Paul Saladino MD · 2026-08-21 · Paul Saladino (host)

The Truth About Using Nicotine in 2026

33 research-tied claims examined: 3 overstated 4 context 21 supported 3 corroborated online 2 unverified

21

Supported by research

0:06:01Paul Saladino (host)supportedmoderate

The Royal College of Physicians in the UK concluded that nicotine is not a significant contributor to smoking-related diseases.

"The Royal College of Physicians in the UK has concluded that nicotine is not a significant contributor to smoking-related diseases." (said at 0:06:01)

The Royal College of Physicians (RCP) in the United Kingdom evaluated the health impacts of nicotine and non-combustible delivery systems (such as electronic cigarettes and medicinal nicotine) in major landmark reports, notably 'Nicotine without smoke: Tobacco harm reduction' (2016) and 'Harm reduction in nicotine addiction' (2007). The RCP established that the substantial morbidity and mortality of smoking are overwhelmingly caused by the toxic and carcinogenic products of tobacco combustion (such as tar, carbon monoxide, and volatile organic compounds), rather than nicotine itself. While nicotine is the primary addictive agent in tobacco and produces mild hemodynamic effects, the RCP concluded that nicotine in doses delivered by clean nicotine replacement or non-combustible products is not a significant direct cause of smoking-related cardiovascular disease, chronic obstructive pulmonary disease, or cancer.

0:07:38Paul Saladino (host)supportedhigh

Original Juul pods contained about 5% nicotine by weight, equivalent to approximately one pack of cigarettes per pod.

"Juul pods contained about 5% nicotine by weight, equivalent to about a pack of cigarettes in a single Juul pod." (said at 0:07:38)

Standard original JUUL pods in the United States were marketed and formulated with approximately 5% nicotine by weight (about 59 mg/mL, or ~40–48 mg of total nicotine per 0.7 mL pod). Multiple reviews and aerosol studies confirm that one 5% JUUL pod delivers nicotine roughly equivalent to smoking a standard pack of combustible cigarettes (~13 to 30 cigarettes, with a median around 18–20 cigarettes, depending on user puffing behavior and experience).

0:08:08Paul Saladino (host)supportedmoderate

By 2018, Juul controlled 75% of the US e-cigarette market.

"By 2018, Juul controlled 75% of the e-cigarette market, and "Juuling" was a term well known within every high school in the United States." (said at 0:08:08)

Retail market sales data show that JUUL underwent unprecedented growth in the US e-cigarette market between 2015 and 2018. Having risen to approximately 40% of retail market share by late 2017 and nearly 50% by early 2018, JUUL's share of US retail e-cigarette sales peaked at approximately 70% to 75% by late 2018.

0:09:20Paul Saladino (host)supportedhigh

In 2022, Philip Morris acquired Swedish Match, the owner of Zyn, for $16 billion.

"In 2022, Philip Morris acquired Swedish Match, the company that owns Zyn, for $16 billion." (said at 0:09:20)

In November 2022, Philip Morris International (PMI) completed its acquisition of Swedish Match, the manufacturer and owner of the nicotine pouch brand Zyn, in a transaction valued at approximately $16 billion.

0:10:39Paul Saladino (host)supportedmoderate

Paul Newhouse's research at Vanderbilt University found that nicotine does not enhance cognition in healthy individuals who sleep and eat well.

"This researcher's name is Paul Newhouse. He's a PhD at Vanderbilt University. He's been studying nicotine in the human brain for 30 years and this is what he discovered: that in a healthy person, nicotine does not enhance cognition." (said at 0:10:39)

Paul Newhouse's research on nicotinic stimulation developed the 'baseline dependency' model of nicotine's cognitive effects. In his reviews and empirical studies examining healthy non-smoking individuals versus clinical populations (such as individuals with ADHD, mild cognitive impairment, or Alzheimer disease), Newhouse and colleagues reported that healthy individuals operating at optimal baseline cognitive performance generally do not experience cognitive enhancement from nicotine (and may experience adverse or disruptive effects), whereas individuals with baseline cognitive deficits show significant improvements. Broader literature outside Newhouse's group notes modest acute gains in specific laboratory tasks (such as fine motor speed and orienting attention) in healthy non-smokers, but the claim accurately describes Newhouse's central research findings and conclusions.

