Nicotine

How? How Much? When? For how Long?

As with any drug, the correct dose for you depends on factors such as weight, gender, metabolism, whether you have taken the drug recently or not, amongst many others.

Read our section on dosing and tolerance in ME for more information.

How you take it matters...

There are various ways of consuming nicotine, some more harmful than others.^{7 8}

Smoking is both the most popular and the most addictive method of consuming nicotine; delivering nicotine to the brain within seconds.

• Tobacco cigarettes: Cigarettes are made from dried and processed tobacco leaves, with some additives. As a result of combustion, tobacco smoke contains many carcinogens which are the main culprit for premature death.
• Cigars and Pipes: Most smokers only partly inhale the smoke, drawing it into the mouth but not the lungs, making cigars and pipes slightly less harmful than traditional cigarettes.
• Hookah: Non-filtered smoke is generated from a water-based smoking device and is flavoured and sweetened. Regular hookah smoking confers the same tobacco-associated health risks.
• Electronic cigarettes (e-cigs/vapes, including brands such as iQOS and Juul): Electronic, combustion-free devices delivering vaporised liquid, containing different percentages of nicotine. Preliminary findings suggest they are much less harmful than cigarettes, but can be more addictive due to the pleasant flavours added.

Other ways:

• Snus: tobacco placed on the gum for nicotine absorption. Safer alternative to smoking as it causes no lung damage, involves almost no carcinogens, and doesn’t affect those around you (i.e. second-hand smoking).
• Chewing tobacco (e.g. gutkha): Thought to be more dangerous than snus, and strongly linked to causing oral cancer.
• Snuffing tobacco (snuff): involves powdered tobacco inhaled up the nose. Although it confers a lower overall harm than cigarettes, it’s still linked to an increased risk of cancer of the nose, mouth and throat.
• Dissolvable tobacco (e.g. sprays, lozenges, chewing gums, nicotine patches): mostly used during smoking cessation as ‘nicotine replacement therapies’

How much?

It’s difficult to talk about nicotine dosage because it’s very person-dependent. Using nicotine is legal and, in most cases, a sociable act. This means that you get a significant range in how often or heavily people use it. The average cigarette contains 10-14mg of nicotine but you only actually inhale about 1-2mg¹⁸. The best way to understand nicotine dosing is by looking at how much nicotine a doctor will prescribe for some trying to quit smoking. The BNF advises 2mg, whenever cravings arise, for someone who smokes less than 20 cigarettes a day and 4mg for someone who smokes more than 20. Take this into account when purchasing nicotine products to avoid a nicotine overdose.

When do the effects kick in?

Onset: when inhaled, nicotine reaches the brain within 10-20 seconds¹⁴.

Duration: Nicotine has a half-life of 1-2 hrs, and so the effects wear off after a few hours¹⁵.

Onset of craving/withdrawal symptoms: Cravings, as well as withdrawal symptoms, can set in as soon as the last dose of nicotine is cleared from the body. This is about 4 hours after the last cigarette.

How often can I take it?

New reports have shown that smoking even 1 cigarette a day confers a significant increased risk for cardiovascular diseases, stroke and lung cancer.^{11 12} Social smoking can also confer significant risk for the same conditions and is advised to be kept at a minimum.¹²