Get the Facts
Nicotine is a powerful drug, with a highly addictive nature that makes it difficult for many users to quit. Smoking tobacco products remains the most popular way to consume nicotine, but the rise of alternative nicotine products—including nicotine gums, smokeless tobacco, and vape pens—means the drug is more available with more options than ever.
Some of these alternative products are used legitimately to help people wean themselves off using nicotine, but they are often marketed as a “safe” alternative to smoking, which is false.
- Death
- Increased risk of cardiovascular, respiratory, and gastrointestinal disorders
- Decreased immune response
- Negative impacts on reproductive health and pregnancies
- Influence on the emergence of cancer cells, proliferation of tumors, and metastasis
- Sexual dysfunction and ED (erectile dysfunction)
What is Nicotine?
Nicotine is found naturally in plants belonging to the Solanaceae family, but concentrations high enough to have a pharmacological effect on its users are seen only in the tobacco sub-family. Eggplant has the highest concentration of any food with nicotine. However, you would have to eat 23 lbs of eggplant to equal the amount of nicotine in 1 cigarette (which is usually 1 mg).
Human beings have used tobacco for thousands of years, almost exclusively in smoked form, across all countries and cultures. In fact, other than the caffeine found in coffee and tea, nicotine consumed in tobacco is the second most commonly-used drug in the world.
Despite tobacco’s historical popularity, however, the nicotine contained within is a dangerous and highly addictive chemical.
A Dangerous Drug Hiding in Plain Sight
Nicotine can be delivered to users through a number of readily-available products.
Smoked Tobacco
Nicotine ingested by smoking or vaporizing ("vaping").
- Cigarettes
- Vaping devices
- E-cigarettes
- Cigars
- Bidis
- Hookahs
- Kreteks
Smokeless Tobacco
Nicotine ingested by snorting, chewing, "dipping" (a pinch of tobacco powder between the lower gum and bottom lip).
- Snuff
- Spit tobacco
- Chew/chaw
- Dip
Other Methods
Nicotine ingested using methods other than tobacco products.
- Nicotine gum
- Nicotine patch
- Oral nicotine pouch
What Makes Nicotine So Addictive?
As with illegal drugs such as cocaine and heroin, using nicotine activates your brain’s reward centers and releases dopamine, a chemical messenger that fills you with a sense of euphoria and encourages you to use more to recapture that feeling. It is this constant need for reinforcement that makes you more and more addicted to nicotine with each use.
Why Is Nicotine So Harmful?
Nicotine in any form readily absorbs into the blood when you use it, and immediately stimulates your adrenal glands to release the hormone epinephrine (adrenaline), which increases your blood pressure, breathing, and heart rate. Additionally and most importantly, it damages the inner lining of cells in the blood vessels called the endothelium. This causes endothelial dysfunction which increases the risk of a plaque and plaque rupture inside the arterial blood vessels. This dramatically increases your risk of a heart attack and a stroke. In 2023, a heart attack is the #1 way of dying in the United States and a stroke is #3. Nicotine is the strongest preventable risk factor for both.
Nicotine also damages your respiratory (lungs), renal (kidneys), and reproductive systems, and has been found to be carcinogenic in several studies. It may even cause your body to resist chemotherapy and other cancer treatments. Among many other adverse effects, using nicotine can also increase feelings of anxiety and depression, especially when you try to quit.
Nicotine’s Known Health Hazards
Short-term Dangers of Nicotine
- Using nicotine in any form increases your blood pressure and heart rate and causes endothelial dysfunction, which can cause a heart attack and a stroke.
- Smoking nicotine products also exposes your lungs to a variety of hazardous chemicals.
- Vaping nicotine exposes your lungs to acetate fillers and metallic vapors from the heating coils.
- There is a risk of lethal poisoning, with only 10mg for a young toddler and 50mg for an adult.
Long-term Risks of Nicotine
- Cancer (particularly lung cancer when smoked and oral cancers when chewed, snorted, or dipped).
- Cardiovascular illnesses, including heart disease, high blood pressure, and stroke.
- Respiratory illnesses, such as chronic bronchitis, emphysema, COPD, and pneumonia.
- Promotion of other serious diseases such as leukemia, cataracts, and even Type 2 diabetes.
- Complications in pregnancy, including miscarriage, premature and stillbirth delivery, low birth weight, and SIDS.
- Problems in the development of the brain circuits that control attention and learning in adolescents and teens.
- Nicotine can cause sexual dysfunction and erectile dysfunction.
Withdrawal Symptoms
- Irritability
- Trouble sleeping and insomnia
- Depression
- Increased appetite
- Powerful cravings to consume nicotine
If Nicotine Is So Dangerous, Why Is It Still Legal?
Many people believe that because nicotine is legal and available, it must not be that bad, despite all the evidence to the contrary. This sentiment was widespread throughout the early- to mid-20th Century, particularly toward smoking cigarettes, a belief the tobacco companies were more than happy to cultivate.
Toward the end of the century, however, attitudes began to shift among the public and lawmakers. Since 1994, a series of key court cases and legislation has brought scrutiny of the dangers of tobacco and nicotine use. While nicotine products are still legal, they face greater regulation and deeper study than ever before.
1964
First Surgeon General Report
Smoking cigarettes peaked in the 1960s until the first Surgeon General’s Report was released, shining light on the adverse health effects cigarettes were causing.
1994
Congressional Hearings
When CEOs from seven of the largest US tobacco companies testified before Congress, they were asked if nicotine was addictive. They all stated that it was not addictive. Other hearings by the Congressional committee, however, discovered that the tobacco companies hid evidence that nicotine was incredibly addictive and that cigarettes caused cancer. Two years later, under investigation for lying to Congress, all seven tobacco executives resigned and left the industry. No legal consequences took place for lying under oath, but this hearing established the government’s path forward in dealing with the dangers of nicotine.
