Nicotine gets a bad rap. Thought to be extremely addictive due to its mind-altering properties, it has been blamed for everything from heart disease to cancer.
Known as the main psychoactive ingredient in tobacco, public health experts have been warning for years that even one nicotine-laced puff of a cigarette can leave one hopelessly addicted for life. Many also warn that nicotine itself is very dangerous – it is extremely toxic, even used as an insecticide, and has no benefit whatsoever other than to provide relief from the insufferable withdrawal that results from addiction.
No benefits at all??
Yet, now nicotine is being offered as a medication, used to help ease people off of cigarette addiction. It is widely available over the counter at pharmacies everywhere and is one of the most highly recommended medications for smoking cessation.
If nicotine is so dangerous, then why would it be freely offered as a medical treatment to millions of people?
Also, if nicotine is the main psychoactive ingredient in tobacco, yet has no benefits at all, then why would nearly 20% of the population smoke daily? If it really does nothing but feed the addiction, then they should all be able to just quit smoking and never touch it again. Right?
What are the real effects of nicotine, apart from cigarette smoke?
The truth is, nicotine isn’t nearly as dangerous, or as addictive, as we’ve all been led to believe.
So how dangerous is nicotine?
It is true that nicotine is an effective insecticide, and that it is toxic in high doses. However, just about everything is toxic in high doses. People can die from drinking too much water in one sitting, but you don’t hear doctors telling people to stay away from water.
How much nicotine is deadly? It has been long believed that only 60 mg is required to kill an adult human when ingested (to put that in perspective, that is less than 3 ml of 24 mg/ml e-liquid). This figure has recently been contested however, and traced back to faulty experiments conducted in the 19th century.
The true lethal dose has since been estimated to be at least 500 mg for an adult, or no less than 6.5 mg per kg of body weight. Unfortunately many health experts and researchers continue to tout the false lethal dose of 60 mg, thereby misleading the public into believing that e-liquid is extremely dangerous.
Reportedly, calls to poison control centers over ingestion of e-liquid have been increasing in recent years. However, there has not been a single reported death or serious injury from nicotine ingestion in the last few years, which is consistent with our current understanding of what the lethal dose of nicotine actually is. In the majority of cases the most severe side effect reported from nicotine ingestion is vomiting.
Effects of normal use
Dr. Riccardo Polosa, noted tobacco harm reduction expert, summarized the effects of nicotine on the human body in his review here.
Nicotine is rapidly absorbed in the bloodstream when ingested, inhaled, or placed on the skin. It reaches the brain rapidly, leading to mild psychoactive effects such as relaxation and heightened focus. Nicotine can increase heart rate temporarily, but there is no apparent risk of long term cardiovascular effects.
Nicotine may have an impact on fetal development, though it is likely that the effects are far less than in continued cigarette smoking by the mother. The actual effect on fetal development has not been fully determined.
There is no evidence that nicotine is carcinogenic, nor is there any evidence of lung damage from long term inhalation of nicotine. However, long term nicotine use may lead to some weight loss.
Overall the effect of nicotine on the human body is very similar to that of caffeine.
As I said earlier, nicotine has long been considered the main addictive component of tobacco. This seems reasonable considering its effects on the brain, but it is not true.
There has been a lot of research in the last decade on other chemicals in tobacco smoke and how they affect the addictiveness of smoking. Several other chemicals have been identified as having what’s known as a synergistic effect when administered alongside nicotine. What this means is that when these other substances are delivered with nicotine, they boost its effects on the brain – it is the combined effect of these chemicals that is highly addictive.
Several tobacco alkaloids have been identified to exert this synergistic effect, including anabasine, nornicotine, anatabine, cotinine, and myosmine. These chemicals are naturally occurring in tobacco, and when administered alongside nicotine in rats the effect of the nicotine was boosted. Further research has shown that these tobacco alkaloids can have effects on acetylcholine receptors in the brain similar to that of nicotine.
