Is Nicotine Harmful to Your Heart? Expert Warns of Risks

Nicotine is a potent cardiovascular toxin regardless of how it is delivered. Whether through traditional cigarettes, vapes, heated tobacco, or pouches, nicotine stimulates the sympathetic nervous system, raising heart rate and blood pressure while promoting arterial stiffness. Experts emphasize that the absence of smoke does not mean the absence of harm to the heart.

Key Takeaways:

Universal Risk: All nicotine products, including vapes and pouches, pose cardiovascular dangers.
Mechanism of Harm: Nicotine causes endothelial dysfunction, arterial stiffness, and increases clot risk.
Secondhand Danger: Aerosols from vapes and shisha smoke also impair heart health in bystanders.
Policy Need: Stronger regulations on flavors, marketing, and taxation are essential for public health.

Cardiovascular toxicity refers to the harmful effects substances have on the heart and blood vessel system, a critical concern highlighted by Dr. Sushil Sharma, Head of the Department of Cardiology at GMCH Jammu. During a recent cardiac awareness camp, Dr. Sharma stressed that the evolving landscape of nicotine products presents a persistent threat to heart health, debunking the myth that modern alternatives are safe.

The Transformation of Tobacco and the Persistence of Harm

While traditional cigarettes have long been the primary villain in heart disease, the market has shifted towards newer delivery systems like electronic cigarettes (vapes), heated tobacco products, nicotine pouches, and shisha. These products are often marketed with sleek designs and appealing flavors, fostering a widespread belief that they are “safer than smoking.”

However, Dr. Sharma warns that this narrative is scientifically unsound. Emerging evidence and expert consensus confirm that nicotine itself is a potent cardiovascular toxin. The absence of combustion smoke does not equate to an absence of cardiovascular risk.

How Nicotine Attacks the Cardiovascular System

Dr. Sharma elaborated on the multiple mechanisms through which nicotine damages the heart and blood vessels:

Sympathetic Stimulation: Nicotine triggers the sympathetic nervous system, causing acute spikes in heart rate, blood pressure, and the heart’s demand for oxygen.
Endothelial Dysfunction: Chronic exposure damages the inner lining of blood vessels (endothelium) and impairs vasodilation, a key early step in the development of atherosclerosis (hardening of the arteries).
Arterial Stiffness: It accelerates the stiffening of arteries, increasing the workload on the heart.
Pro-Thrombotic State: Nicotine increases platelet activation and aggregation, raising the risk of blood clots that can lead to heart attacks and strokes.
Secondhand Exposure: Aerosols from vapes and smoke from shisha are not benign; they can impair endothelial function in bystanders and contribute to indoor air pollution.

A Call for Unified Action and Regulation

From a public health perspective, the economic burden of nicotine addiction—including healthcare costs and lost productivity—is immense and largely preventable. Dr. Sharma argues that clinicians, policymakers, and the public must move beyond a narrow focus on smoke alone.

To curb initiation and promote cessation, he advocates for strong regulatory measures, including:

Flavor Bans: Reducing the appeal of products to youth.
Strict Marketing Controls: Limiting aggressive advertising tactics.
Age Enforcement: Preventing access for minors.
Taxation: Basing taxes on nicotine content to discourage high-dose consumption.
Smoke-Free Laws: Including all nicotine products in clean air regulations.

Ultimately, protecting cardiovascular health requires a unified approach that prioritizes prevention and dismantles the myths surrounding “safe” nicotine alternatives. The goal, Dr. Sharma concluded, should be to reduce and eliminate nicotine exposure altogether to safeguard current and future generations.