1998
The Tobacco Master Settlement Agreement (MSA)
Attorneys General from 52 states and US territories signed this agreement with the four largest US tobacco companies, seeking compensation for tax dollars spent on treating nicotine-related diseases. The agreement further revolutionized the regulation of the tobacco industry by placing strict limits on the advertisement, marketing, and promotion of cigarettes, particularly advertising that targeted young people. Millions of tobacco industry documents were also released to the public to expose the decades of coverups and falsehoods, and to emphasize that the manufacturers knew how addictive and dangerous nicotine was all along.
2000
FDA v. Brown & Williamson Tobacco Corporation
When the Food and Drug Administration (FDA) asserted jurisdiction over tobacco products in 1996, the agency began regulating the marketing of nicotine to minors and adolescents. The Brown & Williamson Tobacco Corporation sued the FDA because they believed the agency lacked the authority to regulate tobacco products. In a 5-4 decision, the US Supreme Court decided that regulating tobacco products was outside the scope of the FDA’s foundational law and ruled for the tobacco companies. This court decision was eventually overridden by the Family Smoking Prevention and Tobacco Control Act of 2009.
2006
RICO Verdict
U.S. District Judge Gladys Kessler found that the major US tobacco companies had violated civil racketeering laws (RICO) and engaged in a decades-long conspiracy to deceive the American public about not only the health hazards of smoking, but also about their marketing of tobacco products to children. She wrote that the tobacco companies had “suppressed research, destroyed documents, and manipulated the use of nicotine so as to increase and perpetuate addiction.” Consequently, the tobacco companies were compelled to issue corrective statements and the judge’s order placed new restrictions on how the tobacco companies could describe their products in advertising.
2009
The Family Smoking Prevention and Tobacco Control Act
This legislation gave the Food and Drug Administration (FDA) the power to regulate the tobacco industry and their sales, distribution, and marketing practices. The act created a federal Center for Tobacco Products, which set new limits on how the industry could advertise its products, and launched a tobacco use prevention campaign (“The Real Cost”), aimed at youths aged 11–18.
2016
FDA Deeming Rule
The Food and Drug Administration (FDA) extended their authority to regulate tobacco products to include all tobacco products, not just cigarettes. The “deeming” rule restricted the sale of the following products to minors…
- e-cigarettes and liquid solutions
- cigars
- hookah tobacco
- pipe tobacco
2019
Minimum Age Increased
The federal government raised the minimum legal age for the sale of tobacco products from 18 to 21 years.
2020
Rule on Flavored Vaping Cartridges
The Food and Drug Administration (FDA), in an effort to reduce the appeal of vaping to children, set a policy restricting the manufacture and sale of flavored vaping cartridges, except for tobacco-flavored cartridges used for smoking cessation.
2022
FDA Ban on Juul Products
On June 23, 2022 the FDA denied authorization for Juul to continue selling its products in the US, and issued Marketing Denial Orders banning any further marketing or sale of the products effective immediately. That order was blocked by the US court of Appeals in Washington, DC the next day. The purpose of the court order stay was to allow the court sufficient time to consider Juul's briefing for an emergency review and not a ruling on the merits of that motion.
2023
Juul Settlement
Juul Labs Inc. agreed to pay $462 million to six states and the District of Columbia to resolve lawsuits and investigations into the e-cigarette manufacturer’s marketing of addictive vaping products to children.
Questionable Practices
We now know that the tobacco companies hid evidence, lied to authorities, and fooled the public into believing cigarettes and nicotine were safe. Countless deaths can be attributed to their inaction and outright misinformation about the dangers of their products.
Not only did they know nicotine was addictive and that smoking tobacco carried substantial health risks, but the companies spent a lot of money on studies, experts, and lobbyists to support their case, and donated millions in political contributions seeking cover from government regulators.
During this time when they were trying to conceal the dangers they knew about, the tobacco companies actually worked to make their products even more addictive to users…
- Ammonia was added so that nicotine travels to the brain faster.
- The nicotine content in tobacco products doubled.
- The cigarette design was modified to increase nicotine delivery to smokers.
- Sugars, flavors, and menthol were added to dull the harshness of the smoke and make it easier to inhale.
Despite the advances made both in uncovering the truth about nicotine and in regulating the tobacco industry, the companies continue trying to get around the laws by exploiting loopholes and new technologies. The newest nicotine danger comes from electronic cigarettes, also known as e-cigarettes, vaporizers, or vape-pens—battery-powered devices that do not contain tobacco, but deliver nicotine with flavorings and other chemicals to the lungs in vapor form instead of smoke.
The manufacturers of these nicotine products are actively marketing them to young customers today, and often advertise them as safer than traditional cigarettes because they don't burn tobacco. In fact, researchers know little about the health risks of using these devices.
The manufacturers of these nicotine products are actively marketing them to young customers today, and often advertise them as safer than traditional cigarettes because they don't burn tobacco. In fact, researchers know little about the health risks of using these devices.
All major tobacco companies own a vaping company. The tobacco companies are intentionally trying to perpetuate the addiction to nicotine by transitioning from tobacco to vaping.
Get Help Today to End a Dependence on Nicotine
Be sure to ask your doctor about the various options to quit, including counseling and support groups, and safe, affordable medications such as Varenicline.
Are you aware of nicotine’s danger to your heart?
Have you had a heart attack or other cardiovascular disease from using nicotine products?
Are you concerned about a friend or family member’s use of nicotine products and want to encourage them to quit?