An ironic contradiction has emerged alongside the Make America Healthy Again movement: nicotine is being promoted as a wellness aid and performance booster. Across social media, podcasts, wellness communities and tech startups, influencers are recasting it as a misunderstood compound unfairly defined by cigarettes.

That makeover moves nicotine from its established role as an addictive substance linked to tobacco toward a supposedly natural tool for focus and protection against cognitive decline. Products include noncombustible nicotine pouches and combinations of nicotine, caffeine and nootropics marketed to enhance cognition.

Hasmeena Kathuria, a pulmonary physician and scientist who studies nicotine addiction and the health consequences of tobacco and nicotine products, is concerned about claims involving wellness, productivity and cognitive performance. Kathuria is a professor of medicine at the University of Wisconsin-Madison.

Some claims lean on nicotine being a naturally occurring plant compound found mainly in tobacco and in trace amounts in nightshade vegetables such as tomatoes, potatoes and eggplant. Advocates also cite studies showing that nicotine can affect certain aspects of cognition and brain function.

Extending those findings to sweeping promises about productivity, brain health, longevity or wellness goes beyond what human studies have shown. Nicotine remains the primary driver of tobacco addiction in cigarettes, vapes and most other commercial tobacco products.

The greatest risks arise when tobacco is burned, generating thousands of toxic substances, including carcinogens, carbon monoxide and fine particulate matter. Repeated exposure can cause cancer, chronic obstructive pulmonary disease, cardiovascular disease and numerous other illnesses associated with smoking.

Nicotine itself also has established negative effects on the brain and body. It activates the sympathetic nervous system, which governs the fight or flight response, increasing heart rate and blood pressure, disrupting sleep and potentially adding strain to the heart.

Exposure is particularly concerning during critical phases of development. Prenatal nicotine exposure has been associated with adverse effects on fetal growth and development, while adolescent exposure can alter neural systems involved in attention, learning and reward.

Acetylcholine is a chemical messenger involved in attention, learning, memory and information processing. Nicotine acts on many of the same receptors, temporarily increasing alertness, attention and arousal while influencing dopamine release and the brain pathways involved in reward and reinforcement.

Nicotine does not reproduce normal acetylcholine signaling because its effects last much longer and alter activity throughout the brain. With repeated exposure, receptors become less responsive, and the brain increases the number of nicotine receptors, contributing to dependence.

Some studies indicate that nicotine may temporarily improve attention, vigilance, reaction time and aspects of working memory, although the findings are mixed. Research suggests possible benefits for people with mild cognitive impairment, but not for healthy individuals, and performance may worsen in people who already perform highly.

Another complication is that many studies include regular users who are dependent on nicotine. When they stop, these users commonly experience difficulty concentrating, irritability, anxiety, restlessness and impaired attention.

Reintroducing nicotine can relieve those symptoms, making it difficult to distinguish genuine cognitive enhancement from the reversal of withdrawal. Evidence remains limited that nicotine meaningfully improves academic achievement, intelligence, creativity, executive functioning or workplace productivity.

Nicotine can activate reward pathways and create a temporary sense of pleasure and wellbeing. Long term use, however, can interfere with the body’s stress response system, potentially making stress and anxiety more difficult to manage.

Research consistently shows that people who quit smoking experience reductions in anxiety, depression and stress, along with improved mood and quality of life over time. Current evidence does not support nicotine as a treatment for stress, anxiety or depression.

More ambitious claims suggest nicotine protects against dementia, Alzheimer’s disease, Parkinson’s disease or cognitive decline. Although laboratory and animal studies have examined relevant pathways and disease processes, human studies have not shown that nicotine prevents dementia, slows Alzheimer’s progression or improves Parkinson’s outcomes.

Similar longevity claims draw largely from laboratory research into oxidative stress, inflammation and cellular pathways. Those findings have not become evidence that nicotine slows biological aging, extends human lifespan or prevents diseases associated with aging.

Food and Drug Administration approved patches, gum and lozenges can help people with nicotine dependence manage withdrawal and cravings while stopping smoking. That approved treatment should not be confused with wellness claims, since nicotine use outside treatment for reducing or stopping tobacco use carries a risk of dependence.

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