This article is republished from The Conversation under a Creative Commons license.
An ironic development emerging alongside the “Make America Healthy Again” movement is the portrayal of nicotine as a wellness and performance-enhancing product. Across social media, podcasts, natural medicine communities and tech startups, prominent wellness personalities and other influencers are portraying nicotine as a misunderstood compound whose potential benefits have been overshadowed by its negative association with cigarettes.
In these circles, nicotine is now being hailed as a natural product that can be used for everything from improving focus to protecting against cognitive decline. As a pulmonary physician-scientist who studies nicotine addiction and the health consequences of tobacco and nicotine products, I am concerned about these claims.
Some of this rebranding stems from the observation that nicotine is a naturally occurring plant compound found primarily in tobacco and in nightshade vegetables such as tomatoes, potatoes and eggplant in trace amounts. Proponents of nicotine use also draw on studies suggesting that nicotine can affect certain aspects of cognition and brain function. However, extending these findings to broad claims about productivity, brain health, longevity or wellness goes well beyond what has been shown in human studies.
The greatest health risks arise when tobacco is burned, which generates thousands of toxic substances, including carcinogens, carbon monoxide, and fine particulate matter. Repeated exposure to these combustion products can cause cancer, chronic obstructive pulmonary disease, cardiovascular disease, and numerous other smoking-related illnesses.
Photograph: Getty ImagesNicotine’s comeback as a wellness product is more about non-smoking options, such as nicotine pouches, or some combine nicotine with other substances marketed as cognition enhancers, like caffeine and nootropics. While many smoking-related diseases result from the chemical products of combustion, nicotine itself has well-known negative effects on the brain and body.
Nicotine activates the sympathetic nervous system—the body’s “fight or flight” response—which increases heart rate and blood pressure and disrupts sleep. Repeatedly kick-starting this system can place additional strain on the heart. Exposure is also of particular concern during critical phases of development.
Not to mention the extremely well-known risk that nicotine is addictive. It activates reward pathways in the brain, acting on receptors for acetylcholine, a key neurotransmitter involved in attention, learning, and memory. Though it may temporarily increase alertness and attention, nicotine does not reproduce normal acetylcholine signaling. The effects last much longer and alter activity throughout the brain.
With repeated exposure, the brain adapts to nicotine’s presence. Receptors become less responsive, and so the brain compensates by increasing the number of nicotine receptors, contributing to dependence. Activation of these receptors also influences the release of other neurotransmitters, including dopamine, which plays an important role in reward and reinforcement.
A common claim within wellness communities is that nicotine is a cognitive enhancer that improves focus and productivity. While there are some studies indicating that nicotine may temporarily enhance attention, vigilance, reaction time, and some types of memory, the results are mixed.
If any benefit does exist, the research suggests that this may only be the case for people with mild cognitive impairment. For healthy individuals, it doesn’t appear to offer any boost and may even worsen cognitive operation among higher-performing people.
In addition, many of these studies include people already dependent on nicotine. When these regular users stop consuming nicotine, they’re likely to experience irritability, anxiety, restlessness, and impaired attention. Reintroducing nicotine often relieves these symptoms, making it difficult to determine whether any improvements reflect true cognitive enhancement or are simply the reversal of withdrawal symptoms.
Wellness influencers also promote nicotine as a tool for managing stress and improving mood. Nicotine does activate reward pathways in the brain, which can create a sense of pleasure and wellbeing—temporarily.
Long-term users of nicotine often find that the substance makes stress and anxiety harder to manage. Research consistently shows that people who quit smoking experience reductions in anxiety, depression, and stress, along with improvements in mood and overall quality of life over time. In fact, long-term discontinuation of nicotine use is associated with better mental health.
But the most ambitious claims emerging from the pro-nicotine wellness movement suggest that nicotine protects against Parkinson’s disease, Alzheimer’s, and other forms age-related cognitive decline. Or further, that nicotine slows biological aging and promotes longevity.
There’s some kernels of research underneath these claims, such as laboratory studies showing that nicotine can affect cellular pathways related to oxidative stress and animal studies suggesting effects on inflammation and other mechanisms linked to aging and disease. However, such findings have not translated into anything that indicates nicotine promotes healthy aging, extends lifespan or prevents age-related disease in humans.
