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The nicotine competes with acetylcholine to bind to the nicotinic receptors and it wins

There is increased risk also of birth defects 2 including: limb reduction defects 14,17,18 , clubfoot 14,18 , cleft lip or palate 14,18 , anophthalmia 14,18 , microphthalmia 14,18 , esotropia 18 , exotropia 18 , optic nerve hypoplasia 18 , heart defects 14,18 , craniosynostosis 14,18 , gastroschisis 18 , anal atresia 14,18 , hernia 14,18 , and cryptorchidism 14,15,18

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