  • supports: Effects of nicotinic stimulation on cognitive performance. (Current opinion in pharmacology 2004) · cited 406x in the literature
    "In contrast to studies in pathological states, studies of nicotine in normal-non-smokers tend to show deleterious effects. This contradiction can be resolved by consideration of cognitive and biological baseline dependency differences between study populations in terms of the relationship of optimal cognitive performance to nicotinic receptor activity. Although normal individuals are unlikely to show cognitive benefits after nicotinic stimulation except under extreme task conditions, individuals with a variety of disease states can benefit from nicotinic drugs." (abstract, results, passage verified)
    pubmedfull study (doi)
  • context: Meta-analysis of the acute effects of nicotine and smoking on human performance. (Psychopharmacology 2010) · cited 653x in the literature
    "We conducted a meta-analysis on the outcome measures of 41 double-blind, placebo-controlled laboratory studies published from 1994 to 2008. In all studies, nicotine was administered, and performance was assessed in healthy adult nonsmokers or smokers who were not tobacco-deprived or minimally deprived (<or=2 h)... We found significant positive effects of nicotine or smoking on six domains: fine motor, alerting attention-accuracy and response time (RT), orienting attention-RT, short-term episodic memory-accuracy, and working memory-RT" (abstract, results, passage verified)
    pubmedfull study (doi)
0:11:35Paul Saladino (host)supportedmoderate

Research shows that nicotine supplementation can improve cognitive function in individuals with mild cognitive impairment or dementia.

"Now, for the sake of completeness, I want to point out that in their research, they have shown that if your cognition is impaired, if you have mild dementia or memory issues, nicotine supplementation may be helpful." (said at 0:11:35)

Randomized clinical trial evidence supports the claim that nicotine supplementation may improve cognitive measures in individuals with mild cognitive impairment (MCI). In a 6-month double-blind pilot randomized controlled trial of 74 nonsmoking individuals with amnestic MCI (Newhouse et al., 2012), transdermal nicotine (15 mg/day) led to statistically significant improvements in primary cognitive measures of attention as well as secondary measures of memory and psychomotor speed compared to placebo, although it did not produce statistically significant changes on clinician-rated global impressions.

0:12:08Paul Saladino (host)supportedmoderate

Getting the amount of nicotine found in a single cigarette requires eating 20 pounds of eggplant.

"All of these foods contain naturally occurring nicotine. But to get the amount of nicotine found in a single cigarette, you would have to eat 20 pounds of eggplant." (said at 0:12:08)

Dietary plants in the Solanaceae family (such as eggplants, tomatoes, and potatoes) naturally contain small amounts of nicotine. Seminal analytical measurements published in the New England Journal of Medicine (Domino et al., 1993; PMID: 8326992, 'The nicotine content of common vegetables') established that fresh eggplant contains approximately 100 ng of nicotine per gram of wet weight (equivalent to 100 µg/kg or 0.1 mg/kg). Because a standard smoked cigarette delivers roughly 1 mg of bioavailable nicotine to a smoker, consuming 1 mg of nicotine from eggplant requires eating approximately 10 kg, which equals approximately 22 pounds (rounded commonly to 20 pounds).

0:12:49Paul Saladino (host)supportedhigh

No nicotine is naturally produced in the human body; the endogenous ligand for the nicotinic acetylcholine receptor is acetylcholine.

