September 21, 2021

Vaping, Smoking, Dipping & Chewing Tobacco Cause Reflux


  • Nicotine has adverse effects on many different organs in the body, and it specifically causes pharmacological relaxation of the lower esophageal sphincter, leading to acid reflux and Barrett’s esophagus.
  • Cigarette smoking is associated with acid reflux occurring within two minutes of almost every cigarette. Nicotine from vaping and dipping or chewing tobacco causes reflux by the exact mechanism.
  • A large study of people with reflux (including smokers and lifetime non-smokers) showed that the smokers had twice as many reflux episodes, lasting twice as long.
  • Using any nicotine product, including nicotine gum and lozenges, significantly worsens a person’s reflux.

All Nicotine Is Created Equal: It’s BAD for Reflux, Both GERD and LPR

The lower esophageal sphincter (LES) is the most critical barrier preventing the backflow (reflux) of stomach contents upwards into the esophagus, and the throat is the lower esophageal sphincter (LES). It has been shown that nicotine makes the LES sphincter relax, like a pharmacological drug effect.

The author (Koufman) examined the reflux testing (pH-monitoring) data of 750 known (smoking and non-smoking) reflux patients and showed that reflux was twice as severe in smokers. It has been reported that reflux events occur within two minutes, with two-thirds of cigarettes smoking. Furthermore, it has been shown that smoking and smokeless tobacco are linked to Barrett’s esophagus, considered an esophageal pre-cancer.

In conclusion, all forms of nicotine use — smoking, vaping, pipe, cigarette, water pipe (hookah), and all forms of smokeless tobacco — are associated with causing and worsening acid reflux, both GERD and LPR, and their sequelae.  

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