Eating Disorders and Nicotine

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Reviewed by Kim Dennis, MD, CEDS (SYR) provides helpful information for people who are dealing with substance use issues — and their family members, friends, and co-workers, too. SYR knows that there is no one-size-fits-all solution to the challenges faced by those who misuse alcohol, prescription or illegal drugs, or other substances, and they aim to break through the clutter to help people at any stage of recovery.

Today, fewer Americans smoke cigarettes than in years past. However, a growing number of people mistakenly think it’s safe to vape, smoke cigars, or chew tobacco instead.1,2,3 All of these contain nicotine, a highly addictive and potentially dangerous stimulant. And people who vape are at greater risk of developing an eating disorder.4

If you or a loved one is experiencing disordered eating and using nicotine, know that help is available and treatment works.

What is Nicotine?

Nicotine is a highly addictive chemical that comes from the tobacco plant. It’s the reason people become dependent on harmful tobacco products like cigarettes, cigars, smokeless tobacco, and electronic cigarettes. Intake of nicotine rapidly floods the brain’s reward system, causing euphoria and relieving stress.4

These effects wear off quickly, and the brain requires more nicotine to maintain these feelings and stave off cravings.5 These effects make it very hard to stop using tobacco products without help.5,6

Nicotine can raise blood pressure and harm health in various ways.7 The main danger of using nicotine is that it can lead to dependence on tobacco products that contain hazardous chemicals. These chemicals can cause cancer, heart and lung disease, and other serious health problems.8,9,10

Commonly used tobacco products include:

  • Cigarettes, cigars, and cigarillos.11,12
  • E-cigarettes and other vaping devices.
  • Hookah and other flavored tobacco.
  • Smokeless tobacco such as chew, snuff, and dissolvable tobacco.13

Stopping use of tobacco products benefits your health. Nicotine dependence can be treated with a combination of nicotine-replacement medication, nicotine cessation medications, behavioral therapies, and self-help tools.14

What’s in an E-Cigarette?

Electronic cigarettes — also known as vapes, vape pens, e-cigs, tanks, or mods — contain a liquid mixture of nicotine and other chemicals and flavorings. The e-cigarette heats up this liquid, dissolving it into an aerosol, which is inhaled.

E-cigarettes that deliver nicotine are considered tobacco products and are not safe, especially for youths, young adults, and pregnant people. Breathing e-cigarette aerosol repeatedly exposes your body to nicotine and other harmful and potentially carcinogenic substances, such as fine particles, heavy metals, and organic compounds.15,16

Link Between Eating Disorders and Nicotine Use

Both eating disorders and regular use of nicotine products can be serious and lead to early death. Nicotine use may lead to disordered eating, and disordered eating may also lead to nicotine use.4

Because nicotine can suppress appetite, people sometimes use tobacco products to suppress their weight.17 This may be one of the reasons why rates of cigarette smoking are higher among people with eating disorders.4

People with an eating disorder are significantly more likely than the general population to have a substance use disorder, and vice versa. Eating and substance use disorders share common risk factors, such as:18,19,20,21

  • Anxiety
  • Depression.
  • Family history of these or other mental illnesses.
  • Low self-esteem or a susceptibility to social pressures.
  • Traumatic and adverse life experiences, including racialized trauma and weight stigma.
  • Genetic predispositions.

Get Help with Quitting

If you smoke or vape, chances are you want to quit.22,23 The good news is you don’t have to go “cold turkey.”24,25 To get help with quitting: 

Find Treatment and Start Your Recovery

Recovery from eating disorders and nicotine dependence is a personal journey, and there’s no single solution that works for everyone.26

Start by finding a trained health care professional to assess your mental and physical health needs. They can work with you to create a recovery plan.27 Find treatment and support near you for eating disorders and substance misuse

Learn More


[1] Centers for Disease Control and Prevention (U.S.) (2016). MMWR. Morbidity and Mortality Weekly Report, Vol. 65, no. 48, December 9, 2016. 65(48). Available at:

[2] Truth Initiative. (2022). Cigars: Facts, stats and regulations. Available at:

[3] Sherburne, M. (2021). Teen use of illicit drugs decreased in 2021, as the COVID-19 pandemic continued. The Regents of the University of Michigan. Available at:

[4] Ganson, K. T., & Nagata, J. M. (2021). Associations between vaping and eating disorder diagnosis and risk among college students. Eating behaviors, 43, 101566.

