Substance is presented as a performance resource; WHO warns of advertisements aimed at young people and risk of addiction
Nicotine, historically associated with cigarettes and smoking, has returned to circulation among young people with a new promise: improving focus, productivity and mental performance. In formats such as sachets, electronic cigarettes and patches, the substance has been presented as a “modern” alternative, while experts warn of the risk of addiction and health impacts.
Small, discreet and sold in flavors such as sweets and fruits, nicotine sachets have advanced in several countries with a promise of clean consumption. Placed between the gums and the lip, they release nicotine through the mouth mucosa and usually contain flavorings, sweeteners and other additives. Authorities are already on alert.
On May 15th, the (World Health Organization) released a note on the global expansion of these products and the use of marketing strategies aimed at adolescents and young people. According to the WHO, retail sales exceeded 23 billion units in 2024, an increase of more than 50% compared to the previous year. The global market was estimated to be worth almost US$7 billion by 2025.
The concern is that products advance before control rules. Around 160 countries do not have specific regulations for nicotine sachets, 16 prohibit their sale and 32 regulate them in some way. For the WHO, the combination of discreet packaging, sweet flavors and a strong presence on social media reduces the perception of risk among young people.
The warning adds to a broader change in the way nicotine is being presented. In addition to traditional cigarettes and sachets, it appears in electronic cigarettes and heated tobacco products. It is also present in patches and gum used in replacement therapy to stop smoking, but which are sometimes used on social media to talk about focus, productivity, appetite control or mental performance.
It is important to know, however, that any product with nicotine can be addictive. It acts quickly in the brain: within a few seconds, it can bind to nicotinic and cholinergic receptors, triggering the release of dopamine, a neurotransmitter associated with the brain reward system. By increasing and maintaining the concentration of dopamine, the substance produces a sensation of pleasure, relief or well-being that the brain begins to seek again.
Dependence does not just appear as a desire to consume the substance, it starts to shape the routine: the person can avoid situations in which they are unable to smoke or use the product, become anxious in environments where consumption is prohibited or organize the day around the next dose. “We understand smoking today as a disease, not simply as a lifestyle habit”says psychiatrist Joana Rodrigues Marczyk, from the Chemical Dependent Women’s Program, from (Institute of Psychiatry of the University of São Paulo).
THE PERFORMANCE PROMISE
The idea of using nicotine for focus or productivity comes from a known effect of the substance. A meta-analysis published in 2010 in the journal Psychopharmacology evaluated 41 double-blind, placebo-controlled studies carried out with healthy adult smokers and non-smokers.
The authors found acute positive effects of nicotine or smoking in some domains, such as fine motor skills, attention, short-term episodic memory, and working memory. The effects, however, were small to moderate. And the study itself relates these findings to the initiation of smoking and the maintenance of dependence, not to a recommendation to use the substance to improve performance.
Some of the research into possible therapeutic uses involves specific populations, such as people with mild cognitive impairment. In a pilot clinical trial published in the journal Neurology in 2012, nicotine patches used for 6 months improved measures of attention, memory, and processing speed in nonsmoking adults with this diagnosis. The authors themselves emphasize, however, that larger studies would be needed to assess the clinical importance of these effects.
Therefore, displacing nicotine in the field of focus and productivity is problematic. According to Marczyk, there may be a temporary sensation of improved concentration, but not a real and sustained improvement in performance. With repeated use, the effect can be reversed: withdrawal symptoms and the time spent consuming the substance start to harm the performance that was sought to improve.
Nicotine replacement therapy has another purpose. A review of the Cochrane published in 2018 concluded that gums, patches, lozenges, sprays and other licensed formats increase the chance of quitting smoking by 50% to 60% in people motivated to give up smoking. In this case, the benefit comes from treating addiction and reducing exposure to tobacco smoke, not from turning nicotine into a wellness or performance product.
The association between nicotine and productivity did not arise with sachets. Over the past century, cigarettes have been incorporated into work environments and military contexts as well as a resource to deal with fatigue, boredom and pressure. In the 1920s, tobacco advertisements already presented cigarettes as an ally of attention, emotional control and performance.
During the First World War (1914–1918), cigarettes were even distributed to soldiers in different armies. Later, smoke breaks became part of the factory routine because they were brief, predictable and compatible with the production line.
For pulmonologist Luiza Helena Degani Costa, professor of Pulmonology and Internal Medicine in the Medicine course at Einstein Teaching, the new products show an attempt to maintain nicotine consumption in different formats. “The tobacco industry is no longer just a tobacco industry, it is a nicotine industry. And it wants to sell nicotine in any of its forms”assesses the doctor at Einstein Hospital Israelita.
