What is it?
Nicotine occurs in tobacco and is present in vapes, pouches and nicotine replacement products. Most harm from smoking comes from the other components of tobacco smoke rather than nicotine itself.
Common forms
- Cigarettes and rolling tobacco
- Vapes
- Pouches
- Nicotine replacement therapy
How it affects the body
Nicotine acts on receptors involved in reward and alertness and produces dependence quickly.
Short-term effects
- Alertness and reduced stress in dependent users
- Raised heart rate
- Dizziness or nausea in new users
Long-term effects
- Smoking causes cancer, cardiovascular and respiratory disease
- Strong dependence
- Effects on pregnancy and children's health
Dependence and addiction
Dependence can develop when the body and brain adapt to regular use. It is not a moral failing or a lack of willpower. Signs people describe include needing more to get the same effect, difficulty cutting down, spending more time thinking about use, and continuing despite harm. Support is available at any stage — you do not need to have reached a crisis point. Stop-smoking services and pharmacy support significantly improve the chances of stopping.
Withdrawal
Irritability, restlessness, low mood, poor concentration and cravings are common and time-limited. Nicotine replacement and medication can help — ask a pharmacy or NHS stop-smoking service.
Overdose risks
Nicotine poisoning is a particular risk for children who swallow e-liquid or pouches. Call 999 or 111 immediately if this happens.
Mixing substances
Smoking cannabis with tobacco adds nicotine dependence. Some medicines are affected by smoking — ask a pharmacist when you stop.
Harm-reduction information
- Free NHS stop-smoking support improves success rates
- Ask a pharmacist about nicotine replacement
- Store e-liquids and pouches out of reach of children
- Cutting down is a valid step — support is not conditional on quitting
When to seek urgent medical help
Call 999 if someone is unconscious or cannot be woken, is having difficulty breathing, has a seizure, has chest pain, becomes very confused or agitated, or you are worried they may have overdosed. For urgent advice that is not life-threatening, call NHS 111. You will not get someone into trouble by calling for medical help.
Treatment and recovery options
- Talking therapies and structured psychosocial support
- Community drug and alcohol services, including self-referral where available
- Medication-assisted treatment where clinically appropriate
- Medically supported withdrawal, arranged and monitored by clinicians
- Peer support and recovery communities
- Residential rehabilitation for some people, usually via assessment
- Support for related needs — mental health, housing, family and welfare
UK support resources
- NHS — health information and service finders (nhs.uk)
- Talk to FRANK — UK drug information service (talktofrank.com)
- Your local community drug and alcohol service — many accept self-referrals
- Local pharmacy teams, who can offer advice and signposting
Sources / references
This page is a plain-language summary written for education. For clinical or legal detail, use authoritative UK sources: NHS (nhs.uk), Talk to FRANK (talktofrank.com), NICE (nice.org.uk), UK Government and devolved government publications, and guidance from UK professional bodies. Each page on this site carries a review date, and we welcome corrections.