[5] NIDA. (2021). Is nicotine addictive?.

[6] Widysanto, A., Combest F.E., & Dhakal, A. (2023). Nicotine Addiction In: StatPearls. Treasure Island (FL): StatPearls Publishing.

[7] Mishra, A., Chaturvedi, P., Datta, S., Sinukumar, S., Joshi, P., & Garg, A. (2015). Harmful effects of nicotine. Indian journal of medical and paediatric oncology: official journal of Indian Society of Medical & Paediatric Oncology, 36(1), 24–31.

[8] U.S. Food & Drug Administration. (n.d.). Why are tobacco products so hard to quit? (Nicotine Fact Sheet). 

[9] Blaha, M. J. (2022, January 20). 5 vaping facts you need to know. Johns Hopkins Medicine. 

[10] American Lung Association. (2023). Health Risks of E-Cigarettes and Vaping.  

[11] National Institute on Drug Abuse (NIDA). (2021). What are the physical health consequences of tobacco use? National Institutes of Health. 

[12] Centers for Disease Control and Prevention. (2023). Smoking and tobacco use, Cigars. CDC. 

[13] Centers for Disease Control and Prevention. (2020). Smokeless Tobacco: Health Effects. CDC.

[14] National Institute on Drug Abuse. (2021). Tobacco, nicotine, and e-cigarettes research report: What are treatments for tobacco dependence? National Institutes of Health. 

[15] Centers for Disease Control and Prevention. (2023). About electronic cigarettes (e-cigarettes). CDC. 

[16] Office of the U.S Surgeon General, U.S. Centers for Disease Control and Prevention, &  Office on Smoking and Health. (n.d.). Know the risks: E-cigarettes & young people: U.S. surgeon general’s report.  U.S. Department of Health and Human Services. 

[17] Bloom, E. L., Farris, S. G., DiBello, A. M., & Abrantes, A. M. (2019). Smoking-related weight and appetite concerns and use of electronic cigarettes among daily cigarette smokers. Psychology, health & medicine, 24(2), 221–228.

[18] National Center on Addiction and Substance Abuse at Columbia University. (2003). Food for thought: Substance abuse and eating disorders. Commonwealth Fund & National Institute on Drug Abuse.  

[19] Eskander, N., Chakrapani, S., & Ghani, M. R. (2020). The Risk of Substance Use Among Adolescents and Adults With Eating Disorders. Cureus, 12(9), e10309. 

[20] Ressler, A. (2008). Insatiable Hungers: Eating Disorders and Substance Abuse. Social Work Today, (8) 4, 30. Available at: 

[21] Munn-Chernoff, M. A., Grant, J. D., Agrawal, A., Sartor, C. E., Werner, K. B., Bucholz, K. K., Madden, P. A., Heath, A. C., & Duncan, A. E. (2015). Genetic overlap between alcohol use disorder and bulimic behaviors in European American and African American women. Drug and alcohol dependence, 153, 335–340.  

[22] Centers for Disease Control and Prevention. (2023). Smoking cessation-the role of healthcare professionals and Health Systems.

[23] Truth Initiative. (2022). More than half of young people consider quitting vaping in 2022, New Survey finds. 

[24]  Truth Initiative. (2022). What you need to know to quit smoking.

[25]  Truth Initiative. (2022). Read this before trying to quit smoking “Cold turkey.” 

[26] Bahji, A., Mazhar, M. N., Hudson, C. C., Nadkarni, P., MacNeil, B. A., & Hawken, E. (2019). Prevalence of substance use disorder comorbidity among individuals with eating disorders: A systematic review and meta-analysis. Psychiatry research, 273, 58–66.

[27] Substance Abuse and Mental Health Services Administration. (2011). Clients With Substance Use and Eating Disorders. SAMHSA Advisory, (10) 1. Available at: