What nicotine does to your brain
46 comments
·November 19, 2025michelpp
fragmede
I caught Covid march 2020 and it broke my brain. watching Netflix was too difficult. I'm better now through a wide variety of things, but nicotine, via patches for me (half of a 7mg patch - don't want to get used to too much), gave me my life back. That, and a vagus nerve stimulator.
jovial_cavalier
I have a similar average intake to you, and I've been on it much longer, about 3.5 years. I have had periods where I go off the stuff entirely, including a whole month and a half earlier this year. I've also had periods where my intake has spiked much higher.
The withdrawal symptoms are actually strangely pleasant to me as long as I'm in the right mood and have something interesting to focus on. You will get irritable at things you shouldn't, but as long as you keep that in mind, you should be able to stop yourself from totally flying off the handle. In terms of "fogginess," I find that it's actually mostly in your head. As in, I feel like my mind is dulled, yet when I present myself with a task I somehow find it solved to about the same standard that I'm used to. If you end up feeling foggy coming off of the stuff, give yourself at least a week or two to adjust.
sph
I am diagnosed ADHD. I have used dexamphetamine as prescribed which worked pretty well, in moderate dosages because I am sensitive, but I came to dislike the effect it had on me: I felt like I was attached to a horse that kept pulling me around even when I just wanted to stop and take a break. And the fact that I would crash 5 hours later.
In 2020, before even knowing I had ADHD, let alone being medicated, I managed to quit my (vaped) nicotine habit after using progressively smaller patches; meanwhile my executive dysfunction grew so much, during the most stressful time of my entire life, that I literally had a major nervous breakdown. It took years of therapy, diagnosis with ADHD, medication, to connect the two factors: I had been self-medicating with nicotine by entire life, and as I reduced the amount of it in my bloodstream, the more scattered I became [1]
Then I tested my theory: I bought some nicotine patches, cut at very low dosage. And lo! it was as effective as dexamphetamine was, with much fewer of the side-effects, no pulling effect [2] and cheaper. It's been now a year and a half and honestly it's been working great. I slap on a small patch in the morning, it lasts MUCH longer than a pill, and it even allowed me to move and still lead a productive life in a country where ADHD is not even recognised. I asked my psychiatrist and they confirmed that nicotine is known to work as a third-line medication but usually amphetamines are preferred.
This is not medical advice, yadda yadda, but worked for me, and I've always wanted to write a post about it. Regarding addiction: pretty much none, patches take too long to take effect to create addiction (i.e. caused by a predicable spike in dopamine). My dosage (~7.5mg patch cut out from a larger one) has been the same for the past 18 months, and trying larger doses just makes me sleepy (nicotine has a U-shaped effectiveness curve). Nicotine is much maligned, but if you do the research, avoid the smoking and inhalation devices but only use patches, maybe you'll find it helps you as well.
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1: I read that cigarette smoke during the formative years is associated with lifelong ADHD, and my pet (silly) theory is that the increasing stigma surrounding smoking of the past ~30 years might be one of the many factors we see ADHD on the rise. We might have 2 or 3 generations of smoking parents that were themselves self-medicating because of growing up in times where smoking was commonplace.
2: if I need to feel like a productive machine for a couple hours, coffee and a tyrosine pill can recreate the amphetamine feeling pretty well
nandomrumber
My experience parallels yours. I’ve been intermittently using cutdown patches, and B vitamins + magnesium, in an effort to have fewer complete nut-job breaks from reality.
Nicotine is a CNS stimulant, and cigarettes are somewhat of a fidget spinner, and social lubricant. What’s not to like.
For most people, long term nicotine use is probably less deleterious than long term amphetamine use.
More recently I starting testosterone, and that’s made me feel heaps less like a histrionic toddler.
0xAFFFF
Fellow ADHDer here, I'm not a smoker but long before I was diagnosed, lyrics from a song of my favorite band/artist hit me particularly hard. It was Drag by Joey Cape/Lagwagon, a song about the struggles of smoking. Here's the part, especially the last two lines.
