Debunking the benefits of nicotine

Have you heard that nicotine has health benefits – especially when used in tobacco-free products like oral nicotine pouches and vapes?

Most of these claims about nicotine’s so-called health benefits have been overinflated by the tobacco industry, which has funded this research to help sell more tobacco.

Using nicotine in any form poses many risks, says Jennifer Cofer, Dr.P.H., executive director of UT MD Anderson’s EndTobacco™ program.

“It's like nicotine is getting a rebrand,” Cofer says. “The tobacco industry has been trying to sell its products as beneficial for performance enhancement and intellectual stimulation since at least the 1990s.”

In more than 60 years of research, no long-term health benefits of nicotine have been proven. And, the risk of nicotine addiction outweighs any short-term “benefits” immediately after use, such as improved alertness and focus or anxiety reduction and mood improvement.

What is nicotine, and why is it addictive?

Nicotine is a chemical that naturally occurs in some plants; the most known is tobacco. It can also be created in a lab, where it’s commonly used in some smokeless nicotine products like vapes and oral nicotine pouches, delivering the substance without smoke, vapor or tobacco.

In tobacco, nicotine is the substance that creates addiction. Nicotine works by binding to specific receptors in your brain that are important with memory, concentration and learning.

While nicotine itself doesn’t cause cancer, nicotine can harm your health in other ways, causing users to become addicted to tobacco. Cigarette smoking is the leading cause of preventable cancers and cancer-related deaths.

Nicotine, as used in “nicotine replacement therapy,” is delivered at a low pace and low dosage meant to decrease tobacco dependence. But it’s important to note that these products, like nicotine patches, gum and lozenges, have been carefully studied and designed specifically to help people quit smoking.

Where does tobacco-free nicotine come from and in what forms is it sold?

It’s important to know what forms nicotine takes when it is sold separately from tobacco, such as cigarettes, chewing tobacco, pipe tobacco or cigars.

On its own, nicotine is non-combustible, meaning it is not burned. It comes in three forms, which have slightly different chemical compositions — all of which are bad for your health:

• Nicotine that’s naturally derived from tobacco plants in liquid form
• Nicotine salts, which are also naturally derived
• Synthetic nicotine, which is made in a lab

The tobacco and vape industry uses all three to create products like oral nicotine pouches meant to be placed between your gums and teeth, as well as electronic cigarettes and vapes.

Additionally, there are patches, gum and oral lozenges meant to help ween tobacco users off toxins found in tobacco smoke, as well as the chemicals used in vaping.

Are there any health benefits to nicotine?

The short answer is no. Nicotine does not provide any long-lasting health benefits.

While there is some research that suggests potential health benefits of nicotine, it’s either paid for by the tobacco industry or includes other biases in methodology, Cofer says.

“The industry is taking a play out of the Big Tobacco playbook, using the science and manipulating it to their game,” she notes.

Here are some common claims about nicotine and why you shouldn’t believe them.

Mood, focus and cognitive function

This is the one area in which credible research has found some benefits. But, Cofer stresses, these benefits of nicotine do not last and are still outweighed by the risks of smoking to obtain nicotine.

Some studies have shown that nicotine helps improve cognition, focus and attention. It binds to specific receptors in the brain that trigger an immediate release of dopamine. This surge mimics your body’s natural “reward” signals.

“It's a central nervous system stimulant, so it’s going to produce some short-term improvements. You could see an aspect of cognition improve like you do with other stimulants,” Cofer says. “But it’s the addiction, the usage over time, that’s going to cause withdrawals and tolerance to make you use more. That’s the concern.”

Physical performance

There are several brands of nicotine products that claim to enhance physical performance and are even marketed similarly to a health supplement. They claim to boost energy and aid in workout recovery.

But there’s no evidence they actually do this, aside from temporarily making you more alert, since nicotine is a stimulant, Cofer says.

Weight loss

“Because nicotine is a stimulant, it’'s going to suppress appetite and increase your metabolic rate — the rate at which your body burns energy to maintain important functions,” Cofer says. “But it is not an approved weight loss drug or shouldn't be a part of the weight loss regimen.”

Stress and anxiety

Yes, nicotine does reduce stress and anxiety, Cofer says. But if you keep using it, your desire for more nicotine is likely to increase.

Our brains are actively developing until roughly age 26. Research shows that if you’re 25 or younger, you are more likely to experience elevated stress and anxiety, says Cofer, whose research primarily centers on youth and young adults.

“Nicotine use amplifies anxiety and signs of depression worse among youth and young adults,” she says. This is true both with tobacco products and those without tobacco.

The one exception: Nicotine may help you quit smoking

Nicotine replacement therapy is when you use decreased amounts of nicotine, either through a sticky patch placed on your skin or via an oral lozenge or gum, to wean yourself off tobacco products.

It can be part of an effective quitting strategy, which includes behavior modification and counseling.

What does nicotine do to your brain?

Nicotine poses many health risks, especially in youth and young adults. Nicotine is known to disrupt the developing connections in the brain that are involved in regulating things like your:

• Mood
• Impulse control
• Attention
• Learning

“After age 26, nicotine still will impact those parts of the brain,” Cofer says. “When it’s used repetitively, that’s when the addiction forms and you’re craving more and more of it. And you’re going to have withdrawals if you are trying to cut it back.”

The tobacco industry has often compared nicotine dependence to that of caffeine, but it’s more like that of cocaine or methamphetamine, Cofer says. This is because of the types of brain receptors in the brain that nicotine affects.

What are the risks and side effects of using nicotine?

Along with making it more difficult to stop using cancer-causing tobacco products, nicotine can cause side effects like:

• Racing heartbeat
• Elevated blood pressure
• Dizziness and nausea
• Headaches
• Trouble sleeping
• Anxiety

Even without tobacco, nicotine products may increase your risk of tooth decay and gum disease.

“It depends on how it’s ingested,” Cofer says. “Oral nicotine products will impact the oral cavity. It can irritate the throat and vocal cords. If a vape is sweetened with flavors, it could cause additional cavities.”

Research has shown that in the short term, vaping can cause respiratory and cardiac illnesses. Because oral nicotine pouches are so new, their side effects are not yet well understood, she adds.

Consuming nicotine by smoking cigarettes and vaping is especially dangerous for pregnant or breastfeeding women. It can harm your baby’s brain and lung development and increase risks of:

• Low birth weight
• Preterm birth
• Sudden infant death syndrome (SIDS)

“Pregnant women and those breastfeeding should absolutely avoid smoking and all forms of nicotine ingestion,” Cofer says.

Nicotine’s risks outweigh any possible benefits

Unless you’re using nicotine products to help you quit smoking as recommended by a medical professional, the risks and health effects of all products containing nicotine far outweigh any potential benefit.

Remember: Any research you find online that says otherwise is likely coming from the tobacco industry rather than reputable institutions, Cofer says.

If you’re trying to quit tobacco, nicotine replacement therapy may be an effective treatment for you. If you’re a UT MD Anderson patient, you can get help quitting smoking through our Tobacco Research and Treatment Program. Ask your care team for a referral.

You also can get phone and text support through the National Institutes of Health Quitline by calling 1-800-784-8669, texting QUIT to 47848, or visiting SmokeFree.gov. If you live in Texas, you can use the Texas Tobacco Quitline by calling 1-877-YES-QUIT or visiting YESQUIT.org.

Learn more about tobacco cessation studies at UT MD Anderson.