Nicotine Effects
A variety of ingredients in tobacco smoke cause cancer, heart disease, and lung disease. Nicotine is not one of them.
Nicotine is believed to be addictive because people have a great deal of difficulty giving up smoking. But there are major differences between nicotine and drugs such as alcohol, heroin, cocaine, and methamphetamines that people use to "get high. For one thing, nicotine does not cause intoxication. It does not impair judgement, motor skills, or the ability to get along with others. In fact, it improves these abilities.
Nicotine Benefits
Nicotine is being considered as a therapeutic agent to treat such conditions as attention deficit disorder, Alzheimer's Disease, Parkinson's Disease, Tourette syndrome, sleep apnea, obesity, ulcerative colitis, obesity, and inflammatory skin disorders. [1]
Nicotine has the following benefits:
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Relieves depression [2]
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Reduces anxiety [3]
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Improves ability to concentrate and long term memory [4]
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Protects against developing high blood pressure [5, 6]
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Protects against weight gain [7]
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Protects against developing Parkinson's Disease [8]
Nicotine Abstinence
Theoretically, the healthiest thing a smoker can do is to totally give up using nicotine in any form. But does reality conform to the theory?
The official list of nicotine withdrawal symptoms in the Diagnostic and Statistical Manual (DSM-IV) includes depressed mood, sleep disturbance, irritability, anxiety, difficulty concentrating, restlessness, decreased heart rate, and increased appetite or weight gain. These symptoms are supposed to peak within a day or so and disappear altogether after a couple of weeks. However, researchers have found that in some groups of quitters, symptoms do not dissipate and can, in fact, worsen as time goes on. [9]
The problems with concentration, memory, and mood make it difficult to fulfill responsibilities of daily living. How many employers are willing to overlook impaired job performance for weeks or months at a time? What effect does prolonged irritability that sometimes escalates into anger have on relationships with family, coworkers, and friends?
For many would-be abstainers, the Catch 22 is that some improvements in physical health—for example, better lung function—must be paid for with possibly permanent declines in cognitive and emotional health. Is it any wonder that so many relapse to smoking within a few days of quitting?
For those who do manage long-term nicotine abstinence, the picture is not 100% better in terms of physical health. For years the medical community claimed that smokers only gained 5 pounds after quitting. More recent studies reveal that the average weight gain is closer to 5 kilograms (11 pounds), accompanied by an average increase in waist circumference of 3.88 cm. [10] In 13 percent of women and 10 percent of men, weight gain exceeds 28 lb. The weight gained with smoking cessation is very resistant to weight loss interventions. [11]
Smokers who become nicotine abstinent develop hypertension at a higher rate than continuing smokers and those who are at risk for diabetes develop that disease 26% more often than continuing smokers. [12]
Conclusion
Those at risk of long-term cognitive and/or mood impairments, hypertension, and diabetes, should be allowed to pursue smoking cessation through permanent replacement of adequate amounts of nicotine using a reduced-harm smoking alternative. In view of the fact that alternatives that are reduced-harm to a smoker are totally without harm to general society, there is no compelling reason to deny reduced-harm alternatives to anyone who wants to take advantage of the beneficial effects of nicotine.
[1] Powledge (2004). Nicotine as Therapy. PLoS Biology. 2004 Nov; 2(11). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC526783/
[2] Bertrand (2005) The possible contribution of neuronal nicotinic acetylcholine receptors in depression. Dialogues in Clinical Neuroscience. 2005;7(3):207-16. http://www.ncbi.nlm.nih.gov
[3] Cohen (2009). Anxiolytic effects of nicotine in a rodent test of approach-avoidance conflict.. Psychopharmacology (Berl). 2009 Jun;204(3):541-9. http://www.ncbi.nlm.nih.gov/
[4] Warburton (1992). Nicotine as a cognitive enhancer. Progress in Neuropsychopharmacology and Biological Psychiatry. 1992 Mar;16(2):181-91. http://www.ncbi.nlm.nih.gov/
[5] Dowling (2007). Nicotine inhibits cytokine production by placenta cells via NFkappaB: potential role in pregnancy-induced hypertension. Molecular Medicine. 2007 Nov-Dec;13(11-12):576-83. http://www.ncbi.nlm.nih.gov/
[6] Lee (2001). Effects of smoking cessation on changes in blood pressure and incidence of hypertension : a 4-year follow-up study. Hypertension 2001 Feb;37(2):194-8. http://www.data-yard.net/
[7] Nordstrom (1999). Long-term effects of nicotine gum on weight gain after smoking cessation. Nicotine & Tobacco Research. 1999 Sep;1(3):259-68. http://www.ncbi.nlm.nih.gov/
[8] Huang (2009). Multiple roles for nicotine in Parkinson's disease. Biochemical Pharmacology. 2009 Oct 1;78(7):677-85. http://www.ncbi.nlm.nih.gov/
[9] Piasecki (1998). Profiles in discouragement: Two studies of variability in the time course of smoking withdrawal symptoms. Journal of Abnormal Psychology. Vol 107(2), May 1998, 238-251. http://psycnet.apa.org/
[10] Pisinger (2007). Waist circumference and weight following smoking cessation in a general population: the Inter99 study. Preventive Medicine. 2007 Apr;44(4):290-5. http://www.ncbi.nlm.nih.gov/
[11] National Heart Lung and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. http://www.nhlbi.nih.gov/
[12] Smith (2005). Incidence of type 2 diabetes in the randomized multiple risk factor intervention trial. Annals of Internal Medicine. 2005 Mar 1;142(5):313-22. http://www.ncbi.nlm.nih.gov/