The drag on the next one
Is something I can look forward to
Something to slow the synapse
Something to do with my hands
Knufen
Not a doctor, but can recommend methylphenidat any day over amphetamine. It is a much less "angry" version and the slow release evens the effect.
actionfromafar
That pet theory might have legs. I like it.
sph
I also blame screens. My other pet theory is that in 30 years we'll discover there is really no such thing as ADHD, just pre-frontal dopaminergic dysfunction from a lot of different causes, such as addiction (there is a great presentation by Dr. Todd Love about how ADHD and drug addiction present exactly the same), superstimuli frying our reward systems and natural differences in drive between people. What we're doing now is just treating the symptoms.
actionfromafar
I think screens can provoke AHDL-like symptoms or perhaps even trigger ADHD, but it existed before screens. Also a lot of illnesses are managed, even when we actually know the cause, we can't always undo the damage, just manage it.
cleansingfire
Except that ADHD is older than screens, and exists without drugs or addiction.
Pilottwave
I was just recently talking to my fellow ADHD friends on the benefits that i felt when i started vaping this summer. It was like i was medicating away my ADHD. I turned to AI to investigate further, its response seemed to underwrite this observation
Gemini output: Research is exploring nicotinic acetylcholine receptor (nAChR) agonists as a potential non-stimulant treatment for ADHD, sidestepping the issues of pure nicotine's high addiction liability.
The mechanism focuses on boosting dopamine (DA) and acetylcholine (ACh) release in brain areas governing attention and executive function, primarily by targeting the alpha4beta2 and alpha7 nAChR subtypes.
The goal is highly selective compounds that target the cognitive benefits (linked to alpha4beta2) while avoiding undesirable side effects and addiction pathways.
Selective alpha4beta2 Agonists (e.g., ABT-418, ABT-894/Sofinicline): These were developed to strongly activate the receptor most associated with DA release. Pilot and Phase II studies showed a signal of efficacy in adults with ADHD, with effect sizes similar to non-stimulant medications like atomoxetine.
Varenicline (Chantix/Champix): This is a partial alpha4beta2 agonist, FDA-approved for smoking cessation. Smaller trials suggested improvements in ADHD symptoms, but large-scale development for ADHD has been limited or terminated, and it is not approved for this indication.
Bupropion (Wellbutrin/Zyban): An established non-stimulant ADHD treatment (NDRI) and smoking cessation aid. While its main action is norepinephrine-dopamine reuptake inhibition, it also acts as a nicotinic receptor antagonist (blocking it), which is believed to help reduce nicotine craving. It is an approved non-stimulant option for ADHD.
nandomrumber
You’re not participating in the conversation when you do this.
Provide snippets and references from primary sources or turn off.
NalNezumi
There's also this short video from Kurzgesagt about smoking (nicotine) about this topic
jesuswasjew
That's a bad propaganda channel.
HipstaJules
Hey! Why do you say that? Curious to understand your POV
ff10
0 Karma / 7 days old account.
NotGMan
They are funded by wealthy people who most likely have them push their agenda.
ramon156
Brain fog for me became a lot less prevalent recently. I got no idea what it is but I don't want it to stop.
I honestly think brain fog is mostly a mentality thing, but I have no evidence to back this up. It doesn't really matter what I eat. The only thing I changed was I started gymming again and I'm taking creatine. I still eat garbage food
dsego
Creatine is supposedly good for cognitive performance, at least that's what I took from a couple of youtube videos I watched.
qmr
I take 2mg gum 0 to perhaps 8 times a day. Usually 2-3.
When box empties, I take a week or two off.
Slightly sharpens thought and suppresses appetite in combination with caffeine. Helpful for getting reducing body fat and getting abs in my advanced age. Supposedly neuroprotective effects as well.
elcritch
I can't read the article unfortunately.
However nicotine also seems somewhat palliative to a range of mental illnesses like schizophrenia, bipolar, anxiety, etc. I once read a paper that said something like 90% of schizophrenics were chain smokers who were self-medicating.
By that lens the widespread amount smoking in the past makes sense in eras before other pharmaceuticals.
johnisgood
Nicotine has lots of benefits, as per many articles on PubMed. That said, tobacco is still one of the worst (unhealthiest) ways to consume nicotine.
vladvasiliu
What other widespread way of consuming nicotine was there before patches and vapes?
