Nicotine is the only consumer stimulant that is an entirely natural and normal part of the diet - it is contained in many vegetables, and every single person tested in all the large-cohort clinical trials that tested for nicotine has always tested positive. To deny its value or question its safety, in dietary quantities, is the equivalent, in every way, of saying that vitamin D or copper are dangerous, toxic,
alien chemicals. They are certainly dangerous in large amounts - but so is everything.
Where nicotine is questioned as a safe or normal material for consumption, the effects of propaganda are evident. There is nothing wrong with nicotine in dietary quantities, and everyone tests positive for it (unless they eat no vegetables) at a value of approximately 2ng/ml of blood plasma. This is commonly referred to as the 'background level' in blood tests for nicotine to determine smoking status, and a smoker can be identified by values generally higher than 10ng/ml.
Nicotine is co-located in plants that supply vitamin B3 or nicotinic acid, a related compound that in some cases can be a metabolyte of nicotine. Very little research has been done on the body's need for nicotine, especially from certain subgroup's point of view, but it is well known that nicotinic acid (aka niacin, an acronym of nicotinic acid) is a required vitamin, and lack of it causes a nutritional deficiency. Some individuals are shown to have a requirement for additional B3 and may take
supplements of up to 2,000mg daily to assist with cognitive issues and work capacity. As yet no proper research has been carried out on whether nicotine may have a similar role in terms of cognitive function for certain individuals versus the dietary amount delivered. Many of us believe that it does have such a role.
Long-term ad lib consumption of nicotine has been proven (not just demonstrated) to be virtually without risk by the epidemiology and national health statistics from Sweden, where Snus consumers have been monitored by over 150 clinical studies for several decades. A slight increase in risk for stroke appears just above the background noise, in the giant-scale meta-analyses of dozens of studies.
Nicotine is conflated with smoking, by tradition, which is why the first researchers in a large-scale trial who found that everyone tests positive for nicotine assumed that everyone is exposed to ETS (2nd hand smoke). A good knowledge of nutrition does not seem to have been necessary for a doctor's qualification until fairly recently, and even now it seems a Cinderella science. When the propaganda is also added to the mix, an honest appreciation of issues surrounding nicotine consumption becomes rather difficult. What we do know is that every healthy person consumes it; some may need more than others, as is common for many dietary components; and consuming a lot of it in the long term appears relatively safe at population level.
Individuals, though, may need to take account of their own medical situation and perhaps especially their family genetics. Cardiac and vascular issues appearing more commonly than the norm might be a sign that moderation is in order. Until there is more real research, unaffected by commercial interests, we don't really know which individuals should be more careful than the majority. Nicotine is just another normal dietary ingredient that is toxic in large quantities - and that is about the only point of agreement at present.