Smoking Versus Vaping Versus Nicotine Pouches Explained WITHOUT Bias - Episode 329

I break down what the newest research says about cigarettes, vaping, and nicotine pouches, and why the “glamour” narrative is never the same thing as health. I also connect nicotine to addiction science, menopause and HRV, and the deeper emotional reasons people reach for a chemical pause button.  

Beware of those posts from wellness "influencers" telling you to use their discount code for the miracle nicotine gum "nootropic" for your brain...you need all the facts before you decide if it's right for you.

• 90s nostalgia and media trends that glamorize smoking again  
• the hard science on cigarette combustion, toxins, and long-term risk  
• what 2026 studies suggest about vaping and cardiovascular harm  
• where the vaping and cancer evidence is early, mixed, and still concerning  
• nicotine pouches as “clean” marketing versus heart and oral health realities  
• why nicotine can feel like focus while strengthening dependence  
• quit-rate data and why repeated attempts are normal, not weakness  
• menopause, estrogen, HRV, and nicotine as a fight-or-flight drug  
• the “thing under the thing” and what we are trying not to feel - you know I will always bring a little bit of soul into every podcast episode.

I am one of the rare independent podcasts left...please do your part to help support me to keep going 6+ years and I know how much my integrity has helped the wellness space.  Share this with a friend so that they can get the details on what we know right now. Rate my podcast and leave a review. Don't forget to hit subscribe wherever you are listening or watching.  

Transcript

Welcome And Why This Matters

Sandy Kruse 0:02

Hi everyone, it's me, Sandy Kruse. Welcome to Sandy K Nutrition Health and Lifestyle Queen. For many years now, I've been a trusted voice for people in midlife and beyond who want a deeper, more honest conversation about wellness. One that includes the physical, the emotional, the mental, and the esoteric. Most episodes are solo now because I want to bring you thoughtful research, lived experience, and grounded insight without noise or bias. And when I do bring on a guest, it's because their work genuinely adds something meaningful to the conversation. Here we explore the full spectrum of what it means to be well, how the body functions, how the mind heals, how the spirit expands, and how all of these layers shape life lived with clarity and joy. Thanks for being here. And if this show resonates with you, please follow rate, review, and share it. It truly helps the message reach more people. Hi

