Observational analysis demonstrates lower well-being and higher problem behaviors in adolescents using nicotine, suggesting health risks.
German adolescents who use nicotine, especially dual use of e-cigarettes and cigarettes, are at an increased risk for internalizing and externalizing behavioral problems and have lower overall well-being. Due to design limitations, we are unable to draw causal conclusions.
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Hanewinkel et al. (2026) studied this question.
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