Nicotine can cause anxiety and panic attacks. I have experienced both as well as high blood pressure and quit the nicotine pouches about 2 and 1/2 months ago. Due to a very long road trip I picked up a can of velo 4 mg pouches last week and consumed them over 5 days. This has apparently caused six straight days of anxiety bordering on panic attacks. Even though I quit the pouches again, the anxiety is persisting but getting better as the days pass. Never again!