 1.2) and the consumption of any alcohol at study initiation (OR, 2.4).

Caffeine may affect adenosine receptors and striatal pathways connected to dopamine synthesis and sensitivity to rewards in early teens, regions in the brain that are extremely susceptible during this period.

Caffeine use may be highly gratifying for young adolescents, promoting nicotine usage for mood regulation and nicotine addiction. Furthermore, caffeine's effects may be linked to stressors related to transitioning to middle-level schooling from the elementary level, increasing academic requirements, and alterations in the routine and structure of schools.


Overall, the study findings showed that caffeine intake among middle school students who did not consume nicotine correlated positively with the chances of consuming nicotine at six months of follow-up.

The modeling findings indicated that for every decile unit elevation in caffeine consumption, the risk of consuming nicotine after six months elevated by 13.0% to 15.0%.

The findings indicated that students near the upper range's upper limit had a 2.50-fold greater likelihood than non-caffeine users to use nicotine ≥1.0 times between study initiation and follow-up.

In addition, according to previous study findings, the students predominantly consumed ENDS as tobacco.

Journal reference:
  • Kristjansson, A. et al. (2023) "Possible role of caffeine in nicotine use onset among early adolescents: Evidence from the Young Mountaineer Health Study Cohort", PLOS ONE, 18(5), p. e0285682. doi: 10.1371/journal.pone.0285682.

Posted in: Child Health News | Medical Science News | Medical Research News | Medical Condition News

Tags: Addiction, Adenosine, Adolescents, Alcohol, Brain, Caffeine, Children, Cigarette, Coffee, Dopamine, Drugs, Education, Frequency, Nicotine, Nicotine Addiction, Research, Smoking, students, Tea, Tobacco

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Pooja Toshniwal Paharia

Dr. based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.

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