Let’s make one thing clear: cigarettes are terrible. Because science is usually hard to prove definitively, journalists and scientists almost always say that things—like, for instance, processed meat or lack of exercise—“may” increase your risk of cancer. Cigarettes will increase your risk of cancer.
Nicotine, however, is not the same thing as tobacco. The common stimulant is found in tobacco—and in lower amounts in eggplants and tomatoes—but it shares cigarettes with more than 4,000 other chemicals, including dozens of compounds known to cause cancer.
Even when you isolate nicotine, inhaling it is still a lousy delivery system that stresses the lungs and probably increases the risk of lung disease. But when taken orally (such as with nicotine gum or lozenges) or through a transdermal patch, without all of the other chemicals in cigarettes, it may be a different story.
Nobody in the healthcare field can officially recommend nicotine for purposes not approved by the FDA, and the FDA has only approved it for smoking cessation. But there is a growing body of evidence suggesting other potential neurological benefits that do deserve attention. The largest human studies ever undertaken looking at the potential benefits for both Parkinson’s disease and Alzheimer’s disease are currently underway, and their conclusions may significantly change the way healthcare providers discuss nicotine moving forward.
Nicotine Could Help Fight Parkinson’s Disease
Epidemiological data has long shown that smokers—while way more likely to get cancer, heart disease, stroke, and more—are actually less likely to develop Parkinson’s disease. Because of the close association nicotine has with cigarettes and their ills, it’s been tough for researchers to get funding for human studies, but years of research on other mammals has yielded some pretty positive results and led to a large trial funded by the Michael J. Fox Foundation that’s currently underway.
“Over the years, people have tested this idea in mice and rats and monkeys, and we found that nicotine can protect against the damage that occurs in Parkinson’s disease in the brains of monkeys,” says Maryka Quik, a former senior research scientist at The Parkinson's Institute.
Of the dozens of studies Quik has worked on in this area, one of the best known found that monkeys suffering from dyskinetic movements—involuntary movements common in Parkinson’s —experienced a 60 to 70 percent reduction in movements when treated with nicotine-laced water. This could be because the nicotine molecule fits into receptors for the neurotransmitter acetylcholine, which may give it the capacity to moderate other families of receptors in the brain.
“In Parkinson’s disease there is a degeneration of neurons, and nicotine has been shown to increase some growth factors in the brain,” Quik says. “So it’s possible that nicotine can partially prevent the degeneration that happens in the brain by increasing these growth factors.”
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Nicotine Can Enhance Brain Function in People With Cognitive Decline
It’s been observed that nicotine appears to reduce the loss of neurons that produce dopamine in the brain, which is one reason why it may have applications for Parkinson’s disease and Alzheimer’s disease. Some preliminary studies on subjects suffering from mild cognitive impairment — considered "a transitional state between the cognition of normal aging and dementia" — have found that using transdermal nicotine patches over several months showed significant improvements in attention, memory, and ratings of cognitive impairment. Subjects usually receive between 15 and 21 milligrams per day, about as much a standard over-the-counter patch would deliver over a day.
Paul Newhouse, director of Vanderbilt University’s Center for Cognitive Medicine, has been researching the role of nicotine in neurological disorders for 30 years and is currently undertaking a study of 300 older individuals, the largest-ever study of nicotine patches among non-smokers, to further test his hypothesis.
“In a pile of studies at three different universities, we tested whether transdermal nicotine patches could help patients who are developing early signs of memory loss that often lead to Alzheimer’s and found that there was significant evidence of improvement in cognitive performance in both attention and memory,” he says. “That’s not necessarily suggesting that nicotine by itself would prevent Alzheimer’s disease, but the hypothesis is that it will enhance attention and memory function in patients who already have early memory decline. So it is a treatment study, not a prevention study.”
It Might Help With Depression
If the notion that nicotine may affect dopamine-producing neurons made you wonder if it could help treat depression, experts are split. Quik doesn’t think there’s enough evidence at this point in time, while Newhouse believes there's real potential. “We have a small, open label, pilot study of nicotine augmentation in older adults with depression and found a very strong positive effect,” Newhouse says, noting that the study was recently accepted for publication. “We do think there is an interesting potential for depression, but it’s not linked to dopamine. What we think is that nicotine alters cortical network activity and it’s reorienting the activity of certain intrinsic networks in the brain to be more outward looking and less inward looking.”
If true, that could be significant: Brain scans of people with high-functioning depression show hyperactivity in regions of the brain associated with rumination. Depressed brains are often considered more “inward looking” than healthier ones, which is one reason why the condition tends to involve obsessively replaying one's past mistakes and agonizing about the future. Therapy and medication help to calm these overactive networks, and if nicotine can play a role in producing more extroverted qualities and de-emphasizing introverted ones, it could potentially be another tool for combating depression. For now, a lot more research is needed.
Nicotine Could Enhance Your Attention
In World War 1, General John Pershing sent a cable to US War Department saying, “You ask me what we need to win this war. I answer, tobacco as much as bullets. Tobacco is as indispensable as the daily ration; we must have thousands of tons without delay.”
He may have meant that smoking fosters camaraderie, but he also could have been referring to something that studies have shown again and again: It takes the edge off.
“We know if you’re anxious then nicotine will calm you down, and it will tend to alert you if you’re drowsy,” Newhouse says. “I remain a bit of a skeptic as to whether nicotine is going to help normal people function better, except under circumstances when their functioning is otherwise degraded.”
While Newhouse isn’t quite convinced—and he’s certainly earned the right to his reservations— there has been interesting research suggesting nicotine could have a beneficial effect on certain aspects of cognition. Research on smokers from the University of Sussex has concluded that nicotine may exert a small but significant effect on a person’s prospective memory, or the ability to remember information over a short period of time, with one of the university’s psychology professors calling nicotine “the most reliable cognitive enhancer that we currently have, bizarrely.” Other research has found beneficial effects on attention capacity and alertness among small groups (less than 50) of nonsmokers who received 7 milligrams of nicotine through patches.
“It’s thought to improve your attention,” Quik notes. “In animal studies, if you inject them with nicotine they definitely seem to remember certain tasks better. It’s not a huge improvement, it’s like 10 or 15 percent, but if you can improve your attention and remember things better by 10 to 15 percent, that could be a good thing."
Trevor Kashey, an Ohio-based biochemist and nonsmoker, occasionally takes small, one-milligram hits of nicotine through gum. “Oh, it gives me a buzz," he says. "That’s the short answer. It’s an alternative stimulant to prevent becoming dependent on typical stimulants like caffeine. What I have noticed is caffeine affects your vigilance, while nicotine might be able to help you make decisions faster. It improves your performance on tasks that require attention, or more accurately, it decreases how easily you are distracted from doing things.”
It’s tough to talk about nicotine like this. The word is emotionally and politically charged, and many lawmakers and academics justifiably have difficulty separating it from the horrendous, and frankly, better-documented consequences of smoking. The negative effects of cigarettes have reams and reams of studies that have been confirmed a hundred times over by governments and the World Health Organization. Nobody wants people to slyly associate cigarettes with any health benefits.
That’s not what’s happening here. Nicotine exists outside of tobacco, and while it can still be addictive (although to a lesser degree) in patch or gum form, the potential benefits deserve serious attention. Those aforementioned large human studies will wrap up in 2018, and if their hypotheses pan out, nicotine may one day be considered a potential weapon in the fight against neurological disorders. If there’s one thing we’ve learned from the history of medicine, after all, help is often found in the most unlikely of places.
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