Nicotine has been used for millennia throughout the history of humankind, spreading from the Americas to the rest of the world. Nicotine has transformed with society, initially smoked using the raw tobacco leaves to the more recent use of electronic cigarettes and tobacco-free nicotine pouches. In this chapter, we will explore nicotine’s history, nicotine use disorder epidemiology and presentation, and review how to approach individuals with nicotine use disorder.