Why Smoking Looks Glamorous Again

Sandy Kruse 1:32

everyone, welcome to Sandy K Nutrition Health and Lifestyle Queen. Today I'm going to break down the newest research that we have. Remember, we can't have all the research on this yet, but comparing smoking to vaping to nicotine gum to those pouches that you put in your mouth. I actually did a deep dive on this because most of you have probably noticed that since this series love story, the JFK uh Carolyn Bassett series, it's almost like we're trying to make smoking look beautiful again. And I'm seeing all kinds of memes, I'm sure you guys are too, of people, you know, what would be the last thing you'd be doing if you were going down in the Titanic and it's like a person almost drowning in water smoking a cigarette. I mean, I love it because it's funny. But I really wanted to get down into what does the research say about the safety of these things? Okay. So most of you have seen Love Story, probably who's watching this. I think it was one of the most watched limited series of FX's history. I think over 65 million hours streamed. And it is wall-to-wall cigarettes. And Carolyn Bissett in the slip dress, lighting her smoke, flicking her hair. I mean, this is the whole 1990s world, right? Lit, gorgeous, effortless, classy, right? And it's not just the show. According to a fashion data account called Style Analytics, searches for smoking pose. Okay, quote unquote, smoking pose on Pinterest jumped 75% in a single year among women aged 18 to 24. That's an entire aesthetic revival. In the 90s, it was all about like the rebel and you know being cool and all of that. And then the cigarette is right at the center of it. It's being sold to us again as glamour. Now, I smoked for 20 years at least. I was about 18 when I started smoking regularly, when my parents allowed me to smoke around. I think I even smoked in the house back then. So 18, that would have been 1988. And I will say uh, you know, this is this is my past aesthetic. So I'm when I'm coming to you about this podcast, it's not about me jumping on a soapbox. I actually lived in it. Okay, so today is what the actual research says. And I'm talking about named research and new stuff, 2026 peer-reviewed stuff about smoking versus vaping versus nicotine pouches. Everybody's got them, you know, under their lip right now. And then there's some brand new studies on vaping that genuinely rattled me. And then the part I most want to get to, which is always something that I always touch on, is why do we reach for these things in the first place? I'm gonna tell you a little story before I get into all the research. I was at the corner store and there were these young guys buying, because now here in Ontario, you can buy alcohol at the corner store, as well as those pouches, as well as cigarettes. And the funny thing is, they have big signs about vapes and the pricing, but the cigarettes are hidden behind this metal, whatever I don't even know what you call it. It's like they're hidden, you can't even see the packs, but they're advertising vapes. It's just so interesting. And then these young guys were buying their booze, and the one guy very politely says to me, Is it okay if I go ahead? And he puts down his little nicotine pouches. And I'm like, Oh, interesting. I go, Well, I guess you got to get your drink and your nicotine on, right? For the night. It was like a Friday night. He starts laughing. He and I go, Well, you know, I used to smoke long ago. He goes, Smoking is way cooler than vaping. And it was funny because this came from a 20-year-old. Before I actually get started, I just want to make sure everybody who listens realizes I'm not coming from a place of judgment. And this isn't any kind of medical advice. I had a lighter in my bag for like over 20 years. So everything I talk about today is really also the version of me who couldn't put cigarettes down for a very long time. So I'm coming to you without medical advice, without any of that, just really from compassion, because I always believe that information is power and shame is not. So, and I'm gonna tell you why I quit too. So I'm gonna name what's really like going on because this is at random. Culture runs on about a 20-year nostalgia cycle. So we romanticize the era of our youth, our clothes, the music, the symbols. I do that all the time. And right now, the machine has landed on the late 90s, and that's my era. I was in my 20s in the 90s, and back then the cigarette was everywhere, so it's kind of come back stitched into aesthetic now. But here's the trick inside the nostalgia: a show like Love Story shows you the slip dress, the cigarette, and the beautiful, doomed romance. What no aesthetic can show you is the part that comes 30 years later. The lung scans, the heart data, the people who are my age paying the bill for how cool it looked in 1996. So the aesthetic has changed, the biology did not. So let's actually look at the biology with some research behind

What Cigarettes Do To The Body

Sandy Kruse 8:18

it. So smoking is really the one thing that there is no scientific debate. And I say this actually to my kids a lot of the time. I'm like, back when I smoked, there was no research really. Like people were smoking everywhere, and the research was light. Okay. They would say, Oh, it's not good for you. But there was no real definitive health scare. It's not like the packs now with the you know the face of the tongue hanging out that has cancer all over it, like just really horrid um visuals, right? So let's start with the real cigarettes because that's what's being glamorized. When you burn tobacco, you're not just getting the nicotine. Now remember, this is a multi-pronged uh toxin. There's a lot wrapped into this little smoke. You're actually getting combustion. Although I think you're getting this from vaping because it heats up. Anyway, that's a whole other thing. A single cigarette causes more than 7,000 chemicals, and roughly 69 of them are known to cause cancer. So this is CDC and U.S. Surgeon General data. It's just not just a talking point. Smoking is tied to about one in five deaths in the United States. 50 plus years of airtight evidence. Okay. I'm 56. I don't remember hearing all this evidence. They would just make, you know, uh comments about how dangerous it was, but I don't remember the definitive side. So what I will say is that of all of these that I'm talking about, vaping, smoking, the pouches, definitely we know definitively that it is the most lethal of the three. And I'm gonna be honest about my own body. 20 years of smoking is not nothing. I'm gonna say that there's always going to be a little piece of your health journey that's tied to what you did in the past. How soon you quit, what you do after also matters. And, you know, I can't imagine, I can't imagine smoking and dealing with that now. So, yes, I guess if I was going down on the Titanic, I'd grab a butt and have that smoke if I knew I was going down, but I certainly wouldn't want it now. Now,

