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                Health Effects of Tobacco Use

Health Effects of Tobacco Use

                        Nicotine Is Why Tobacco Products Are Addictive
          How Smoking Affects Heart Health
          Keep Your Air Clear: How Tobacco Can Harm Your Lungs
          How Smoking Can Increase Risk for and Affect Diabetes
          Chemicals in Tobacco Products and Your Health
          What It’s Like to Quit Smoking
          How Smoking Affects Reproductive Health
          How Smoking Can Contribute to Vision Loss and Blindness
          Health Fraud
          Quitting Smoking and Other Tobacco Public Health Resources Home
          Tobacco Products
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          Health Effects of Tobacco Use
          Nicotine Is Why Tobacco Products Are AddictiveHealth Effects of Tobacco Use Nicotine Is Why Tobacco Products Are Addictive
  
  	
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Why Are Cigarettes, E-Cigs, and Other Tobacco Products So Hard to Quit?
	What Is Nicotine?
	What Makes Tobacco Use Harmful?
	What Are Nicotine Replacement Therapies (NRTs) and How Can They Help?
	Where Do E-Cigarettes Fall on the Continuum of Risk?
	Is Nicotine Hazardous Waste?
	Why Can’t My Teen Quit Smoking or Vaping?
	Will Smoking or Using Tobacco Products Containing Nicotine Hurt My Baby?
	Is FDA Lowering the Levels of Nicotine in Cigarettes?Why Are Cigarettes, E-Cigs, and Other Tobacco Products So Hard to Quit?

**Nicotine**. Tobacco products are addictive because they contain nicotine. Nicotine keeps people using tobacco products, even when they want to stop.

Fact Sheet (English)

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CTP - TERL - Nicotine Fact Sheet - English

Fact Sheet (Spanish)

Order Free Print Version | Download Fact Sheet

CTP - TERL - Nicotine Fact Sheet - Spanish

What Is Nicotine?

**Nicotine is a highly addictive chemical compound present in a tobacco plant**. All tobacco products contain nicotine, including cigarettes, non-combusted cigarettes (commonly referred to as “heat-not-burn tobacco products” or “heated tobacco products”), cigars, smokeless tobacco (such as dip, snuff, snus, and chewing tobacco), hookah tobacco, and most e-cigarettes.

Using any tobacco product can lead to nicotine addiction. This is because nicotine can change the way the brain works, causing cravings for more of it.

Some tobacco products, like cigarettes, are designed to deliver nicotine to the brain within seconds,1 making it easier to become dependent on nicotine and more difficult to quit. While nicotine naturally occurs in the tobacco plant itself, some tobacco products contain additives that may make it easier for your body to absorb more nicotine.2

What Makes Tobacco Use Harmful?

Nicotine is what keeps people using tobacco products. **However, it’s the thousands of chemicals contained in tobacco and tobacco smoke that make tobacco use so deadly.** Some of these chemicals, known to cause lung damage, are also found in some e-cigarette aerosols.

This toxic mix of chemicals—not nicotine—cause the serious health effects among those who use tobacco products, including fatal lung diseases, like chronic obstructive pulmonary disease (COPD) and cancer.3

Tobacco products containing nicotine pose different levels of health risk to adult users. Combustible products, or products that burn tobacco, are the most harmful. An example of a combustible product is cigarettes, which deliver more than 7,000 chemicals1 along with nicotine that makes it hard to quit.

FDA-approved nicotine replacement therapies (NRTs), such as gums and lozenges, are the least harmful. Noncombustible products, such as heat-not-burn tobacco products, smokeless tobacco, and e-cigarettes, fall somewhere in between combustible products and NRTs.

If you’re an adult who currently doesn’t use tobacco products, we strongly encourage you to stay tobacco-free. If you’re an adult who currently uses tobacco products, there are resources to help you quit.

To learn about the additional harms tobacco can have on young people and their developing brains, read “Why Can’t My Teen Quit Smoking or Vaping?”

What Are Nicotine Replacement Therapies (NRTs) and How Can They Help?

**FDA-approved nicotine replacement therapies, also known as NRTs, are safe and effective products that contain nicotine and are designed to help adults quit smoking** by delivering small amounts of nicotine to the brain without the toxic chemicals found in cigarette smoke.

NRTs such as nicotine skin patches, gum, and lozenges can help you through the early part of quitting by relieving cravings and lessening nicotine withdrawal symptoms. When used properly, NRTs are a safe and effective way to help quit smoking and can double the chances of successfully quitting cigarettes.4

While there are no FDA-approved NRTs for youth use, talk to your health care provider about treatment options for youth.

Where Do E-Cigarettes Fall on the Continuum of Risk?

**FDA is committed to protecting the public health of all Americans while regulating an addictive product that carries health risks**. We’re conducting ongoing research on potentially less harmful forms of nicotine delivery for adults, such as electronic nicotine delivery systems (ENDS), or e-cigarettes. Though more research on both individual and population health effects is needed, many studies suggest e-cigarettes and noncombustible tobacco products may be less harmful than combustible cigarettes.

