Aside from the fact that it is powerfully addictive, nicotine is a relatively safe stimulant when you separate it from traditional cigarettes. There are, however, several health conditions that are contraindications for nicotine use. If one of these contraindications applies to you, you should not use nicotine at all. If you already use nicotine because you smoke, though – and you have been unsuccessful in your attempts to quit – you should evaluate your options with your doctor. If you would continue smoking either way, your doctor may conclude that it would be healthier for you to switch to vaping instead.
Diabetes
Medical professionals have long known of a connection between smoking and elevated blood glucose levels. In 2011, a presentation given at a meeting of the American Chemical Society suggested that nicotine is the component of cigarette smoke that increases blood sugar. In a study conducted by researchers from California State Polytechnic University, it was discovered that nicotine increased the haemoglobin A1c in human blood samples. Since HbA1c levels are a key health indicator in individuals with diabetes, you should not use nicotine at all if you have type 1 diabetes or are at risk of developing type 2 diabetes.
Heart Disease and High Blood Pressure
There is a well-established link between cigarette smoking and an increased risk of heart disease. It is unclear, though, whether using nicotine alone lowers that risk compared to smoking. We do know that nicotine increases heart rate and blood pressure while constricting the blood vessels. Since nicotine impairs blood flow, it can contribute to macular degeneration and reduce the body’s ability to heal injuries. It can also potentially contribute to heart disease or worsen symptoms in those with pre-existing heart conditions. You should not use nicotine at all if you have high blood pressure, chest pains, an irregular heart rhythm, arterial blockage or a prior heart attack.
Hypothyroidism
Cigarette smoking stimulates the production of thyroid hormones. A 2014 study suggests that the sudden decrease in thyroid activity can be so great after quitting smoking that doctors should monitor the thyroid activity of anyone who discontinues long-term nicotine use. Some people who stop using nicotine require supplemental hormones to maintain proper thyroid function.
There is an alternative viewpoint. A 1998 study suggests that nicotine is not the component of cigarette smoke that leads to an overactive thyroid. The study suggests that the smoke itself is what causes the overproduction of thyroid hormones.
If you have any thyroid condition or are taking medication to regulate thyroid function, you should talk to your doctor before switching to vaping.
Impaired Kidney Function
Studies suggest that nicotine causes progressively worsening symptoms in those with kidney damage or disease. If you have impaired kidney function, discuss vaping with your doctor.
Impaired Liver Function
A 2018 study published in "The Endocrine Society” examined the liver health of mice exposed to e-cigarette vapour. The mice were examined after 12 weeks and were found to have gene changes associated with abnormal circadian rhythms and fatty liver development. Although the study’s findings don’t necessarily indicate that vaping is harmful to the liver health of humans, it may be wise to discuss vaping with your doctor if you have any issues relating to hepatic health.
Lung Disease
Whether or not vaping causes lung disease is an unanswered question partly because, as a 2015 review published in "Lung Cellular and Molecular Physiology” points out, studying the effect of vaping on the lungs is like trying to hit a moving target because popular devices and e-liquids never stop changing. It is certain that e-liquid aerosol contains far less chemicals than cigarette smoke. It is also certain, though, that you should not use any inhaled form of nicotine if you already have chronic lung disease.
Pregnancy and Nursing
There is a well-established link between smoking during pregnancy and foetal damage. Smoking during pregnancy increases the risk that the child will have a low birth weight, and there also appears to be a link between low birth weight and lower IQ scores.
A study in India showed a link between smokeless tobacco use and stillbirth. In another study of mothers who smoked 20 cigarettes or more per day, more than 50 percent of new-borns involved in the study required intensive care treatment. Smoking increases the risk of foetal or infant death by 150 percent.
Nicotine use by the mother increases the chance that the child will one day use nicotine, perhaps in part because a small dose of nicotine is present in the mother’s milk. While the risks of vaping during pregnancy aren’t definitively established, it seems safe to say that pregnant and nursing mothers should not consume nicotine in any form – including vaping.
Prescription Medication Interactions
Nicotine causes known moderate interactions with a few prescription medications. We’ll describe those below.
- Bromocriptine is a dopamine agonistused in the treatment of type 2 diabetes, Parkinson’s disease, pituitary tumours and many other conditions. It also constricts the blood vessels, and nicotine can amplify that effect.
- Bupropion is an antidepressant used to treat clinical depression. It is also prescribed as a smoking cessation aid. Used in conjunction with nicotine, it can cause an unsafe increase in blood pressure.
- Ceritinib is prescribed to patients with a specific form of lung cancer. If you use nicotine while taking it, your body may have higher than normal blood-nicotine levels.
- Ergotamine is a drug that treats acute migraines by causing blood vessels to constrict. Nicotine can amplify the drug’s effect, leading to a dangerous reduction in blood flow. The related drugs dihydroergotamine and ergonovine – and any other ergot-based medications – carry similar risks when used in conjunction with nicotine.
- Hydroxyprogesterone is a synthetic progestin used to prevent preterm birth and miscarriage. It is also prescribed for birth control purposes. It may reduce the concentration of nicotine in the blood.
- Telotristat is prescribed to prevent diarrhoea in those suffering from carcinoid syndrome. It may reduce the concentration of nicotine in the blood.
- Varenicline is a drug that assists with smoking cessation by reducing the pleasurable effects of tobacco use. When used in conjunction with nicotine, the likelihood of side effects such as nausea, vomiting and dizziness is increased.
If you take any prescription medications – particularly the ones listed above – you should consult with your doctor before switching to vaping. The above listed medications are only the ones known to have moderate interactions when used in conjunction with nicotine. Nicotine also has known mild interactions with many other prescription medications.
Ulcer
Chronic nicotine use stimulates stomach acid production, which can aggravate ulcers. If you have an ulcer, you should not use nicotine – particularly if overproduction of stomach acid is the cause of your ulcer.