"There is actually no nicotine naturally produced in the human body. But this receptor is called a nicotinic acetylcholine receptor based on historical research where researchers used nicotine to activate the receptor. The actual endogenous ligand, the thing in your body that binds to the nicotinic acetylcholine receptor, is acetylcholine." (said at 0:12:49)

Nicotinic acetylcholine receptors (nAChRs) are pentameric ligand-gated ion channels whose primary endogenous neurotransmitter/ligand is acetylcholine. Nicotine is an exogenous alkaloid produced by Solanaceae plants (such as tobacco) that historically served as a pharmacological tool (alongside muscarine) to distinguish receptor subtypes, and it is not endogenously biosynthesized in the human body.

0:13:51Paul Saladino (host)supportedhigh

A 2010 meta-analysis by Heishman of 41 double-blind placebo-controlled trials found cognitive effect sizes of nicotine supplementation ranged from 0.16 to 0.44.

"There's a 2010 meta-analysis by Heishman that did find benefits to nicotine supplementation... The effect sizes were 0.16 to 0.44. That's small to moderate in scientific research terms." (said at 0:13:51)

A 2010 meta-analysis by Heishman and colleagues evaluated 41 double-blind, placebo-controlled laboratory studies of acute nicotine administration in healthy adult non-smokers or non-deprived smokers. The analysis identified significant positive effects across six performance domains (fine motor abilities, alerting attention accuracy/response time, orienting attention response time, short-term episodic memory accuracy, and working memory response time), with effect sizes ranging from 0.16 to 0.44.

0:16:49Paul Saladino (host)supportedmoderate

A 2020 systematic review found that 59% of researchers publishing studies on nicotine's cognitive benefits had tobacco industry funding, and over half did not disclose it.

"a 2020 systematic review found that 59% of researchers publishing studies on the cognitive benefits of nicotine had prior or current tobacco industry funding. And over half of them didn't disclose it." (said at 0:16:49)

A 2020 systematic review evaluating cognitive performance effects of nicotine and industry affiliations found that among 32 included studies, 59% (n = 19) of authors had received prior tobacco industry funding, and 53% (n = 10) of those with industry funding did not disclose it.

0:19:10Paul Saladino (host)supportedhigh

A 2025 review in the European Heart Journal concluded that no nicotine delivery system can be considered safe for cardiovascular health.

"According to the scientific literature, a 2025 review in the European Heart Journal concluded that no nicotine delivery system—not cigarettes, not vaping, not nicotine pouches—can be considered safe for the heart and blood vessels." (said at 0:19:10)

A 2025 expert consensus and policy statement published in the European Heart Journal evaluated the cardiovascular impacts of nicotine across various delivery mechanisms. The authors concluded that nicotine itself acts as a direct cardiovascular toxin independent of combustion, noting that all nicotine delivery systems—including traditional cigarettes, electronic cigarettes, heated tobacco, and nicotine pouches—pose substantial cardiovascular risks and that the concept of 'safer nicotine' is misleading.

0:19:58Paul Saladino (host)supportedlow

A 2024 study found that e-cigarette users were 20% more likely to develop heart failure.

"A 2024 study found that e-cigarette users were 20% more likely to develop heart failure." (said at 0:19:58)

The statement accurately reflects findings presented in 2024 from a large observational study using the NIH 'All of Us' Research Program dataset (175,667 participants, presented at the American College of Cardiology Scientific Session 2024 by Bene-Alhasan et al.). That study reported that participants who used e-cigarettes had a 19% higher risk (often reported as ~20%; HR 1.19) of developing incident heart failure, particularly heart failure with preserved ejection fraction (HFpEF), compared with non-users. Published 2024 reviews also document that e-cigarette use is associated with an increased incidence of cardiovascular conditions, including heart failure. Because the primary findings derive from an observational cohort design and conference presentation data, certainty is rated as low.

0:21:30Paul Saladino (host)supportedvery low

A 2024 study in Communications Biology found adolescent nicotine exposure produces qualitatively different brain effects in the prefrontal cortex, nucleus accumbens, and ventral tegmental area compared to adults.