In addition to these naturally-existing compounds in tobacco, other research has shown that many additives in cigarettes also increase the addictiveness of smoking. In particular, seven of these chemical additives suppress the metabolism of nicotine, which leads to higher, longer-lasting nicotine concentrations in the blood.
Also, sugar, sorbitol, and other sweeteners are added to tobacco which lead to the formation of acetaldehyde when burned. Acetaldehyde has been found in laboratory experiments to exert a synergistic effect on nicotine, increasing the addictiveness of tobacco.
The verdict is in: unless it’s combined with the many chemicals listed above, nicotine is not addictive.
At this point it’s useful to describe the clinical difference between addiction and dependency.*
Addiction is defined clinically as having dependence on a substance, coupled with acute withdrawal symptoms when not able to consume it, and an increase in tolerance of the substance over time.
Many vapers have noticed that after not smoking for a while, their withdrawal symptoms seem to vanish. Also, vapers often find it rather easy to decrease their nicotine levels over time, and some quit using nicotine entirely.
Thus, nicotine is not addictive, but it can lead to dependency.
Dependency is trickier to discuss because it’s not so much a property of the drug, but of the need that it fulfills. The effect that nicotine has on the brain can have benefits for some, which can lead to a dependency.
Again, however, this is not the same as having an addiction. It must be stressed that dependency alone is not necessarily a terrible thing. Some people are hopelessly dependent on making sure they eat their breakfast every morning, but no one would argue that a person’s dependency on eggs and toast is a major health crisis.
A dependency is only a bad thing if it leads to harm. As discussed earlier, normal nicotine use does not lead to harm. Therefore, being dependent on nicotine is not a bad thing.
Benefits of Nicotine
I mentioned earlier that nicotine has psychological effects that include relaxation and improved focus. That barely scratches the surface of the potential benefits nicotine may have.
Nicotine is currently being researched as a possible treatment for Parkinson’s disease, Alzheimer’s disease, and other neurodegenerative conditions. Current data show that it may help to prevent these illnesses, and it has potential to slow the progression of these conditions.
Nicotine’s role in mental illness is enormous. People with schizophrenia and bipolar disorder show marked improvement in symptoms after consuming nicotine, and individuals with many other mental illnesses such as depression, anxiety disorders, and attention deficit disorders often experience improvements in mood, focus, and clarity of thought with nicotine.
Keep in mind that many of these illnesses are difficult or impossible to treat otherwise. Nicotine is not just a recreational drug, it is a beneficial medicine that we cannot afford to ignore any longer.
Nicotine is not bad for you!
Nicotine is rarely toxic, has few negative effects, is not addictive, and can be used as a treatment for some medical problems.
It is terribly sad that so many public health experts have put so much time and energy into demonizing nicotine. As smokers and former smokers, many of us have spent years wondering what was wrong with us – we’ve been told, over and over, that it’s just an addiction and we’re not getting any ârealâ benefit from smoking other than to ease the withdrawal symptoms.
It turns out that we were getting benefits from smoking this whole time, and those benefits were coming from the very thing we were led to believe was the most dangerous part of smoking.
These benefits, though, are more noticeable in some than in others. Nicotine will have a very distinct effect on some people, and very little effect on others. It seems that many who wish to deprive the world of nicotine genuinely believe that since it seems to have no effect on them, it must not have a positive effect on anyone else either.
That’s a silly way to look at things. It’s like if I were to say that since I don’t need to eat breakfast everyday, no one else does either – and then proceed to try to cleanse the world of its useless breakfast addiction.
Nicotine does not need to be eradicated. It needs to be harnessed.
*Note that the psychiatric criteria for substance use disorders has changed recently so that all substance use is now defined as varying degrees of ‘addiction,’ and the term ‘dependency’ was deleted. Also there is much disagreement among experts from different fields over what addiction is and whether it exists at all.