ok with a confession to that, it is more like 5-6 a day HA HA HA
just jokin’ on it
but yea it should never effect ketosis obviously, but your overall health IS obviously effected so it could make ya run slower with getting some good health changes quicker on your timeline as you heal up more and just less healthy in a way even with a good eating change so? choice of course is how ya wanna flow and do your own thing…not a darn thing wrong with just that to me.
I read that long term nicotine use can affect people who are prone to lower back pain because it narrows the arteries. I’ve been using nicotine pouches for several months. They don’t contain tobacco, but they contain whatever chemicals they used to extract the nicotine I guess. And depending on the brand, maybe some hidden sugars? Though the brand I buy claims no sugar.
I manage to only do them at most once a day after dinner. It’s not like I still have hunger cravings after almost 6 months on keto, but I like how they put you firmly in the “I will not eat again tonight” camp, which is also nice for IF. But, I am one of those people who has lower back issues, so I’m one strained back away from throwing them in the trash. Ok, maybe two strained backs away… 
The discs of the spine are not served by blood vessels; they depend on oxygen perfusing through the surrounding tissues. This is why nicotine affects them the way it does.
One thing that (very heavy) smoking certainly did for me was cunningly hide a shocking case of gum disease… no bleeding, you see. I was a depressed wreck and not taking care of myself. I lived largely on wine and cigarettes.
So of course, it was when I made the healthy decision to quit smoking that my gum issue came to light in quite the horrific manner. I expected to lose my two bottom front teeth, but they hung on in there in spite of the bone having been quite handily destroyed by my body as it battled the infection. I just have a rather unsightly gap where they drifted apart in the receded gums : (
I’ll probably get that fixed… one day…
I wasn’t speaking only to spinal issues, I would categorize lower back sprains, which are tissue/muscular, as a type of lower back pain. To quote some sources I read: “Nicotine can shrink blood vessels, which restricts the flow of crucial nutrients like calcium.” and “Nicotine affects hormone levels, vitamin D and calcium absorption, blood vessel constriction and bone oxygen supply.” Guess I substituted arteries for blood vessels, but you get the point. All in all, it’s not good, but jeez, we aren’t nuns here people!! Gotta have some vices.
Surely can’t be specific to just back pain in that case, shouldn’t it be said that nicotine makes people hurt?
I tried it as a preworkout, gross, made me feel sick and jittery. Binned it.
Ex-smoker here, 22 years clean and never looked back.
