Scientific Nutrition Update 43: Nicotine

This episode is a special request from my good friend Jeff Jenkins.  He is a dip user and was curious about the health effects of nicotine and so this episode is focused on that.

Script (Remember I ad-lib):

For today’s episode I am going to talk about nicotine.  One of the most highly addictive compounds that is commonly used, and highly villianized.  My good friend Jeff Jenkins, who is a chewing tobacco user was curious about the specific health effects of nicotine so he requested this one.  If you would like to request one then you can send me a voice message on Anchor and I’ll try to answer it for you. Also we will not be discussing tobacco in general, we are focusing much more closely on nicotine alone.  Remember highly addictive you guys. Do not start smoking cigarettes because of this episode, they are really bad for you.

I am going to start with Parkinson’s disease.  Parkinson’s disease for a while now has been shown to occur less frequently in people who smoke than non-smokers.  Though, there does seem to be a capped benefit to this, wherein smoking more cigarettes per day does not help, but smoking for more years does.  So it would seem that for nicotine and parkinson’s once you have reached the effective dose there is no additional benefit beyond that. It’s important for me to note again here that I am not a doctor and I am not giving medical advice, purely noting what the literature suggests.  There also does not seem to be a reduction in Parkinson’s mortality once the disease develops, so it’s use a treatment is still pending. However, in animal models of Parkinson’s disease nicotine does protect against the neuronal damage and as such would be a promising candidate for more study in my opinion.  In monkey models it even seems to help with some of the side effects of the treatment, reducing the dyskinesia, or urge to move. Obviously this is all very interesting and does suggest that nicotine, when freed from harmful delivery mechanisms could be a useful tool.

What is also interesting is to look at nicotine’s potential for cognitive enhancement.  Many people anecdotally report more focus or improved performance when taking nicotine, however, anecdote is not enough for us.  So let’s go to the literature and see what it says. There was a study done on people suffering from mild cognitive impairment, which is often a precursor to Alzheimers and what was found was significant cognitive enhancement along with improvements in memory, attention, and psychomotor speed.  The patients also said they felt less impaired. This is a fascinating result but it is important to remember that a result in this population does not necessarily generalize to a healthy population.

Looking at healthy populations there are still some interesting results.  There is evidence among smokers that cigarettes may help with attention and memory.  That only helps us a little bit though, because it still might not be showing the actual benefit of the nicotine itself.  Luckily there are a couple of good studies that actually did look at healthy non-smokers. One was specifically looking at attention and inhibitory control and found a significant improvement on specific attention, but a decrease in a specific type of attention called the orienting effect.  This suggests to me that the interaction between nicotine and cognition is likely going to be quite complex and depend on the interactions between multiple types of cognition. The second study looked at spatial attention and alertness and found a decrease in reaction times, but not an improvement in accuracy.  They also found an increase in alertness as would be expected. My overall interpretation of the studies on non-smokers remind me of the studies of caffeine I have read before. What I think we are seeing is just the general effects of a stimulant, and that it likely does not have significant benefits beyond its stimulatory effect, although I would love to be proven wrong.  

Nicotine is also being looked at as a potential treatment for depression.  Now before I begin this section, depression is a very serious disease, and you should be consulting with a trained professional.  I am not that. Do not change, begin, or stop any treatment without consulting the appropriate professionals. There are studies currently looking into this but as far as I can find none of them have concluded yet.

Overall, my conclusions from this is that nicotine does have potentially beneficial effects.  Especially for Parkinson’s it is definitely deserving of more research. There is some limited evidence for its ability to improve cognition but for me it looks a lot like any other stimulant like caffeine that could have similar effects.  I am curious about its potential effects on depression, but that needs way more research. Finally, remember I am not telling you to smoke. Smoking causes cancer. I am not telling you to dip or use chewing tobacco. Also causes cancer. I am not telling you to vape.  It likely causes lung damage and may cause cancer. I am looking exclusively at nicotine. Do not do dumb things. If you learned anything in this episode please share it with a friend, thank you for tuning in and Jeff stop dipping.

Bibliography (I may not directly address these studies in the episode but I looked at them and thought they might be valuable):

Years of smoking associated with lower Parkinson’s risk, not number of cigarettes per day [Internet] [cited 2018 May 3,]. Available from: https://www.sciencedaily.com/releases/2010/03/100310162823.htm .

Gandelman JA, Newhouse P, Taylor WD. 2018. Nicotine and networks: Potential for enhancement of mood and cognition in late-life depression. Neurosci Biobehav Rev 84:289-98.

Griesar WS, Zajdel DP, Oken BS. 2002. Nicotine effects on alertness and spatial attention in non-smokers. Nicotine Tob Res 4(2):185-94.

Newhouse P, Kellar K, Aisen P, White H, Wesnes K, Coderre E, Pfaff A, Wilkins H, Howard D, Levin ED. 2012. Nicotine treatment of mild cognitive impairment: A 6-month double-blind pilot clinical trial. Neurology 78(2):91.

Quik M, Perez XA, Bordia T. 2012. Nicotine as a potential neuroprotective agent for parkinson’s disease. Movement Disorders 27(8):947-57.

Quik M, Mallela A, Ly J, Zhang D. 2013. Nicotine reduces established levodopa‐induced dyskinesias in a monkey model of parkinson’s disease. Movement Disorders 28(10):1398-406.

Rusted JM, Caulfield D, King L, Goode A. 2000. Moving out of the laboratory: Does nicotine improve everyday attention? Behav Pharmacol 11(7-8):621-9.

Wignall ND and de Wit H. 2011. Effects of nicotine on attention and inhibitory control in healthy nonsmokers. Experimental and Clinical Psychopharmacology 19(3):183-91.

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