New Vaping Research On Heart Risk

Sandy Kruse 10:48

vaping, let's get into vaping. The harmless story is falling apart. So, this is where I have to update what a lot of us were told because the 2026 research is not landing in vaping's favor. For years, the pitch was 95% safer. Basically, it's water vapor. And because there's no combustion, which no tar, okay. There's no tar, no carbon monoxide. I think there is though. Like there's just so much that really sensible, like when you really analyze it, I think that there's so much more to this. But there is a difference from cigarettes, and I won't pretend otherwise, but no smoke was never no harm. And now these products have been around long enough to study people over years. The picture is darkening. Let me give you a few of the actual studies. The heart. We're talking about the heart. This is really new research, you guys. In February 2026, the journal Heart and Lung published a systemic review pooling seven different studies and 522 participants. Okay, not that many, but it found e-cigarettes consistently raised both numbers of your blood pressure, along with a higher heart rate, endothelial dysfunction, oxidative stress, and arterial stiffness. The author's conclusion is the part that stopped me. They wrote that the cardiovascular risks of e-cigarettes may be comparable to or even greater than traditional cigarettes. Pause. Go look up that that research, okay? February 2026, Heart and Lung. Journal of Heart and Lung. That same month, a study in the American Journal of Physiology, Heart and Circulatory Physiology analyzed over 6,000 people in the U.S. National NHANES study survey. People who smoked or vaped had about 46% higher odds of hypertension, so high blood pressure. That study, although I will say it lumped smokers and vapors together. So there's a limitation there. And the exclusive vaping group was small, which I noted. Okay. And it also didn't point out or measure past smoking history. So take the vaping specific piece of it as directional. But the direction is consistent across everything that we're seeing. I mean, how many times have you heard the terms popcorn lung, collapsed lung, all of this from vaping in our youth? And then this is how fast this is moving. Just days ago, I'm recording this on July 2nd. This was on June 29th, 2026. The American Heart Association issued a formal scientific statement in its journal called Circulation, saying the growing evidence now points to real cardiovascular harm from the chemicals in e-cigarettes. When the AHA writes it down formally, the harmless vapor error is over. We knew this, guys. We knew this. We knew that it can't be that harmless. Now let's let's get into the cancer question.

Vaping And Early Cancer Red Flags

Sandy Kruse 14:53

This is early, so I'm gonna you know hold it as you know, early because the evidence is genuinely mixed, but it's a started, it has started. So I always say where there's smoke, there's fire, right? And depending on how big that fire is, you know, we got to do a little more research, but also add into it common sense. There's a 2021 study in the journal Genes, a small pilot, only a few subjects. So you got to hold this loosely, where researchers had people just take 20 puffs on their own vape, and then they looked at their cells. 20 puffs was enough to significantly change the activity of TP53. This is a tumor suppressor gene, one of the body's core anti-cancer genes in the cells of their mouths, and to turn down a DNA repair gene in their and so this turns down a DNA repair gene in their blood. Lab studies back this direction. A 2017 paper uh in PLOS one found e-cigarette aerosol called call, sorry, caused measurable DNA damage in human mouth and lung cells. And a 2023 study showed e-liquid aerosols could push human lung cells toward a pre-cancerous state. I'll give you the other side too. A scientific reports paper this past April found that in one particular lung cell line, cigarette smoke did the damage, but the e-cigarette vapor didn't. So this isn't exactly settled. But the early cellular red flags are exactly the ones you don't want to see, and why the honest scientists are no longer calling this harmless. So there's two this is why I always say we can't prove everything with science, because nobody can look and analyze everybody to exactly their human genealogy. You can't. We are not robots, so there's always going to be differences, and you hear about this all the time. You hear about people who smoked until the day they died, and they were fine until they died at like 85. You see, and you can't so you can't put everyone in a box. However, clearly there's evidence here that's going on. So this is one that I can't soften, and it's the addiction part. In November 2025, JAMA Network published a study out of USC led by Dr. Abby Masonbrink that tracked over 115,000 kids through the Monitoring the Future survey. Among teens who vape, daily use nearly doubled from 15% in 2020 to 29% in 2024. And of the daily users who tried to quit failed attempts, jumped from 28% to 53%. In rural areas, daily vaping went from 16 to 40 percent. The researchers use the word hardening, meaning the kids still vaping are severely treatment-resistant addicted. That easy little pocket device turned out to be one of the hardest nicotine habits anyone's ever tried to break. So here's my honest line on vaping, and I'll say it plainly so no one can twist it. The science does not say vaping is worse than smoking. Cigarettes still win the harm contest, and some researchers now worry people overestimate vaping and then go back to cigarettes, which might be worse. But the story we were sold harmless, clean, water vapor, basically nothing. That story is clearly coming apart in all the peer-reviewed literature in real time.

