Vaping, smoking, snus causing dozens of daily ER visits due to nicotine overdoses

A study has found that smoking, vaping, and the use of snus are the cause of dozens of visits to the first aid department every day. A total of 7 percent of emergency department patients had symptoms that could be fully linked to nicotine use, according to the study. When these findings are extrapolated to the roughly 1.8 million annual emergency department visits nationwide, the researchers estimate that around 26,000 visits per year are a direct result of nicotine use.

In November 2025, a research team headed by Nicole Kraaijvanger, an emergency physician at Leiden University Medical Center (LUMC), carried out a 24-hour nationwide survey in Dutch emergency departments. During the study, patients aged 12 and above were invited to answer a short questionnaire on their use of nicotine products such as cigarettes, e-cigarettes, and snus. The study included 67 out of the Netherlands’ 78 emergency departments, with 2,061 patients in total filling out the survey.

The study represents one of the Netherlands’ first national attempts to quantify the impact of nicotine use, whether from smoking, vaping, or snus, on acute hospital care. Its findings make clear that nicotine use creates real pressure on emergency services and point to potential opportunities for prevention and intervention, both in the emergency department and in other healthcare settings.

The findings suggest that in almost 44 percent of cases involving nicotine users, smoking or vaping may have contributed to the patient’s symptoms, corresponding to an estimated 193,000 emergency department visits annually where nicotine likely played a role.

Cigarette smoking continues to be the primary source of nicotine-related complaints seen in emergency departments: 86 percent of nicotine users in the study smoked traditional cigarettes.

Although vapes are commonly viewed as a safer alternative, they are associated with lung irritation, COPD symptoms, sudden breathing difficulties, and occasionally serious respiratory conditions that require medical care. Snus, or nicotine pouches, was reported less often, but because it still delivers nicotine, it may also play a role in health complaints and was therefore included in the questionnaire.

Physicians indicate that the actual number of emergency department visits attributable to nicotine use is likely higher because patients with the most acute or severe conditions, such as heart attacks or advanced respiratory problems, were not always able to complete the survey.