Understanding Nicotine Use: Fact vs. Fiction
Cigarette alternatives such as vapes and nicotine pouches are often touted as a healthier option when compared to smoking cigarettes. Here, local medical professionals share their expertise on the adverse effects of nicotine use and break down common misconceptions.
Researchers have studied cigarette use since the early 1900s, and studies in the 1950s directly linked tobacco products to cancer and other diseases. Cigarette use began to decline as awareness grew, including legal efforts such as the Cigarette Labeling and Advertising Act, which requires a warning label on every pack of cigarettes. However, according to the Centers for Disease Control and Prevention (CDC), smoking remains the number one cause of preventable disease and death in the U.S., and the use of products containing nicotine still poses a significant health risk.
Fact: Smoking is harmful to lung health.
Smoking has been proven to be harmful for lung health, causing a variety of lung diseases such as chronic bronchitis, emphysema, and lung cancer. While lung cancer occurs in nonsmokers, the American Lung Association reports that smoking is the cause of roughly 90% of lung cancer related deaths, and 80% of chronic obstructive pulmonary disease (COPD) related deaths.
Dr. Umama Adil, pulmonary and critical care physician at Hamilton Physician Group, shares that smokers can experience “acute inhalation lung injury as you would see in somebody with exposure to toxic fumes.” She adds, “There is a direct relation between smoking nicotine and lung cancer as well as COPD, and children born to mothers who smoke have a higher risk of asthma.”
Outside of lung diseases, smoking can also cause a variety of chronic symptoms. Dr. Troy Jensen, a board-certified family medicine physician with CommonSpirit Medical Group, shares outcomes he observes in patients in his practice. “I commonly see chronic cough, wheezing, shortness of breath, recurrent bronchitis, and worsening asthma. Long-term smokers often develop COPD,” he says. “Avoiding or quitting nicotine products is one of the most powerful steps someone can take to protect their lungs.”
Fiction: Vaping is less harmful than cigarette smoking.
Because cigarettes contain added chemicals that burn while you inhale, vaping may seem like a healthier or less harmful smoking alternative. However, vape fluid can contain nicotine, flavorings, chemicals, and metals that may be dangerous to lung health. Dr. Jensen explains, “Cigarettes are the most harmful because burning tobacco releases thousands of toxic chemicals. Vaping avoids combustion but still exposes the lungs to irritating and potentially harmful substances.”
Dr. Patrick Koo, a pulmonologist at Erlanger Pulmonology and Critical Care, shares that nicotine is still significantly present in cigarette alternatives. “Current medical literature shows that many electronic cigarettes and oral nicotine products deliver nicotine rapidly and at concentrations comparable to, or even exceeding, traditional cigarettes,” he says.
Additional research is needed to compare vaping to the existing long-term cigarette use research, but early research and observation shows that vaping can cause many harmful side effects for users, especially to the respiratory system. “Lung damage observed from vaping and smoking cigarettes is similar,” shares Dr. Adil. “We are also seeing cases of asthma and COPD in patients with long vaping history as you would in someone who smokes cigarettes.” Dr. Jensen echoes this, sharing, “Vape users frequently report persistent airway irritation and even decreased exercise tolerance.”
Early research and observation shows that vaping can cause many harmful side effects for users, especially to the respiratory system.
Fiction: The chemicals in cigarettes or vapes are harmful, but products that only contain nicotine are safe.
Nicotine is a highly addictive chemical compound in tobacco products as well as smokeless, tobacco-free nicotine pouches. Nicotine can significantly affect many parts of the body, including the heart and brain. “Nicotine contributes to elevated heart rate and increased blood pressure, which lead to long-term cardiovascular risk,” says Dr. Koo. “In adolescents and young adults, nicotine exposure may also interfere with brain development. Many users mistakenly view oral nicotine products as a ‘safe’ alternative, despite evidence that they are associated with dependence and carry meaningful long-term health risks.”
Outside of lung health, nicotine can affect almost every organ in our body. Its use can cause increased risk of cardiovascular and respiratory issues, gastrointestinal disorders, and cancers, along with a decreased immune response, and it may have negative impacts on reproductive health.
Fact: All forms of nicotine are highly addictive.
Nicotine reacts with reward pathways in the brain and releases dopamine and other neurotransmitters that provide temporary feelings of pleasure, stimulation, and mood modulation. As use increases, so do cravings, which result from withdrawal. This occurs regardless of the method of nicotine use, including cigarettes, e-cigarettes and vapes, nicotine pouches, and other products.
Although nicotine is highly addictive, quitting is possible. Dr. Koo emphasizes the importance of planning and support, saying,
“Current medical literature shows that the highest long-term quit rates occur when counseling is combined with therapies such as nicotine patches, gum, lozenges, varenicline, or bupropion prescribed by a healthcare professional. Setting a quit date, identifying smoking triggers, and building accountability through support groups or structured cessation programs can significantly improve success. Regular physical activity, adequate sleep, and stress-management strategies may also reduce cravings.”
Umama Adil, MD
Pulmonary and Critical Care Physician, Hamilton Physician Group – Specialty Care, Hamilton Medical Center
Troy Jensen, DO
Board-Certified Family Medicine Physician, CommonSpirit Medical Group - Family Medicine - Ringgold
Patrick Koo, MD
Pulmonologist, Erlanger Pulmonology and Critical Care
Meet the Author
Kristen Dee, BS, MA, Summa Cum Laude
Kristen Dee is a graduate of Winthrop University where she earned a Bachelor of Science degree in integrated marketing communications, with the distinction of Magna Cum Laude and IMC Student of the Year. Following Winthrop, Kristen earned a Master of Arts in Communication from Wake Forest University. Prior to joining CMC Media & Marketing Group as editor, Kristen successfully fulfilled roles involving internal corporate communications. Today, Kristen leads ideation, conceptualization, and development of numerous health, wellness, business, sports, and lifestyle articles published in print and online for HealthScope®, CityScope®, and Choose Chattanooga® magazines – premier publications serving S.E. Tennessee and North Georgia.