RISK WITHOUT SMOKE
The effects of nicotine are not restricted to the brain: the substance also has cardiovascular action. As it is a stimulant, it can increase heart rate, raise blood pressure and promote symptoms such as palpitations and chest pain. In some cases, use may be associated with arrhythmias and increased cardiovascular risk, including heart attack.
The problem increases when nicotine is consumed through inhalation, as occurs with conventional cigarettes, hookah and electronic cigarettes. In these cases, the person does not just inhale nicotine, but a mixture of substances that can affect the respiratory system. You vapes are no longer harmless. “When the liquid in an electronic cigarette is heated, chemical substances react with each other and can form new compounds”reports the pulmonologist.
These substances can cause acute effects, such as irritation to the eyes, nose and throat, as well as coughing, wheezing and bronchospasm. With repeated use, there is an association with conditions such as asthma, chronic bronchitis and COPD (chronic obstructive pulmonary disease).
Costa also cites the EVALUATEan acronym in English for lung injury associated with electronic cigarette use. The condition gained attention during an outbreak in the United States in 2019. By February 2020, the (US Centers for Disease Control and Prevention) had recorded 2,807 serious cases associated with the disease, including hospitalizations and deaths. Of the total, 68 deaths were confirmed.
A review published in 2025 in Scandinavian Journal of Public Health looked at evidence on e-cigarettes, heated tobacco products and nicotine sachets. The work concluded that electronic cigarettes are associated with a greater risk of asthma, respiratory symptoms, chronic bronchitis and COPD.
For cardiovascular diseases, type 2 diabetes, cancer and pregnancy outcomes, the authors found signs of risk, but still without sufficient long-term evidence to estimate the size of the effects.
In the case of sachets, the review highlights that there are few studies on long-term impacts. Therefore, the authors advocate large-scale, longitudinal research that considers dose, duration of use, product formulation and passive or prenatal exposure. They state that it is urgent to clarify the impacts of new nicotine and tobacco products on health, especially given the growth in consumption, to guide public policies and regulatory strategies.
CONSTANT BATTLE
The amount of nicotine these products can deliver is cause for concern. In the case of sachets, the WHO informs that some are sold at different potency levels, with declared amounts of the substance that can reach 150 mg. In electronic cigarettes, the dose can also be higher than the user imagines: some devices use nicotine salts, which allow for higher concentrations with less irritation.
The growth in use among teenagers and young adults raises another alert. The WHO states that nicotine is especially harmful to these groups because the brain is still developing. Exposure at this stage can affect this process, including functions linked to attention and learning, in addition to increasing the risk of dependence.
At the same time, the way nicotine products are presented can make consumption more acceptable. The cleaner, more technological and discreet appearance of the new devices and sachets helps to move them away from the image of the traditional cigarette, associated in recent decades with the harm caused by smoking.
“Risk perception is a defining factor for people when choosing whether to use it or not”observes Joana Marczyk. When the aesthetics of products reduce this perception, resistance to consumption also falls.
The tobacco control experience shows that public policies shape risk perception. In Brazil, measures such as smoke-free environments, advertising bans, restrictions on sales to people under 18, increased taxes and health warnings on packaging have helped reduce cigarette consumption in recent decades. Smoking prevalence has fallen from around 35% of the adult population in the 1980s to less than 10% in recent years.
Now, new products challenge this set of measures. “The tobacco industry constantly opposes these policies”says doctor Ana Natividade, researcher at the Center for Studies on Tobacco and Health at (Oswaldo Cruz Foundation). “With new nicotine products, despite scientific evidence pointing to several health risks, the industry promotes the idea that they are harmless or less harmful products”.
One of the most recent examples comes from the United Kingdom, where a law passed in April banned the sale of tobacco products to people born on or after January 1, 2009, and expanded the government’s powers to regulate vapes and other nicotine products, including rules on advertising, packaging, flavors and device features.
In Brazil, the commercialization, import and advertising of electronic smoking devices are prohibited by the and (National Health Surveillance Agency). The standard maintained the ban on products such as electronic cigarettes and heated tobacco devices and also provides for inspection and education actions. “Data from population surveys, such as Vigitel, indicate that this ban helped contain the spread of the use of these products in the country, keeping the prevalence lower than that observed in countries where commercialization is permitted”observes Natividade.
The challenge is that the existing rules do not end the dispute around nicotine, which from time to time is presented in new formats, such as sachets. “The industry reinvents itself by bringing a revamp of products that are neither regulated nor covered by the public policies that we have developed”analyzes the IPq psychiatrist.
This text was originally by Agência Einstein, on May 31, 2026, at 7:30 am. The content is free for republication, the source is cited, and has been adapted to the standard of Poder360.