Nicotine Pouches And The Clean Myth

Sandy Kruse 19:52

Now, let's break down nicotine, just nicotine in and of itself. This is like the big new one, right? Zin, I don't even know what these are. Velo, velo, sachets that you put under your lip, marketed as clean, discreet, tobacco-free. It's a grown-up choice. Fair points first. No smoke, no tar, bypasses your lungs entirely. On the lung question, though, pouches are mostly out of it. Okay, mostly, mostly. But follow the nicotine. In December 2025, the European Stud Society of Cardiology published its first ever consensus report. So looking at every nicotine product together, cigarettes, vapes, pouches, all of it, their conclusion in twelve evidence-based messages was blunt. Nicotine on its own, stripped of all the smoke and the tar, still damages your heart and blood vessels, raises blood pressure, injures the vessel lining. Their line was essentially that no product delivering nicotine is safe for the heart. That report dismantles this whole clean nicotine fantasy because the entire pitch depends on one move. Separate the nicotine from the smoke, and the nicotine looks like it's innocent. The heart doctors just said it is not. So pouches also carry their own local signature. The oral health case reports, including ones that are published by BMC Oral Health in 2025, describe gum recession and white leathery lesions right where the pouch sits. One, a 22-year-old who uses pouches daily for 11 months had recession and a precancerous-looking white patch exactly at the placement site. The reassuring part was those lesions can often fade when people stop. The honest part, this category barely existed before 2019. So nobody really knows the long game of this yet. So I have to hit on one of the biohacker angles because this is where nicotine got its wellness makeover sold as a nootropic, a focus tool. So here's what the people who are talking to you about it, like it's not a lie. A landmark meta-analysis published in psychopharmacology pulled 41 placebo-controlled studies and found that nicotine produces genuine, measurable improvements in attention, memory, fine motor speed. That's real. And that's probably why all the biohackers are using this. They use it in gum. I'm sure you've seen some of these big biohackers talk about it and then offer you a discount code at the end, right? Right? You know what I'm talking about. But follow this research through. That a little cognitive boost is one of the very things that makes nicotine so hard to quit. The thing that feels like that focus is the hook. You're not buying a nootropic, you're signing a subscription where the rent goes up every month, independence. And now we know

