What is Causing Nicotinophobia?

Jeffrey A. Singer

What is driving politicians’ irrational fear of nicotine? Earlier this week, Senate Majority Leader Chuck Schumer called for a crackdown on a nicotine pouch sold under the brand name Zyn. He claims the nicotine pouches are a danger to teens who use them as an alternative to e‑cigarettes.

E‑cigarettes are a proven and probably the most effective harm reduction strategy for people who want to quit tobacco smoke—more effective than nicotine patches, nicotine gum, or other smoking cessation tools. Nicotine is the addictive component of tobacco smoke. But the tars and other components of tobacco smoke are what cause cancer, cardiovascular disease, and lung disease.

Public Health England claims nicotine e‑cigarettes are 95 percent less harmful than tobacco. If tobacco smokers can get their nicotine using safer means, such as e‑cigarettes, it can make it easier for them to give up tobacco and avoid its harm.

For this reason, Britain’s National Health Service encourages doctors to persuade their patients who smoke to switch to e‑cigarettes. The NHS even places brochures about it in doctors’ offices.

Nicotine by itself is a relatively harmless drug. It is similar to caffeine, which can also addict people. Like caffeine, nicotine functions as a stimulant that enhances concentration. Unlike caffeine, nicotine boosts the production of beta‐​endorphins, providing anxiety relief. This may explain why individuals who use tobacco turn to smoking when seeking to relax or to calm down under stress.

There’s some research suggesting nicotine may help treat Parkinson’s disease. There is also evidence that nicotine can treat depression, Tourette’s Syndrome, Alzheimer’s’ Disease, and schizophrenia.

In fact, research estimates as many as 88 percent of people with schizophrenia smoke cigarettes, a rate much higher than in people with other psychiatric disorders and almost three times the rate of the general population. Recent studies suggest that nicotine normalizes cognitive deficits, called “hypofrontality,” in people with schizophrenia. There is also evidence that nicotine improves short‐​term memory in schizophrenic patients. Nicotine’s beneficial effects on schizophrenia have led many researchers to suspect that people with this disease are self‐​medicating.

People who use nicotine long‐​term can develop high blood pressure. Long‐​term nicotine may also contribute to the narrowing of blood vessels in some people. People who use caffeine long‐​term can develop ulcers, an irregular heartbeat, muscle tremors, and insomnia.

An FDA study found most lay people incorrectly think nicotine is very dangerous. Many people think nicotine causes cancer and is responsible for many of the harms of tobacco smoke. But Senator Schumer and many of his colleagues in Congress who like to “follow the science” should know better.

Ironically, politicians worked hard to take nicotine e‑cigarettes away from teens. In 2019, Congress made it illegal to sell e‑cigarettes to any person under age 21. Teen vaping rates have fallen from their peak of 28 percent in 2019 to roughly 14 percent in 2022.

It is hard to explain why politicians who are intent on keeping teens away from nicotine e‑cigarettes would be upset when teens switch to oral nicotine pouches like Zyn.

I can only think of one explanation: an unfounded and irrational fear of nicotine. I call it nicotinophobia.