Nicotine is Kind of a Wonder-Drug

In this clip from “You Don’t Know Nicotine”, filmmaker Aaron Biebert discusses the public association of “nicotine” with the harm of cigarette smoking. The word “nicotine” has become so closely associated with smoking that it’s often used as a synonym. Let’s be clear: Smoking is harmful. Smoking tobacco kills half its users, over 8 million people each year.

“Nicotine” and “cigarette” are the same thing to many.

But what about nicotine? Psychologists and tobacco-addiction specialists worldwide now think it’s time to distinguish this well-known alkaloid from the effects of smoking. With many smoking alternatives available, nicotine can and is being used responsibly. As a company, RELX Technology wants to help every smoker in the world quit the habit. We also acknowledge that some former smokers will want the option to use nicotine, and deserve access to reliable, high-quality alternatives to cigarettes.

Tobacco: from religious sacrament to public health curse.

Ritualistic and medicinal use of tobacco is probably as ancient as agriculture itself, dating back some 8000 years. Archeological evidence suggests tobacco use in the Americas as far back as the Neolithic. By the end of the 16th century, through colonization and trade, tobacco use became common in most parts of the world, including Africa and Asia.

Photo by Boston Public Library on Unsplash

Nicotine affects dopamine receptors, improving moods and stimulating cognitive functioning. Because of the important role that dopamine has in learning, the stimulation of dopamine production reinforces nicotine consumption behavior. In other words, nicotine is habit-forming. These traits are likely responsible for tobacco’s rapid spread after its introduction to Europe. While many cultures chewed or snuffed tobacco, the fastest and most addictive way to consume the plant was by smoking it. Smoking also allowed the smoker to fine-tune the amount of nicotine consumed (called self-titration by modern researchers).

Posselt & Reimann first isolated nicotine and recognized it as the active ingredient in tobacco in 1828. Specialized research into the effects of the specific chemical rather than smoke could now be performed. Still, the norms of experimental rigor and peer review had not been well established, and faults from early experiments still inform our understanding of nicotine today.

Outside of Tobacco, Nicotine Is Not Particularly Harmful

When removed from the toxic tobacco and combustion adulterants, nicotine, like caffeine, acts as a “mild stimulant that poses negligible risks in healthy people”. Looking at the effects of pure nicotine does not suggest seriously harmful effects — other than addiction. In other words, nicotine is not unlike many medications

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Of course, too much of any substance, even water, can be harmful. What “too much” means for nicotine, however, is somewhat of a mystery. The standard dosage limits rely on a single experiment from 1856. More modern guesses about nicotine toxicity come from real-world instances of nicotine poisoning, which are extremely rare. For an adult, it’s almost impossible to consume enough nicotine to die, short of injecting nicotine directly into the bloodstream. However, the idea that nicotine is deadly persists in the public mind: Some have even tried to commit suicide by nicotine, resulting in mild gastrointestinal symptoms, with no lasting ill effects.

“Smoke for the Nicotine, but Die from the Tar”

By the end of the 1940s, research clearly showed that smoking cigarettes leads to lung cancer. Big Tobacco fought back via advertising, PR, and manipulation of the scientific process. In the 1970s, British psychiatrist Mike Russell was one of the first researchers to identify nicotine as the primary reason for which smokers become addicted. He suggested that people “smoke for the nicotine, but die from the tar,” and became an early advocate for nicotine replacement therapy.

Unfortunately, this insight was misused by the tobacco industry. For decades, companies’ false promises of “light” cigarettes helped lure more smokers. They managed to create enough “controversy” and doubt to last for decades, while fully aware of and covering up the risks. As new health concerns bubbled up, tobacco companies responded with products like filtered and low-tar cigarettes, each marketed as “safe”.

Photo by Tirza van Dijk on Unsplash

As Big Tobacco continues the industry is trying to catch up to the vaping revolution, they are still releasing products that are just as harmful as cigarettes, like the iQOS. This paper tube with tobacco leaves inside is technically an e-cigarette, as it uses electrical heating to “vaporize” the nicotine. It is still a far cry of the much less harmful e-liquid-based e-cigarettes that don’t use tobacco leaves. E-liquid, made of a food-grade solution of base, flavor, and nicotine, is heated into vapor, providing a nicotine delivery system that does not contain the typical tobacco adulterants.

Smearing competing products is standard for Big Tobacco. They have attacked nicotine replacement products, withheld beneficial smoking-cessation technology for decades (until the competition caught up), and caused any nicotine product to be suspect in the public’s mind. As tobacco companies lost grip on the monopoly of selling nicotine, they did their best to take any competition down with them under the rallying cry of “If Anyone Is Going to Take Away Our Business It Should Be Us”.

Nicotine may hold cures to some of the most challenging brain diseases.

In the United States, the FDA has approved nicotine only for smoking cessation. But a growing body of evidence suggests other neurological benefits. There are some promising effects in the treatment and prevention of diseases like Parkinson’s, Schizophrenia, anxiety, ADHD, pain, obesity, and depression. For Parkinson’s, a seemingly intractable disease, nicotine has shown effect in delaying, preventing, and managing the symptoms. By activating acetylcholine receptors, nicotine helps trigger dopamine release, countering the cognitive and motor symptoms of the disease.

Photo by Markus Spiske on Unsplash

Nicotine may be used in the therapy of some of the hardest to manage illnesses that carry significant costs to society and is being actively researched in multiple clinical applications. While the idea of nicotine-based medicine is sound, the lurid past of Big Tobacco has been holding making it more difficult to conduct research and manufacture nicotine-based medication.

Ignoring the reputational issue, entrepreneurs who are looking for a performance edge often explore the idea of “biohacking”. This pursuit of better performance can include fasting, meditation, cold therapy, and microdosing unusual pharmaceuticals or using “smart drugs”. In this context, the use of nicotine to boost performance is making headway, opening the door to public understanding of nicotine as separate from smoking, facilitated by the smoking alternatives available in the market.

Smoking is still a leading killer around the world, and the association with Big Tobacco has drastically slowed exploration of the potential benefits that could be derived from nicotine. It will take years of hard work to eradicate smoking as the 20th century knew it, but it will not sever the tie between humans and nicotine. Instead, we may unlock new uses for nicotine via ethical, evidence-based exploration of its effects, and responsible use that benefits the individual and society.

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