The Surprising Link Between Nicotine and Peripheral Neuropathy

We all have our favorite vices, things we do despite warnings that they might not be good for our health. It could be overeating, sugar cravings, fried foods, too much red meat, marijuana, cigarettes, vaping, mainlining caffeine, working out too much, or living a sedentary lifestyle. Even though we know it may not be the best thing for us, we may grow weary of outside advice from friends, family, and our doctor.

But, if you suffer from peripheral neuropathy, then it is important to understand if and how your vice could be affecting your condition so you can make an informed decision for your long-term health.

Peripheral Neuropathy

Your body relies on a vast network of nerves to function. They transmit information to the brain so the brain can decide how best to protect us. For example, if you step on a nail, the second your foot registers pain, you jerk your foot back, so you suffer as little trauma as possible. It wasn’t a conscious thought. It would take too long for you to register pain, discover its source, make a plan, and act. Your subconscious mind acts independently of thought.

Peripheral nerves lead away from the spinal column to your vital organs, muscles, bones, and skin. They start large as they leave the spinal column and branch into smaller and smaller nerves toward the extremities. These small nerves are more susceptible to change and are often the first to alert us to the damage that is occurring within the body. Damage to the peripheral nerves is called peripheral neuropathy.


Nicotine is a naturally occurring chemical in plants from the nightshade family, such as tomatoes and eggplants. It’s a stimulant found in higher concentrations in tobacco plants than in other nightshade family members. Manufacturers use tobacco to make cigarettes, cigars, pipe tobacco, snuff, chew, and e-cigarettes. It’s also used in products to reduce cravings for people trying to quit tobacco use.

Nicotine triggers the body to produce neurotransmitters such as dopamine, serotonin, and acetylcholine. All of these chemicals are naturally occurring and help your body function. However, dopamine and serotonin can change your mood, relieve pain, and help you feel pleasure, which is why nicotine is so addictive. Acetylcholine, on the other hand, causes your heart rate to increase, causes hypertension, and constricts blood vessels.

Nicotine and Peripheral Neuropathy

While we would encourage every person to steer clear of addictive substances, it is the vascular effects of nicotine that are the leading cause of concern for people with peripheral neuropathy. Vasoconstriction or the narrowing of blood vessels can be especially damaging to peripheral nerves that are already failing.

Every nerve needs four things to thrive:

  1. Free range of motion to prevent nerve damage
  2. Adequate oxygen to ensure healthy cell function
  3. Adequate nutrition to provide the building blocks for cell regeneration
  4. Adequate blood flow to circulate oxygen and nutrients to the nerve cells and carry away waste products created through normal body functions

If the blood vessels constrict, it limits blood flow, nutrient availability, and oxygenation to the nerves. You’ll first see the change in the smallest and most distant nerves from the spinal column, meaning your hands and feet. You may notice tingling, burning, pressure, stabbing pain, or numbness in your extremities. People with neuropathy often can’t sleep, the nerve pain is so intense.

Neuropathy Reversal

It is possible to reverse nerve damage if you eliminate the underlying cause. Your outcome will depend on how long you experienced symptoms before seeking neuropathy treatment and what therapies you use. Ignoring neuropathy can lead to permanent damage and worsening symptoms over time.

If your provider determines that the underlying cause is nicotine use or that nicotine is a contributing factor to your condition, you will need to weigh your discomfort from neuropathy and the possibility of worsening symptoms over time against the pleasure you get from smoking.

Final Thoughts

Life is a balancing act. We constantly face situations where we must weigh the cost and benefit of our choices. If you do decide to quit using tobacco, we applaud you. Talk to your provider about the severity of your symptoms and if nicotine replacement therapy is right for you. If you have advanced symptoms, there are non-nicotine medications that can help with cravings while you make the transition to living a nicotine-free lifestyle.


The information, including but not limited to, texts, graphics, images, and other material contained in this article are for informational purposes only. None of the material mentioned is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new care regimen. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

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