What are the ‘nicotine hiccups’ and why do they happen?

Containers of Zyn, a Phillip Morris smokeless nicotine pouch, is stacked for sale at a newsstand Feb. 23, 2024, in New York. (AP Photo/Bebeto Matthews)

“Nicotine hiccups” sound made up. But experts say they’re a real phenomenon.

Recent data on drug side effects found that nicotine was associated with the hiccups, according to a 2021 study looking at the Food and Drug Administration’s adverse-event reporting system (FAERS).

And anecdotal evidence shows many nicotine users can relate, said Melissa Little, director of the Center for Nicotine and Tobacco Research at the University of Virginia School of Medicine. On TikTok, Reddit and elsewhere online, Zyn users and people who vape are comparing notes on their “niccups.”

“Why do Zyns and nicotine pouches give me hiccups every time?” TikTok user @callmecarolyn asked her followers, before cutting to a scene of her hiccuping in bed.

Well, here’s why.

More: FDA seeks to limit nicotine in cigarettes, most cigars. Vapes and Zyn are excluded.

Nicotine acts by binding to receptors in the brain and nervous system, Little said. When these receptors are activated, they release neurotransmitters throughout the body. One of these neurotransmitters, called dopamine, plays a role in regulating the phrenic nerve, which controls breathing in the diaphragm.

“Instead of them doing what they usually do, they get a little messed up and get activated in certain ways,” Little said. “And that can induce hiccups.”

Nicotine can also irritate the mucus membrane that aligns the throat and esophagus, which can lead to hiccups, she said. It can also stimulate stomach acid production and can cause reflux, triggering more hiccups.

The Centers for Disease Control and Prevention says nicotine is a highly addictive substance found in tobacco products, such as cigarettes, and nicotine replacement therapies, like nicotine gum.

Tobacco use among middle and high school students has decreased from 2023 to 2024, predominately due to a decline in e-cigarette use, according to the 2024 Annual National Youth Tobacco Survey.

However, nicotine pouch use saw a slight uptick from 1.5% in 2023 to 1.8% in 2024. Sales also increased from 126 million pouches in August 2019 to 808 million in March 2022, according to the CDC.

Nicotine pouches, sometimes referred to as “lip pillow” or “upper decker,” are placed between the lip and gum, according to the American Lung Association. They’re similar to snus, which are oral pouches containing shredded tobacco leaf, except nicotine pouches contain nicotine powder. They come in several flavors and are available at different nicotine strengths.

Zyn is the only brand of nicotine pouches that has received marketing authorization for many of its products for consumers 21 and older. The agency said in a statement that Zyn products pose a lower risk of cancer and other serious health conditions than cigarettes and most smokeless tobacco products due to substantially lower amounts of harmful constituents.

Nicotine in adolescence can harm the parts of the brain that control attention, learning, mood and impulse control, the CDC said.

Contributing: Reuters.

Reporting by Adrianna Rodriguez, USA TODAY / USA TODAY