Why Nicotine Hooks So Hard

Sandy Kruse 24:20

also in your cardiovascular system. So now I have to talk and a little bit about the addiction part itself because I lived it. And for a long time, I carried it almost like you know, I'm weak. I lacked willpower. So I'm gonna give you the data that nobody gave me when I quit back in uh it would have been 2008, because it's now uh 2026. Yes, 18 years. The 1988 U.S. Surgeon Journal's uh report placed nicotine in the same category as heroin and cocaine for its grip on the brain. The National Institute on Drug Abuse still says it plainly. Nicotine is as addictive as heroin. Many of us have heard that. I'll be straight with you. Science do argue about that exact comparison, whether it's literally as addictive as heroin is um genuinely debated in the research. But here's what nobody else can debate: the quit data. And the quick data is brutal. Start with the speed. Inhaled nicotine reaches your brain in about 10 to 20 seconds, faster than a drug injected straight into your vein. Every single puff fires a little hit of dopamine into your reward system 10 seconds after you draw. That's hundreds of tiny reinforcements a day, each one carving the habit deeper. Your brain physically rewires itself to expect it. Then the quitting. The CDC's 2022 national data is almost hard. It's it's it's hard to say this out loud. Of the nearly 29 million American adults who smoke, about 68% want to quit, and more than half, 53% actually try in a given year. And how many succeed? Wait for it. Under 9%, fewer than one in 10 in a year, when half where half of them tried. And almost nobody does it on the first try or the fifth. A 2016 study in BMJ Open. One of the most cited numbers in the whole field estimated the average smoker may need 30 or more serious attempts before it finally sticks. 30 cold turkey on your own succeeds only about six to eight percent of the time. And even with the patch, the medication, the counseling, all of which triple your odds, the combined success rate still lands near 30%. That's a 70% failure rate when you're doing everything right. So I think when I quit, I quit with my pregnancies, which was easy because just the smell itself made me actually throw up. So I was lucky. And then after my second was three years old, I finally quit and I did it with the patch. I know some people did it using vape, and then they completely cut everything out. Smoking rates run between 80 and 95 percent. An addiction specialist will tell you nicotine is often the last substance their patients are able to give up. It outlasts the heroin, it outlasts the cocaine. So if you tried to quit and it broke you, I need you to actually hear this. That was not weakness, that was pharmacology. You are fighting one of the most tenacious dependencies known to medicine in a brain that got rewired in 10-second increments thousands of times over. The average person needs 30 tries. If you're still trying, you are not failing. You're doing exactly what quitting actually looks like. And that's why I am laying all this out in an episode about all of it, the pouches, the vapes, all of it. Because it's the same molecule. So the kids in that JAMA study who can't stop vaping, the grown women reaching for a clean little pouch, they're not handling something gentler. They are feeding the exact same 10-second dopamine look loop that took me 20 years and everything I had to break. Now,

Menopause, Estrogen, And Nervous System Strain

Sandy Kruse 29:43

I always have to tie in the soul, and this is the piece that I've not heard one person in this whole conversation talk about. And it's specifically for the woman my age, and actually for men too, because men have some nervous system challenges around midlife and over 50. Because almost everyone covering nicotine right now is a man, too. I'm gonna kind of talk about it from a female perspective. So even these big biohackers who are saying, Yeah, use this gum. It's a nootropic, it's gonna improve your brain. And they're speaking to the general public, and people look to them and him as you know, somebody to listen to. And even if you're a 50-year-old woman, you think, oh wow, he knows more than me. He has over a million followers. I'm speaking to you. Okay. Fact number one estrogen claims, sorry, calms your nervous system. This isn't wellness speak, it's cardiology. Estrogen has what the literature calls a vagotonic. Okay, that sympathetic effect. It strengthens the rest and digest and dampens the fight or flight. There's a measure for this heart rate variability, HRV. We've heard of this. This is your resilience score, how well your body shifts, gears, and it recovers. The clearest proof is a classic study in women who had their ovaries removed. Surgical menopause caused an immediate drop in vagal tone and a shift to sympathetic overdrive, overdrive. And three months of estrogen replacement brought it back to baseline. Estrogen was doing the studying. Steadying, right? It's steadying it. Fact number two, natural menopause does the same thing slower. Cross-sectional studies comparing pre- and post-menopausal women consistently show the post-menopausal group has lower HRV. Okay, lower high frequency power and a shift towards sympathetic dominance. Okay. And the women with the worst menopausal symptoms have the lowest HRV. One study found HRV tracked with the intensity of hot flashes. So this isn't abstract. It's the 3 a.m. palpitations, the hot flashes, the wired but exhausted, the shorter fuse. That's your nervous system using estrogen. Sorry, losing the estrogen used that used to study it before. Now the collision. What is nicotine mechanically? It is a fight or flight drug. The pharmacology is well documented. Nicotine binds receptors on your sympathetic nerve endings and adrenal glands and triggers a dump of adrenaline and noradrenaline. It activates your HPA axis and it raises cortisol. And measured directly, it lowers HRV. A December 2025 review in the tobacco and heart literature laid out exactly this. Nicotine shifts you towards sympathetic dominance and drops your HRV, which is the same direction that menopause is already pushing us in. So picture a woman reaching for a calming pouch. Okay, her nervous system has already lost its estrogen buffer, and she just handed it a drug whose entire job is to turn the fight or flight dial up further. Same needle, push twice, same direction. That cigarette that looks like glamour on a 25-year-old, on a 56-year-old nervous system that's already lost its buffer, it's gas on a fire that's already lit. I will say this: this is just using my common sense and breaking down some of the things that you'll hear these big influencers talk about that they say, oh, it's so great for the brain. But because there aren't any massive studies of menopausal women using these nicotine pouches or these gums and measuring their HRV, that specific research doesn't exist yet. However, I'm giving you research that does and using logic in my brain on why this would not be a good idea for the nervous system of a woman in menopause.