A 2020 Cochrane Library review of ENDS for smoking cessation found:

ENDS may help more people to stop smoking for six months or longer than using NRTs or nicotine free e-cigarettes.
	ENDS may increase quit rates compared to no support, or behavioral support alone.
	The overall incidence of serious adverse effects related to ENDS is low.5While these findings back up anecdotal reports, there is not yet enough evidence to support claims that e-cigarettes and other ENDS are effective tools for quitting smoking. According to the findings, the effects are particularly unclear when it comes to newer types of e-cigarettes that have better nicotine delivery, and the effect of ENDS when combined with an NRT.

**To date, no e-cigarette has been approved as a cessation device or authorized to make a modified risk claim**, and more research is needed to understand the potential risks and benefits these products may offer adults who use tobacco products.

Is Nicotine Hazardous Waste?

Yes. Nicotine, including nicotine salt, is listed by the Environmental Protection Agency (EPA) as an acute hazardous waste.6

Why Can’t My Teen Quit Smoking or Vaping?

**Because their brains are still developing**, young people have a higher risk of becoming addicted to the nicotine in tobacco products than adults.

Many teens don’t understand how easy it is to become addicted to tobacco products. The younger a person is when they start using tobacco, the more likely they are to become addicted.7

Nicotine exposure during adolescence can disrupt normal brain development.7

Because of nicotine’s powerfully addictive nature and major effects on the developing brain, no tobacco products are safe for youth to use.

Free Posters and Fact Sheets



The Tobacco Education Resource Library, run by the FDA Center for Tobacco Products, provides free print materials and web content aimed at communicating the dangers of tobacco use. In the FDA Tobacco Education Resource Library, you can order and download print materials, such as:

Resources for Professionals About Vaping & E-Cigarettes Toolkit
	Signs and Symptoms of Vaping Addiction Fact Sheet
	Smoking Cessation Education Posters

Will Smoking or Using Tobacco Products Containing Nicotine Hurt My Baby?

**Nicotine can cross the placenta when a pregnant person uses tobacco products**. This can negatively impact the baby, including, but not limited to: premature labor; low birth weight; respiratory failure at birth; and even sudden infant death syndrome (SIDS).3, 8, 9, 10

People who use tobacco products can experience negative health effects on their reproductive health, their pregnancies, and their babies. If you use tobacco products and are considering having a child, consult your doctor and learn more about how you can quit smoking.

Is FDA Lowering the Levels of Nicotine in Cigarettes?

Mitch Zeller speaking at TEDx MidAtlantic March 2019
Former Center Director Mitch Zeller’s presentation on “The Past, Present, and Future of Nicotine Addiction.”

Watch >>

Lowering nicotine in cigarettes to a minimally or non-addictive level through the creation of a potential nicotine product standard could decrease the chances that future generations become addicted to cigarettes, and could make it easier for more currently addicted smokers to quit.

On March 15, 2018, FDA issued an advance notice of proposed rulemaking (ANPRM) seeking public comment on issues and questions related to such a potential nicotine product standard. FDA is constantly gathering new evidence and considering evolving data regarding tobacco products and use, and continues to consider a product standard that would require manufacturers to limit the amount of nicotine in cigarettes and certain other combusted tobacco products to a level that would render them minimally addictive or non-addictive for most people. On June 21, 2022, the potential nicotine product standard was included in the Spring 2022 Unified Agenda.

Health Effects
of Tobacco Use

What It’s Like to Quit Smoking

Quitting Smoking and Other Health Resources

References
	U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.
	U.S. Department of Health and Human Services (USDHHS). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.
	U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
	Hartmann-Boyce J, Chepkin SC, Ye W, Bullen C, Lancaster T. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database of Systematic Reviews 2018, Issue 5. Art. No.: CD000146. DOI: 10.1002/14651858.CD000146.pub5.
	Hartmann-Boyce J, McRobbie H, Lindson N, Bullen C, Begh R, Theodoulou A, Notley C, Rigotti NA, Turner T, Butler AR, Fanshawe TR, Hajek P. Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews 2020, Issue 10. Art. No.: CD010216. DOI: 10.1002/14651858.CD010216.pub4.
	EPA opinion letter on e-liquid as hazardous waste: https://rcrapublic.epa.gov/files/14850.pdf. Discarded or neglected vaping products may contain harmful substances, including unused e-liquid.
	U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: Preventing Tobacco Use among Youth and Young Adults. We Can Make the Next Generation Tobacco-Free (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012.
	U.S. Department of Health and Human Services (USDHHS). E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2016.
	U.S. Department of Health and Human Services (USDHHS). Women and Smoking. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2001.
	U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Secondhand Smoke: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006.

                                                                                  Content current as of:
      06/29/2022
              
              
Regulated Product(s)
		 TobaccoHealth Effects of Tobacco Use

          
                        Nicotine Is Why Tobacco Products Are Addictive
          How Smoking Affects Heart Health
          Keep Your Air Clear: How Tobacco Can Harm Your Lungs
          How Smoking Can Increase Risk for and Affect Diabetes
          Chemicals in Tobacco Products and Your Health
          What It’s Like to Quit Smoking
          How Smoking Affects Reproductive Health
          How Smoking Can Contribute to Vision Loss and Blindness
          Health Fraud
          Quitting Smoking and Other Tobacco Public Health Resources
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