Date: Sep 10, 2015
Forget what you think you know about nicotine. Most people see nicotine as a vile, fiercely addictive substance that takes a large share of the blame for the multitude of deaths occurring around the world as a result of smoking.
But there’s another side to the story. As well as having medicinal benefits, nicotine has untapped potential as a cognitive enhancer, boosting attention, working memory and more. The problem – which you undoubtedly guessed – is that using nicotine by smoking cigarettes for its cognitive benefits is like mainlining heroin to treat your cough: it might work, but the negatives considerably outweigh the positives.
However, vaping is changing all of that.
Nicotine is Not the Bad Guy
The big misconception about nicotine – one held by most smokers questioned in several different studies, usually about two thirds of them – is that it causes cancer. It doesn’t.
The reason for opening with this is because it’s a persistent myth and it offers a hint as to why there’s so much misunderstanding about the risks of nicotine. The simple answer is that it hangs out with a bad crowd.
It’s obviously undeniable that smoking tobacco is a significant cause of cancer and a cacophony of negative health effects. Nicotine, as potentially the most widely-known chemical component in tobacco, is inherently linked to these health impacts in the minds of many people: because it’s believed to be only encountered as part of tobacco smoke, nicotine is assumed to carry a lot of risks.
The problem is that nicotine is just one of about 7,000 chemicals in cigarette smoke, and many of the others are carcinogenic and toxic. When taken out of the context of the cigarette smoke, nicotine really isn’t much to worry about at all, which is why nicotine patches, gums and other medicinal products are widely-used and recommended.
In reality, even non-smokers consume nicotine pretty much every day, with trace quantities being present in tomatoes, eggplants, potatoes and cauliflower.
Additionally, nicotine isn’t even solely responsible for the addiction to smoking. It’s one of many “alkaloids” found in tobacco, and adding these to nicotine enhances its addictive properties. In the same way, the monoamine oxidase inhibitors and acetaldehyde found in cigarette smoke have the same effect. Nicotine is addictive, but – as strange as this may sound – it isn’t as addictive as smoking.
The FDA agrees, and may be changing nicotine patch and gum labels as a result. In their words:
“Although any nicotine-containing product is potentially addictive, decades of research and use have shown that [nicotine replacement therapy] products sold [over the counter] do not appear to have significant potential for abuse or dependence.”
The Medicinal Uses of Nicotine
So maybe nicotine isn’t going to give you cancer – and probably carries similarly minimal risks to caffeine when separated from smoke – but that doesn’t mean it’s actually good, does it? Well, there are actually many conditions that could be helped by nicotine, including ulcerative colitis, depression, schizophrenia, ADHD, pain, mild cognitive impairment, Tourette’s, Alzheimer’s and Parkinson’s disease.
The list of conditions possibly helped by nicotine may be surprising, but they’re ultimately a result of its effects in the brain. The best example is the use of nicotine in Parkinson’s disease, which was the first time a potential medical benefit of nicotine was uncovered. In 1966, Harold Kahn – an epidemiologist working for the National Institutes of Health – uncovered a curious fact: non-smokers were about three times more likely to die of Parkinson’s disease as smokers.
In Parkinson’s sufferers, the neurons responsible for releasing dopamine (which you can think of as the brain’s “pleasure” chemical, but it does other stuff too) begin to deteriorate, and a drug called levodopa is used as treatment because it’s a precursor to dopamine. Nicotine also increases dopamine, however, and as well as reducing symptoms in Parkinson’s patients and slowing the progression of the disease, it can even decrease one of the more serious side effects of levodopa itself.
Schizophrenia is another key condition to consider, because about 90 percent of people with schizophrenia smoke. There is debate about the reasons for this, but the idea that they are self-medicating with nicotine is a well-supported one. Smoking reduces the negative symptoms of schizophrenia – such as apathy and lack of motivation, which may be related to deficits in the dopamine system – and could counteract some of the cognitive symptoms of the condition too. These cognitive effects, while very valuable for schizophrenic smokers, may even extend to people not suffering from a condition.
Can Nicotine Improve Cognition?
For healthy adults, potentially the most promising use of nicotine is to improve mental functioning. The reasons behind this are closely tied to the reason nicotine appears to be useful for Alzheimer’s sufferers: the nicotinic system (specifically the acetylcholine receptors that nicotine acts on in the brain) is crucial for maintaining performance on a variety of tasks. Alzheimer’s sufferers have fewer of these receptors, and treatment with nicotine can minimize the effect of this deficit.
For healthy adults, however, the effect still exists. A paper by the British psychologist David M. Warburton entitled “Nicotine as a Cognitive Enhancer” looks at the evidence on the effects of nicotine on attention and memory, suggesting that nicotine helps with various tasks requiring attention. The benefits to memory are often linked to improvements in attention (if you pay attention to something more effectively, then you’re more likely to remember it), but there are also some suggestions of improvements in memory unrelated to attention.
One example study looking at the effects of nicotine on attention involved showing people the names of colors, but with text itself in a different color. So, for example, the word “yellow” would be shown but the text would be red, and the word “green” would be shown but the text would be blue. The task is to name the color of the text rather than the color represented by the word itself, and – as you’ll be aware if you’ve ever tried it – this can be quite challenging. If you do the same task where the words aren’t related to color, people are much more efficient at answering with the color of the text itself.
