© Photo by Bertie
This past weekend was Family Weekend at the University of Virginia, where my son Ariel is a third-year student. Rachel and I took him and three of his friends to dinner, and the conversation turned to medicine.
One of them—a pre-med who reads my blog—asked if I’d write something about Zyn, the smokeless tobacco pouch you slip between your lip and gum. It’s everywhere now. Alongside vaping pens and old-fashioned cigarettes—which seem to have made a comeback if my observations and my kids’ reports are right—Zyn is part of a nicotine renaissance among young people.
Pharmacologically, nicotine is fascinating. It’s one of the few substances that acts as both stimulant and relaxant, which may explain its appeal.
Caffeine stimulates but makes you jittery; alcohol relaxes you but dulls. Nicotine does both—calms and activates—much like the settled alertness you feel after exercise. It’s an alluring neurochemical trick. Give the brain a taste and it wants more.
Medically, nicotine has long been vilified, but the real villains in cigarettes are the carcinogens and combustion products like tobacco-specific nitrosamines, tar, and carbon monoxide, not nicotine itself. Pure nicotine has few known long-term effects, especially in young, healthy users.
Still, nicotine isn’t harmless. It raises heart rate and blood pressure, disrupts blood vessels, and irritates the mouth. And there’s evidence that, while not a carcinogen itself, it may promote existing tumor growth.
Meanwhile, no proof of harm isn’t proof of safety. Zyn is new, and long-term studies don’t exist. As with vaping, flavorings and fillers may carry risks we’ll only learn about later. All you can honestly say from a medical perspective is that, like other nicotine delivery systems, it’s better than smoking but worse than nothing.
But the real danger isn’t toxicity—it’s addiction. Nicotine is among the most addictive substances known. It hijacks the brain’s mesolimbic dopaminergic reward system, the same circuitry that drives cravings for food, sex, and gambling, and yes, social media apps.
Over time, tolerance, dependence, and withdrawal set in. Tolerance means you need escalating doses to feel the full effect. Dependence means you need nicotine just to feel normal. And withdrawal means that without nicotine you feel like crap. At that point you’re hooked.
Mark Twain put it best: “Quitting smoking is easy. I’ve done it hundreds of times.”
And that’s the take-home point I want to leave with Ariel and his friends. Life is made up of habits, some good, some bad. They exist on a spectrum: at one end you control them; at the other they control you. Another way to put this is a useful rule of thumb: good habits are hard to maintain, while bad habits are hard to quit.
So what’s the deal with Zyn?
Bottom line: it’s just another vehicle for nicotine. Which means if you don’t already use it, then better not to start - because once you do you’ll likely find it awfully hard to stop.
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