As a physician, I witness the subtle signs of nicotine use daily. I walk through clouds of sweet-smelling smoke from vape pens as I enter the grocery store. At traffic lights, I glance over to see drivers vaping, the thin cloud briefly visible before dissipating. I’ve spotted vape devices attached to keychains, teens with USB-shaped gadgets, and more recently, small pouches tucked discreetly inside lips, delivering nicotine invisibly to users of all ages.
Nicotine delivery systems have experienced a surge in popularity. Sales of products like Zyn, a spitless oral pouch containing nicotine powder, increased by an astonishing 641 percent between 2019 and 2022.
What’s truly alarming isn’t just their popularity but a disturbing new trend: nicotine being promoted not as a vice or even merely a smoking alternative, but as a wellness product.
Snake oil for the modern age
Scrolling through social media recently, I was stunned to see wellness influencers sharing, “I woke up feeling overstimulated and instantly after putting a nicotine patch on, I was calm and could deal with my kids.”
Even more concerning, I encountered a chiropractor promoting nicotine patches, confidently declaring, “Nicotine is a published cure for Parkinson’s disease, MS, Alzheimer’s, ulcerative colitis.” He even claimed that “autism traits have been tested with nicotine to show improvement.”
Comments sections overflow with testimonials: “better than my ADHD meds and all-natural!”
But here’s what these influencers aren’t telling you: According to UCFSHealth.org, “Nicotine has been proven to be as addictive as cocaine and heroin and may even be more addictive.”
The science versus the hype
While there have been limited studies exploring nicotine’s potential effects on certain neurological conditions, these findings have been preliminary, often misrepresented, and nowhere near establishing nicotine as a “cure” for anything.
For example, one study the chiropractor frequently references, published in January 2023, highlighted how nicotinic acetylcholine receptors may play a role in long COVID syndrome — a chronic condition that occurs after SARS-CoV-2 infection and persists for at least three months with a wide range of symptoms that may improve, linger, or worsen. While this study suggests nicotine’s interaction with acetylcholine receptors might reduce inflammation in some COVID-19 cases, this science is being dangerously oversimplified on social media. The chiropractor repeatedly presents this as a blanket wellness breakthrough but conveniently ignores both the addictive nature of nicotine and the reality that individual health conditions vary dramatically. Promoting an addictive substance as a universal cure-all based on a study focused on one specific condition puts vulnerable people seeking relief for their various conditions, diseases, and even cancer at significant risk of developing a dependency and medical complications that may prove far worse than their original symptoms
In stark contrast, reputable research indicates that nicotine exposure, primarily through smoking or vaping, is associated with increased risk of severe COVID-19 outcomes — the exact opposite of what wellness influencers might suggest.
How nicotine hijacks your brain
The National Institute on Drug Abuse explains that nicotine creates temporary feelings of well-being by triggering a surge of endorphins — chemicals that relieve stress and pain. It also increases heart rate and oxygen consumption.
What makes nicotine particularly dangerous is how quickly the body absorbs it into the bloodstream, delivering it to the brain within seconds. These pleasurable sensations peak rapidly and dissipate just as quickly, creating a vicious cycle as users chase that fleeting high.
More insidiously, nicotine increases levels of dopamine, a neurotransmitter central to the brain’s reward system. This dopamine release reinforces nicotine-seeking behavior, leading to profound changes in brain function related to self-control, stress management, and learning. These alterations ultimately drive addiction and trigger withdrawal symptoms when nicotine levels drop.
What starts as seeking symptom relief can quickly spiral into dependency, with users finding themselves trapped in a cycle of escalating use, increasing tolerance, and distressing withdrawal symptoms when they try to stop. The promised wellness benefits fade, while the addiction remains.
The negative impacts of nicotine
The wellness influencers rarely mention nicotine’s extensive side effects:
Central nervous system: Dizziness, sleep disturbances, changes in blood flow, and headaches.
Cardiovascular system: Increased risk of blood clotting, elevated blood pressure, and irregular heart rhythms.
Respiratory system: Shortness of breath, bronchospasms, and increased risk of chronic conditions like COPD.
Muscular system: Tremors and joint pain.
Gastrointestinal system: Peptic ulcers, diarrhea, nausea, dry mouth, and indigestion.
Wolves in sheep’s clothing
The tobacco industry has masterfully evolved its tactics. When menthol was first added to cigarettes in the 1920s, it created a cooling effect that reduced harshness and suppressed coughing, making smoking easier for beginners. Today’s nicotine products follow the same playbook — they come in appealing flavors like citrus, peppermint, and coffee, making the experience of using an addictive substance more pleasant and approachable.
The companies behind these products insist they’re safer alternatives to cigarettes. There’s some truth to this, as they don’t produce the tar and carcinogens associated with burning tobacco. But “safer” doesn’t mean “safe” — especially for non-smokers. Nicotine itself poses serious health risks, including the cardiovascular problems mentioned above, disrupted brain development in young users, and powerful addiction.
The danger of invisibility
What’s most troubling is how easily these products can escape scrutiny. Unlike cigarettes or vaping, which produce visible smoke or vapor, nicotine pouches and patches leave no trace. This invisibility, combined with wellness industry endorsements, creates a perfect storm for a new addiction crisis affecting people seeking health solutions, not just recreational users.
For individuals with ADHD seeking symptom relief, nicotine represents a dangerous gamble. Research shows people with ADHD may be more susceptible to nicotine addiction and experience more intense withdrawal symptoms when trying to quit. The temporary cognitive enhancement some report comes at the cost of potential lifelong addiction.
We’ve been here before. When vaping products first emerged, regulation lagged behind adoption, and nicotine use spiked dramatically. We’re at risk of repeating this mistake with these new nicotine products if we don’t address the rampant misinformation on social media platforms.
A call for action
As a physician, I urge stronger regulations on nicotine products. The misinformation and disinformation online about these substances is truly scary and affecting real people’s health decisions. Despite sleek packaging and wellness claims, these products contain highly addictive substances that can lead to lifelong dependency. Parents need to have honest conversations with children, healthcare providers must screen for all forms of nicotine use, and we must collectively recognize that smokeless doesn’t mean harmless. The battle against nicotine addiction requires us to see through deceptive marketing and influencer endorsements. Introducing addictive substances to treat health conditions isn’t a solution, but the beginning of another problem.
