Psychology says nicotine pouches and anxiety may be more closely connected than you think - Study raises concerns about how nicotine exposure may affect stress, mood and mental health, particularly among adolescents

Nicotine pouches are increasingly being promoted as a tobacco-free alternative to cigarettes, but their growing popularity is raising a different question: Could nicotine itself affect anxiety and mental health? According to Psychology Today, nicotine pouches may worsen anxiety and panic because nicotine directly stimulates the central nervous system. The outlet points to research suggesting that nicotine can trigger physical responses that resemble or intensify anxiety, including a faster heart rate and heightened alertness. The concern becomes even more significant for adolescents, whose brains are still developing. Recent research involving young people has also found an association between nicotine-product use and generalized anxiety symptoms. Together, these findings suggest that the psychological effects of nicotine deserve closer attention.

NICOTINE CAN PUT THE NERVOUS SYSTEM ON HIGH ALERT

Nicotine is a stimulant, meaning it does not simply produce a calming effect. According to a report in Psychology Today, nicotine activates the central nervous system (CNS)and can increase heart rate, blood pressure and alertness. It also affects several neurotransmitter systems involved in stress, mood and fear processing. The outlet cites a 2023 review by N Singh, A Wanjari and AH Sinha, published in Cureus, which examined nicotine's effects on the central nervous system and sleep. The review describes nicotine's effects on neurotransmitters including noradrenaline, acetylcholine, serotonin and glutamate - systems involved in arousal, stress responses and emotional processing. That helps explain why nicotine can feel stimulating rather than genuinely relaxing. A person may experience a brief sense of relief after using nicotine, but the underlying stimulant effect can produce sensations such as restlessness, increased alertness or a racing heart.


THE ANXIETY CONNECTION IS MORE COMPLICATED THAN IT LOOKS

One of the biggest misconceptions about nicotine is that it reliably reduces stress. In reality, dependence can create a cycle in which nicotine temporarily relieves withdrawal symptoms, making users feel calmer for a short period before cravings and withdrawal return. Psychology Today points to an earlier research by Scott Moylan, Felice Jacka, Jennifer Pasco and Michael Berk, whose 2012 systematic review examined cigarette smoking, nicotine dependence and anxiety disorders. The researchers found evidence of an association between smoking or nicotine dependence and anxiety disorders, although observational research cannot by itself establish that nicotine directly causes anxiety. This distinction matters with nicotine pouches. They do not contain tobacco leaf, but they still deliver nicotine. As a result, removing tobacco does not remove nicotine's effects on the brain and nervous system.

ADOLESCENTS MAY FACE A BIGGER CONCERN

The issue becomes especially important when nicotine exposure begins during adolescence. The teenage brain is undergoing major changes, including development of neural circuits involved in decision-making, reward, emotion and cognition. A 2024 study published in Neuropsychopharmacology by Tsun Hay Jason Ng, Mohammed H. Sarikahya, Roger Hudson and colleagues examined adolescent nicotine exposure in rats. The researchers reported long-lasting, sex-specific changes involving anxiety and depression related behaviors, neuronal activity and molecular changes that persisted into early adulthood. The study does not prove that nicotine pouches produce the same effects in human teenagers, but it adds biological evidence for concern about nicotine exposure during a sensitive stage of brain development.

Human evidence is also emerging. A 2026 preprint by Otto Ruokolainen, Noora Berg, Jenni Helenius, Hanna Ollila and Olli Kiviruusu analyzed data from 166,989 adolescents. Daily nicotine-pouch use was associated with higher odds of generalized anxiety compared with never using nicotine pouches. The association was stronger among girls than boys in the analysis. Because the study is observational and currently a preprint, the findings should be interpreted as an association rather than proof of causation.

GROWING USE HAS PROMPTED YOUTH WARNINGS

The rapid expansion of nicotine pouches has also caught the attention of public-health authorities. In May 2026, the World Health Organization (WHO) urged governments to strengthen safeguards around nicotine pouches, warning that some products contain high nicotine concentrations and that flavors, packaging and social-media marketing can appeal to younger audiences. The agency called for stronger controls, including limits on nicotine content and restrictions on advertising and flavors. At the same time, the picture is not entirely one-sided. Some health authorities consider nicotine pouches substantially less harmful than combustible tobacco because they do not involve cigarette smoke. The WHO report also noted that some researchers and governments see a potential role for pouches as a lower-risk alternative for adults who already smoke. That distinction is important. A product can be less harmful than cigarettes while still carrying meaningful risks - particularly for people who do not already use nicotine and for adolescents.

Nicotine pouches may look very different from cigarettes, but they still deliver an addictive stimulant that acts directly on the brain and nervous system. Emerging research is drawing attention to a possible relationship between nicotine use and anxiety, while laboratory studies suggest that nicotine exposure during adolescence can produce lasting changes in systems involved in mood and emotional behavior. Human studies, including recent research involving large groups of adolescents, have also found associations between nicotine-pouch use and anxiety symptoms. Still, scientists need more long-term research to determine exactly how much nicotine pouches contribute to anxiety and whether the relationship is causal. This is particularly important for teenagers, whose brains are still developing. As nicotine pouches become more visible and accessible, understanding their potential effects on stress, mood and mental health will become increasingly important.