Purpose of Review <p>Nicotine dependency is a significant concern in the realm of public health since it has been observed to have adverse consequences on both an individual's physical well-being and socioeconomic status. Nicotine addiction induces neuroadaptive alterations, particularly within the reward and motivation circuits. Nicotine is classified as a sympathomimetic drug, which induces the synthesis of catecholamines, constricts the coronary and cutaneous blood vessels, increases heart rate and cardiac contractility, and transiently raises blood pressure.</p> Recent Findings <p>Nicotine has been found to not only decrease insulin sensitivity but also potentially worsen or induce diabetes, as well as increase endothelial dysfunction. The complicated interaction between neurotransmitters and transcription factors highlights the intricacy of nicotine addiction and offers valuable understanding for future therapeutic approaches.</p> Summary <p>Gaining a comprehensive understanding of these processes is crucial to successfully tackling this worldwide health concern. Further, pharmacological modulation of CREB with different pathways such as the NO-cGMP-PKG pathway, ERK pathway, BDNF signalling pathway, and DARPP pathway is explored in the review article.</p>