"A 2024 study in Nature's Communications Biology journal found that adolescent exposure to nicotine affects the brain very differently than adult exposure: qualitatively different effects in the prefrontal cortex, the nucleus accumbens, and the ventral tegmental area." (said at 0:21:30)

A 2024 animal study published in Communications Biology (a Nature Portfolio journal) compared the effects of vaporized nicotine self-administration in adolescent versus adult mice across the prefrontal cortex (mPFC), ventral tegmental area (VTA), and nucleus accumbens. The researchers found distinct, age-dependent neurobiological changes: adolescent-exposed mice showed significant increases in mPFC pyramidal neuron excitability that correlated with reinforcement-related behavior, whereas adult-exposed mice showed distinct receptor alterations in the VTA correlating with self-administration. Because the evidence is derived exclusively from a rodent model, the certainty of direct translation to human brain function is very low.

0:22:06Paul Saladino (host)supportedhigh

Cigarette smoking causes approximately 480,000 deaths per year in the United States.

"Let's start with cigarettes: combustion, 7,000 chemicals, 70 known carcinogens, 480,000 American deaths per year." (said at 0:22:06)

Epidemiological estimates from the US Centers for Disease Control and Prevention and the US Preventive Services Task Force establish that cigarette smoking (including exposure to secondhand smoke) is responsible for approximately 480,000 deaths annually in the United States.

0:22:21Paul Saladino (host)supportedmoderate

Vaping delivers 13 times lower formaldehyde and 800 times lower acetaldehyde levels than combustible cigarettes.

"Formaldehyde 13 times lower than cigarettes. Acetaldehyde 800 times lower than cigarettes." (said at 0:22:21)

Laboratory aerosol analyses comparing electronic cigarettes to combustible tobacco cigarettes show that emissions of key carbonyl toxicants, including formaldehyde and acetaldehyde, are substantially lower in e-cigarette vapor. In benchmark aerosol testing across multiple e-cigarette brands and combustible cigarettes, toxicant emissions in vapor were found to be 9- to 450-fold lower than in conventional cigarette smoke. Although exact ratios vary depending on device power, liquid composition, and operating temperatures (which can alter thermal degradation of carrier solvents like propylene glycol and glycerol), the claimed multi-fold reductions in formaldehyde and acetaldehyde relative to combustible cigarettes are well supported by aerosol chemistry literature.

0:23:06Paul Saladino (host)supportedhigh

Zyn nicotine pouches contain sodium carbonate to raise pH and convert nicotine into its freebase form for enhanced gum absorption.

"Zyn pouches use sodium carbonate, a base, to increase the pH of nicotine, converting it to its freebase form. This leads to increased absorption rates through your gums." (said at 0:23:06)

The host's statement accurately describes the biochemical formulation and mechanism of oral nicotine products like Zyn. Nicotine is a weak base, and its absorption across mucosal membranes (such as the gums) depends on its ionization state. At lower pH levels, nicotine exists predominantly in its ionized (protonated) state, which does not easily cross cell membranes. Adding alkaline agents such as sodium carbonate increases the product's pH, shifting nicotine into its non-ionized (freebase) form, which rapidly diffuses across the oral mucosa into systemic circulation. Clinical pharmacokinetic studies confirm that raising the pH of oral tobacco and nicotine formulations using sodium carbonate directly increases buccal nicotine absorption.

0:26:49Paul Saladino (host)supportedhigh

Only 3% to 5% of people attempting to quit nicotine cold turkey succeed without assistance.

"Only 3 to 5% of people are going to be successful at this, which is why packaging of things like this as benign or nootropic are so sinister." (said at 0:26:49)

The statement that only 3% to 5% of individuals succeed in quitting nicotine cold turkey (unassisted) aligns with benchmark long-term abstinence rates established in systematic reviews and clinical trials. Cochrane systematic reviews of smoking cessation interventions generally benchmark the long-term (6- to 12-month) unassisted quit rate at approximately 2% to 3%, with meta-analyses of control cohorts showing cessation rates without formal intervention typically ranging from 3% to 7%.

