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In the brain, nicotine works mostly to release other neurotransmitterslike dopamine (pleasure), norepinephrine (arousal and appetite suppression), glutamate (learning and memory), endogenous opiates, and serotonin (mood modulation)

Clonidine works through the brain and is often reserved for resistant hypertension or withdrawal-related symptoms, while propranolol acts on the heart and is commonly chosen when blood pressure control is needed alongside migraine prevention, anxiety symptoms, or heart conditions

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Mitigation strategies might include prescription requirements for higher-dose products, outright prohibition (as in Singapore, Australia, and Brunei Darussalam), and the classification of synthetic nicotine pouches as pharmaceutical or drug products rather than traditional tobacco products

March 13, 2009