I'm all for measures looking to curb smoking, but the issue is that nicotine seems to be put in the same category, at least judging by PSAs in France. Every nicotine-containing product has scary messages on it, although not to the point of actual cigarettes.
I think it's the general trend of losing nuance in public discourse. Things are either all bad or all good. This only confuses to public who can't be reasonably expected to peruse PubMed and build their own understanding of the subject.
cluckindan
You’d be chasing dopamine hits too if the system forced you to take antidopaminergic medication.
0xEF
Not really a difference for those of us who are not medicated, though. Everything around us, especially the stuff served up on the screen you are looking at now, is all clamoring for our attention, burning out our reward centers with reckless abandon in the process. Jumping from app to app has us chasing dopamine crumbs just like cigarettes did when I smoked them for 15 years of my life. The lesson is if you want to hack a human, make them feel something.
xyzal
Interesting, I remember sometimes actually 'getting' anxiety after a cig when I used to smoke.
eru
Compare and contrast https://gwern.net/nicotine
wtk
It does seem to help with focus, but my attempts to curb adhd and brain fog happily didn’t stop at nicotine. Niacinamide (B3) seems to do much better job for me, without the smell, nausea, and it works longer.
scroogey
How much do you take?
andy_ppp
TLDR;
• Nicotine boosts attention, memory and alertness by releasing dopamine and other neurotransmitters.
• It’s far less harmful than tobacco but highly addictive.
• Some evidence hints at therapeutic effects in Alzheimer’s, Parkinson’s and schizophrenia models.
• Developing brains (foetus, adolescence) show lasting harm in animal studies.
eru
Gwern's page (https://gwern.net/nicotine) and personal anecdata seems to go against the claims of nicotine by itself being addictive, especially 'highly addictive'.
Smoking (or even vaping) might be 'highly addictive'. But nicotine as eg patches that you glue on your skin doesn't seem to cause much addiction, if any at all.
jesuswasjew
Payeall
mamonster
Honestly, now that you have all-white snus, basically all of the issues of cigarettes are gone (and they are so fking expensive in Europe) and you get all of the benefits of nicotine. I don't need to go outside the office, just sit at my desk and continue working. Now that the market is developed you can vary nicotine dosage at will.
Maybe someone else here heard something different, but my dentist told me that there don't seem to be any dental issues associated with oral pouches, at least so far ?
wohoef
Find a new dentist. Nicotine pouches are incredibly bad for oral health. Huge risk of oral cancer. And it’ll make your gums recline, exposing your nerves (this hurts). Also nicotine itself is quite bad for you to begin with (cardiovascular health, anxiety, etc).
Sure snus is better than smoking, but that’s just because most things are better than smoking.
mamonster
>And it’ll make your gums recline
Would you happen to have a source? I mentioned this specifically, he said that he is only aware of gums reclining for very heavy users (5+ pouches a day) and that from the other patients he has 1-2 pouches don't seem to have any noticeable effect.
I caught covid for the first time in jan of 2024, the illness itself wasn't that bad for me, like a common cold, but the aftereffects lingered for months. Eventually my ability to smell and taste came back in a few weeks, but the mental brain fog would not let go. I would sleep over 12 hours a night and still be tired. According to my fitness tracker my daily step and energy burn counts were cut in half. It was so bad I forgot my own phone number at one point and my gmail password. Looking at a screen of code was impossible, I couldn't focus for more than a few seconds. My friends commented on the noticeable changes in my acuity and behavior.
Based on some online anecdotal evidence, I decided to try nicotine "therapy". I bought 4mg smoking cessation mints, cut them in half with a pill cutter, and took 10-12 2mg doses per day at roughly one hour intervals. The effect was immediate and brain fog lifted in less than a week. It was like coming out of a long dream, or like I had been stoned for six months and then suddenly I was sober again. My fitness stats have exceeded where I was before I got sick.
This is just my own anecdotal experience, and there have definitely been some downsides. The mints are about $50/month. My dosage has ticked up a bit and I'm certainly addicted, at least once a day I take a full mint instead of a half for an extra kick. I'd like to taper off, but I'm not sure if I do how to know if any effects are withdrawal or resumption of the covid brain fog. I have a light caffeine habit (2 cups every morning) and I don't see the mints being any more harmful than the coffee, so I think I'm just going to stick with it.