Medical experts believe that e-cigarette use could affect an adolescent’s developing brain and lead to nicotine addiction. It could also lead to abuse of stronger drugs such as opioids. An editorial by JM Drazen et al in the February 14, 2019 issue of The New England Journal of Medicine describes nicotine as a “gateway drug that lowers the threshold for addiction to other agents” and states that “nicotine is as addictive as heroin, so once hooked, most young e-cigarette users will become long-term users.”