Nanny State

Smoking Is Bad for You. Nicotine Isn't—but Politicians Keep Trying To Ban It.

Nicotine has become associated with the worst harms of smoking, even though the chemical is not responsible for the cancers or lung disease caused by combustible tobacco.

Jeffrey A. Singer | 10.1.2026 7:30 AM

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Easthampton just became the 25th Massachusetts municipality to adopt a "nicotine-free generation" policy. Anyone born after January 1, 2006, will never be old enough to legally buy nicotine products there. The ban doesn't just apply to cigarettes. It also applies to noncombustible nicotine products that can help smokers reduce their risk.

Decades of anti-smoking campaigns have dramatically reduced cigarette use, especially among young people. That's great news. But somehow along the way nicotine itself became associated with the worst harms of smoking, even though the chemical is not responsible for the cancers, the lung disease, or most of the cardiovascular disease caused by combustible tobacco. Worse, the pendulum has swung so far in the maximalist anti-nicotine direction that we risk criminalizing some of the most effective smoking-cessation alternatives.

Consider the reports that Marty Makary resigned as Food and Drug Administration (FDA) commissioner to protest the White House's decision to authorize flavored nicotine vaping products. The products in question do not involve combustion—again, one of the core health problems of smoking—and may help adults move away from cigarettes. If Makary's goal was to help Americans avoid the worst maladies of tobacco use, going after vaping is simply the wrong approach. Smoking is the problem. Vapes, not so much.

Public health institutions have spent so many decades fighting smoking that they have come to view nicotine itself as the enemy. In retrospect, it's an easy mistake to make. If nicotine is what makes smoking appealing, then nicotine, critics reason, is the problem. Yet the relationship between nicotine and smoking-related disease is far more complicated than most people realize.

In 2015, Britain's Royal Society for Public Health, not exactly the poster boy for a live-and-let-live approach to medicine, described nicotine as "no more harmful to health than caffeine." That formulation may surprise many Americans, but it reflects an important reality. Nicotine is the addictive component of tobacco cigarettes, but it is not what causes lung cancer or emphysema. Those harms stem primarily from inhaling the products of combustion: tar, carbon monoxide, and thousands of toxic chemicals generated by burning tobacco.

Furthermore, a growing body of research suggests that nicotine may offer benefits that are rarely acknowledged in public discussion.

Nicotine as a Cognitive Tool

Millions of adults use nicotine for the same reason that millions consume caffeine every day: They believe it helps them think more clearly, concentrate more effectively, and cope more successfully with........

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