Is nicotine dangerous?

Nicotine occupies a paradoxical place in our societies. Present for several centuries, it has at various times been considered a remedy, a poison, a recreational substance, and one of the symbols of modern smoking. Even today, it is surrounded by a host of misconceptions: nicotine is said to be responsible for cancer, a genuine danger to health, or even a toxic element of the cigarette. But what is the reality? Does nicotine represent a risk? Is it a proven toxic substance or a substance largely misunderstood, the victim of a conflation between tobacco, combustion, and nicotinic products?

To understand what the danger of nicotine really is, one must first look at its history, then its true effects on the body, before explaining why smoked nicotine and pharmacological nicotine do not present the same risks at all.

What is nicotine?

Nicotine is an alkaloid naturally present in the leaves of tobacco, but also in a few plants of the nightshade family (tomato, eggplant, potato). It is a psychoactive substance that acts on the central nervous system by modulating the so-called "nicotinic" receptors.

It is responsible for part of the physical dependence, but it is neither a carcinogen nor a molecule that causes the main diseases associated with tobacco. These diseases are linked to combustion, tars, and the thousands of chemical products present in cigarette smoke.

History of nicotine

Tobacco, a sacred plant for Native Americans

Long before it became associated with the cigarette, tobacco had a sacred role. Native American peoples used tobacco in rituals, as a medicinal (and antiparasitic) plant, or in ceremonial devices.

A more recreational use by Europeans

When Europeans discovered tobacco, its use changed radically. It went from a sacred use to a recreational consumption, then an industrial one. Tobacco became a commercial product, and nicotine was progressively associated with immediate pleasure… but also with the diseases caused by smoke. It is from this point that the confusion between nicotine and cancer risks was born — a confusion that remains very strong today.

What are the effects of nicotine on the body?

The perceptible effects of nicotine

When nicotine is inhaled or absorbed (via a patch, a gum, or an electronic cigarette liquid), the molecule acts quickly. It causes:

• a slight increase in heart rate,
• a sense of alertness,
• a stimulating effect,
• sometimes a subjective sense of relaxation depending on the individual.

These effects are among the reasons why nicotine can cause dependence, even though it is not responsible for the serious diseases linked to smoked tobacco.

Effects on the brain

The precise mechanism is still being studied. Nicotine activates the nicotinic receptors in the brain and may also modulate dopaminergic receptors, which are responsible for the sensation of reward and pleasure.

It is this dopaminergic modulation that reinforces regular use, as nicotine creates an association between intake of a substance and psychological relief.

Undesirable effects related to excessive consumption

Nicotine remains a toxic substance: it interacts with the body and can cause unpleasant effects in case of overdose.

Symptoms of overconsumption include:

• headaches,
• intense fatigue,
• abdominal pain,
• nausea,
• palpitations or heart rhythm disorders.

Fortunately, these symptoms disappear within 1 to 2 hours after stopping intake. In the long term, the absence of nicotine can generate a feeling of anxiety, linked to withdrawal and not to the molecule itself.

But also positive effects

Although addictive when linked to smoked tobacco, nicotine also has beneficial aspects:

• improved concentration,
• occasional assistance with stress management,
• potential protective effects against certain genetic neurological diseases (Alzheimer's, Parkinson's).

A 1991 study (BMJ) indeed suggests an inverse association between smoking and familial Alzheimer's disease, not due to the smoke but to nicotine itself. This obviously does not mean that tobacco should be recommended, but it does show that nicotine is not solely a danger: its effects are complex and multifactorial.

Smoked nicotine vs. pharmacological nicotine

The most important distinction for understanding the danger of nicotine is this:

Nicotine is not dangerous — it is the combustion of tobacco that is.

Smoked nicotine

In a cigarette, nicotine is associated with thousands of toxic chemical substances, particles, carbon monoxide, and aerosols produced by combustion.

It acts very quickly: an immediate "shot" to the brain, a sudden rise in dopamine and other neuro-modulators.

At the heart of addiction: its association with sugar. Because, to soften the bitter taste of tobacco and make it palatable, manufacturers added sweetened products such as honey, sucralose, or chocolate. As a result, when burned, the sugar + nicotine cocktail creates and releases acetaldehydes that act as MAOIs (Monoamine Oxidase Inhibitors).

MAOIs are indeed used as antidepressants. They work by increasing the concentration of neurotransmitters in the synapses (serotonin, dopamine, and norepinephrine in particular) and by slowing down their degradation. Withdrawal symptoms are as follows: nausea, vomiting, malaise, nightmares, agitation, irritability, insomnia, emotional blunting, weight gain... 

You can see where we are going with this: it is therefore possible that the passing "blues" experienced by former smokers going through withdrawal find part of their origin in this mechanism... 

Pharmacological nicotine

In patches, gums, electronic cigarette liquids, or nicotine substitutes, nicotine is said to be pharmacological:

• it takes longer to reach the brain,
• it disappears from the body more quickly,
• it is not accompanied by toxic substances, tars, or dangerous particles.

It does not increase the risk of cancer, nor the diseases linked to smoke. But it is not associated with sugar, and is therefore not, or much less, addictive in the way that nicotine from smoked tobacco is.

Even if you choose a sweetened e-liquid, it is not burned but vaporized and therefore does not release acetaldehyde (MAOIs) — with the exception of "dry hit" puffs, meaning dry hits with no e-liquid that are therefore burned. Hence the importance of always keeping your tank filled with liquid and regularly changing your coil.

The case of nicotine salts

To help former smokers avoid craving, manufacturers have developed nicotine salt e-liquids.

They allow:

• a faster onset than classic nicotine,
• better satiety,
• less vaping,
• a more comfortable withdrawal.

Nicotine in the e-cigarette: an ally for smokers in the process of quitting

Nicotine remains a toxic substance, which is why it must be avoided by young people, children, and anyone who is not dependent.

But for smokers, pharmacological nicotine becomes an essential ally to reduce risks, prevent deaths related to tobacco, and gradually reduce consumption.

See the best e-cigarettes and e-liquids to quit smoking

In electronic cigarettes, nicotinic products are studied, controlled, and subject to strict national and European standards. Electronic devices now constitute a major tool for smoking prevention, supported by numerous health organizations.

With the right dose, a gradual return to controlled use, and appropriate support, nicotine becomes a powerful substitute for breaking free from dependence on smoked tobacco.