What We Are Trying Not To Feel

Sandy Kruse 34:54

Let's get into what are you actually trying not to feel by using these substances? This is the real thing, this is the thing under the thing. Here's what 20 years of my own my own smoking taught me, and it took me a long time to see it. I wasn't, I'm not gonna say that I didn't love cigarettes, I loved smoking, and people have seen like I mean, I have some classic photos of me, even on my wedding day in 2000, running into the limousine with a beer and a smoke hiding on my wedding day in my wedding dress. And the reason is is because I loved it and I was addicted to it, but at the same time, I was ashamed of it. Okay, I was smoking too because it gave me somewhere to put whatever the feeling was that I was feeling, whether it was the stress, like on my wedding day, I was nervous, the grief, the overwhelm. I didn't have a language for yet. That cigarette was a pause button on my own emotions, a way not to feel it for four or five minutes, and then get back to performing, and everything's fine. And often this is what it is all about the pouch, the vape, the cigarette, the the biohack that promises to make you feel sharper and calmer and fine. A lot of it, but not all, but a lot, is just a deflection, a packaged way to not feel what we actually need to feel, especially in midlife. It's kind of the time that we stop pretending. It's like we're getting ready for the second act. How do we want to be in that second act? Especially in midlife. There's a lot of numbing that goes on in the world. And listen, I've even heard this, and this this may be a little controversial. Believe it or not, there's some guy who, and I'm not gonna name names, who's going on saying how the World Cup is just a way to not feel and not see what's actually going on in the world right now. And I'm one of those people that's always about balance. I always believe that sometimes in the right context and in the right situation, it's okay to have that feel-good thing. I am all for what's going on in the World Cup. Go, Croatia and Canada. I am all for all of it. However, we always do need to get back to reality, and we always do need to feel the things that we need to feel in order to really live a life that's authentic and real.

Reality Check And Closing Requests

Sandy Kruse 38:09

So I wanted to bring this to you, this episode to you, again, as always, really just to bring awareness to smoking and to all the stuff that's saying vaping is not as bad for you, or now you can use those pouches, or nicotine is a miracle drug, use it for your brain. I think we need to bring some reality to these discussions. And I think I've done a pretty good job of that. So I'm gonna end with that. I'm gonna ask you to share this with a friend so that they can just get the details on what we know right now. I don't think we need to glamorize smoking and/or go back to it and think, oh, well, now vaping is really bad. So I'm gonna go back to smoking. I think we need to see these things for what they are. So share this. Definitely rate my podcast, review it wherever you are listening. These things help me to be seen more. I am always coming to you, always passion over profit, integrity first without bias. I thank you. Thank you so much for being here each and every week. Don't forget to hit subscribe wherever you are listening or watching. I hope you enjoyed this episode. Be sure to share it with someone you know might benefit. And always remember when you rate, review, subscribe, you help to support my content and help me to keep going. Bring these conversations to you each and every week. Join me next week for a new topic, new guest, new excited conversation. Help you live your best life.