The difference between completion times when color words are used to the completion times when non-color terms are used is called the “Stroop effect” (named after the task’s creator), and measures the ability to pay selective attention to the important information (the color of the text) and ignore irrelevant information (the word itself). When people were given either 1 mg or 2 mg of nicotine in the form of a tablet, the size of the Stroop effect reduced in both smokers deprived of a cigarette and non-smokers, suggesting improvements in selective attention.
Another example study looked at the ability to sustain attention, by asking participants to watch the minute hand of a clock and detect brief periods where its movement paused. The usual response is accuracy at the beginning, but a slow decrease as the task continues and attention wanes. When this test was conducted on heavy, light and non-smokers, nicotine tablets significantly reduced this waning of attention in all three groups, in comparison to a placebo run-through (with no nicotine).
Warburton explains these findings by suggesting that “nicotine ‘locks’ the brain into a state appropriate for efficient information processing.”
Are the Benefits in Cognition Limited to Smokers?
However – and as you may expect – much of the research in these areas has used people who already smoke, and they are also often deprived of nicotine prior to testing. Being in nicotine withdrawal actually decreases the ability to pay attention and other cognitive ability, and smoking (or consuming nicotine) simply reverses these deficits. The authors of a more recent study correctly point out that to be able to say nicotine enhances these abilities, the same effects would have to be observed in non-smokers or smokers not deprived of nicotine.
To test this, they submitted smokers, non-smokers and ex-smokers to three cognitive tests, either with nicotine gum or while chewing a similar-tasting placebo gum. On two out of three tests, nicotine didn’t help performance (and smokers were actually worse on working memory), but on a task measuring focused attention and the ability to visually scan information, it led to improvements in all groups of participants. The authors also point out that smokers don’t become “tolerant” to this improvement, since they benefited as much as the non-smokers did.
Other studies have also added evidence that the benefits of nicotine still exist for non-smokers. The benefits are greater for smokers, though, with improvements in working memory added to those for paying attention and visually searching for information.
Overall, the evidence suggests that nicotine does lead to some improvements in non-smokers, and although it’s clear that smokers (and groups with attention deficits, like schizophrenics) do benefit more from it, nicotine itself does have an effect on mental functioning, particularly when it comes to paying attention.
How Vaping Could Unlock the Benefits of Nicotine
So what does this all mean for smokers and vapers? A recent report from Public Health England estimated that e-cigarettes are 95 percent safer than traditional tobacco cigarettes, and although this means there is still some risk (meaning they aren’t completely safe), the difference in risk is quite substantial. In short, if you’re a smoker, switching to vaping is definitely a good idea, but if you’re a non-smoker it isn’t.
The key point is that in this considerably safer form, smokers can continue to use nicotine for its attention-boosting properties while not exposing themselves to huge health risks. Whereas the benefits of nicotine were previously dwarfed by the substantial damage from smoking, against the background of drastically reduced risk, they’re allowed to shine through.
“But,” you might be wondering, “Surely these benefits have been available for decades already because of nicotine gums and patches?” Well, as nicotine expert Jacques le Houezec points out:
“The most effective way of delivering nicotine to the brain (where most effects occur) is by smoking tobacco, particularly because smokers can modify their nicotine intake on a puff-by-puff basis (called self-titration of nicotine) […] Nicotine is then a very suitable drug by which you can get the effect you need at the time you need it, because inhalation with tobacco smoke (or now with e-cigarette vapor) brings nicotine to the brain very quickly (actually faster than an intravenous injection).”
Vaping doesn’t deliver nicotine as fast as smoking does, but the on-demand, puff-away-as-needed aspect puts it head and shoulders above nicotine gums and patches as a method for consuming nicotine. Need to read through a lot of research to find some salient information? You could stick a patch on your arm and wait a few hours, or you can just vape while you work.
The real dilemma comes in the form of non-smokers interested in enjoying the benefits of nicotine without the risks of smoking. Is it worth becoming addicted to nicotine to improve your mental functioning? The answer is one only the individual can answer for her or himself, but the similarities between nicotine and caffeine would suggest that perhaps the knee-jerk “no way!” response is more like a hangover from our awkward habit of associating nicotine with smoking than a well-considered answer.
On balance, becoming addicted to nicotine will also have some negative impacts on your mental functioning, so it’s still not advisable for the non-smoker, before you even consider the uncertainties surrounding the long-term risks of vaping. It’s better than starting to smoke, but still likely not a good idea.
For a smoker, though, if you can switch to vaping, the benefits of nicotine could easily outweigh the comparatively minor risks and the continued addiction. Switching your habit isn’t necessarily easy – after all, you get a quicker hit of nicotine and other addictive chemicals from smoking – but if you get a capable e-cigarette and explore the variety of e-liquid flavors available, making the transition can be easier than you think. Many e-liquids use artificial ingredients to produce sweet or fruity flavors, but for smokers, finding some authentic-tasting tobacco e-liquid can help to smooth the transition considerably.
For Parkinson’s patients who smoke but want to quit – or other smokers with a condition helped by nicotine – the medicinal benefits of nicotine could make vaping the ideal solution. For schizophrenia sufferers in particular, vaping offers the core self-medication benefits of smoking, but drastically reduces the associated risks. Since such a large number of schizophrenics smoke, vaping could be an absolute game-changer.
Vaping is Nicotine’s Second Chance
With vaping, nicotine has the chance to cast off its unfortunate association with the deadliest consumer product in history and step into the limelight. Non-smokers still might not be advised to start inhaling vaporized chemicals into their lungs, but for smokers (particularly ones with schizophrenia or conditions like Parkinson’s) e-cigarettes offer the surprising benefits of nicotine and the core enjoyment of smoking in a much safer package.