0:04:28Paul Saladino (host)supportedmoderate

Cigarette manufacturers added bronchodilator compounds to cigarettes to open airways and facilitate deeper inhalation of nicotine into the lungs.

"They also added bronchodilators, pharmaceutical compounds like the ones people with asthma use, to open your airways so you could inhale deeper, so the freebased nicotine in a cigarette could get deeper into your lung." (said at 0:04:28)

Cigarette additives have included substances evaluated and regulated specifically for their bronchodilatory and inhalation-facilitating properties. Published regulatory analyses and pharmacological reviews document that additives such as menthol, methylxanthines (e.g., theobromine from cocoa), and β2-adrenoreceptor agonists have been used or investigated in tobacco products because their bronchodilating, sensory-masking, and airway-relaxing effects facilitate deeper inhalation and enhance nicotine uptake and bioavailability.

0:13:18Paul Saladino (host)supportedhigh

Nicotine crossing the blood-brain barrier and binding to nicotinic acetylcholine receptors triggers the release of dopamine, norepinephrine, and beta-endorphin.

"When exogenous nicotine from any one of these sources crosses the blood-brain barrier and binds to these nicotinic acetylcholine receptors in your brain, it triggers the release of multiple other neurotransmitters. Most importantly, dopamine, associated with reward and motivation. Anything that triggers the release of dopamine in your body is very addictive. Caffeine, anyone? Nicotine also triggers the release of norepinephrine, associated with alertness and focus, and beta-endorphin, which is linked to pain relief and calm." (said at 0:13:18)

Extensive pharmacological and neurochemical research establishes that exogenous nicotine readily crosses the blood-brain barrier and binds to nicotinic acetylcholine receptors (nAChRs) in the central nervous system. This activation stimulates the release of multiple neurotransmitters and neurohormones, including dopamine (particularly in the mesolimbic reward pathway), norepinephrine (noradrenaline), and beta-endorphin.

0:17:13Paul Saladino (host)supportedhigh

Daily nicotine use causes the brain to upregulate and produce more nicotinic acetylcholine receptors.

"When you flood your nicotinic acetylcholine receptors with nicotine day after day, an interesting thing happens. The nicotine actually causes your brain to produce more of these receptors, but they're stuck in a state that needs nicotine to function properly." (said at 0:17:13)

Chronic or daily exposure to nicotine reliably causes upregulation of high-affinity neuronal nicotinic acetylcholine receptors (nAChRs, particularly the α4β2 subtype) throughout the brain. This paradoxical increase in receptor density is a well-established neuroadaptation accompanied by receptor desensitization and intracellular pharmacological chaperoning by nicotine, which stabilizes receptor assembly and alters normal receptor function and sensitivity.

0:22:32Paul Saladino (host)supportedmoderate

A single disposable vape can release more lead in one day of use than smoking 20 packs of cigarettes.

"One disposable vape released more lead in a single day's use than 20 packs of cigarettes." (said at 0:22:32)

Chemical analyses of contemporary disposable electronic cigarettes show that several popular brands (such as those utilizing leaded bronze or brass internal components) release toxic heavy metals at concentrations orders of magnitude higher than conventional combustible cigarettes. Mass-balance and aerosol emission studies have demonstrated that individual disposable vapes can contain and aerosolize hundreds of micrograms of lead (up to ~500 µg per device), whereas mainstream smoke from 20 packs of combustible cigarettes (400 cigarettes) typically yields roughly 4 to 20 µg of lead total.

Unverified means no publication matching the claim was located; it does not prove the claim false. Spotted an error? See the corrections policy - disputes from the people quoted are prioritized.