I’m literally the opposite of a medical expert, but I’m interested in cognitive enhancers and I have personal experience with nicotine which has convinced me that it is cognitively beneficial in the short term. Googling around, I found some research which I would say is markedly outside of the normal opinion, but I think it’s interesting and so I’m linking it and adding some commentary.
Here is a link to The Great Nicotine Myth from E-Cigarette Politics. I printed it as a PDF and have made that available here because the original site seems of mediocre quality and I’m not sure it will be around for very long.
The article argues that health issues from smoking and tobacco are not attributable to nicotine. It argues that smoking is worse than tobacco, but tobacco itself has some compounds that are unhealthy. It allows that “tobacco contains synergens and other compounds that interact with nicotine to create dependence,” but it maintains that nicotine itself is not unhealthy, and it goes into some nuanced differences between addiction and dependence which are often passed over elsewhere. Humans are considered dependent on water, but not addicted, for example.
The article finally argues that nicotine might be classified as a B Vitamin, like niacin to which is biochemically and historically related. This is in direct opposition to the usual view, well-represented by Stanford here, which holds that nicotine is harmful. Stanford states that nicotine competes with nicotinamide, also called Vitamin B3, for absorption, and this is one reason smokers have problems.
In the first place, it’s a classic mainstream mistake to refer to research on smokers as evidence against nicotine. In the second place, on the controversial view from E-Cigarette Politics, one might just as easily argue that Vitamin B3 is crowding out nicotine. I think a less controversial view from me, as a non-medicinal expert, would be to split the difference. Why say either is crowding out the other? Why not consider them as biochemically substitutable. That seems to be the view taken by the human body when it allows either to bind in the use case Stanford talks about. Anecdotally, I would say I feel at least as energized by nicotine intake as by Vitamin B3 intake.
Some other related notes:
- Mainstream science acknowledges that there are safer and less safe ways to consume tobacco. In general, smoked tobacco is more strongly associated with cancer and more dangerous for other reasons too. Smokeless tobacco is less dangerous, and because snus is pasteurized it is particularly safe.
- The types of cancer generated are also less dangerous. Cancer of the lip and mouth are more treatable and less life-threatening compared to lung cancer.
- “Snus was estimated to confer only 5% of the harm of cigarettes.” according to this source and “experts perceive at least a 90% reduction in the relative risk” according to this source.
- According to the CDC, “Life expectancy for smokers is at least 10 years shorter than for nonsmokers.” Combined with the more conservative expert harm reduction figure above, then, long-term snus users would suffer 1 year of reduced lifespan relative to non-users.
- According to other research, “There was little difference in health-adjusted life expectancy between smokers who quit all tobacco and smokers who switch to snus (difference of 0.1-0.3 years for men and 0.1-0.4 years for women).” according to this source.
- According to E-Cigarette Politics, then, snus may be about as safe as caffeine, and pure nicotine is even safer.
- For practical purposes, I think we can estimate the economic tradeoff of life quantity vs quality using the conservative estimate of 1 year of lost life for long-term snus users. It seems to be an even more conservative and safe analysis when we replace snus with nicotine gum or patches.
- Mainstream science acknowledges that there are better and worse ways to ingest nicotine.
- Mainstream science acknowledges that nicotine by itself is not habit-forming. A 2007 paper in the journal Neuropharmacology is quoted secondhand via Scientific American, saying, “Tobacco use has one of the highest rates of addiction of any abused drug. Paradoxically, in animal models, nicotine appears to be a weak reinforcer.” The same article suggests nicotine patches are the safest way to take nicotine.
- It seems like using a patch for a long time has no significant side effects and no association with cancer.
- Hopkins recommends, apparently without preference, nicotine gum, patches, and inhalers as tools to help quit smoking, even while arguing that e-cigarettes and vaping aren’t safe. They seem to gloss over other research which indicates that vaping safety varies greatly by ingredients.
- If tobacco does contain nicotine synergens, I wonder what they do. It seems they tend to generate cancer, but do they also improve the stimulatory or other positive qualities of nicotine?
- What about cocaine? It seems to acutely improve mental performance, but, unlike with nicotine, long-term use leads to partially reversible cognitive impairment.
- Black Buffalo is a tobacco-free snuff made from adding nicotine to processed leafy greens. I’ve never tried it but I thought it was an interesting alternative. Allegedly the texture and flavor are similar to traditional tobacco, but I can’t attest to that.
- Nicotine and caffeine can synergize to burn calories and reduce appetite while producing higher mental and physical performance.
- If you do this, consider pairing with water and an anti-oxidant. Related research here.
- 1mg nicotine combined with 100mg caffeine has a thermogenic response of about 8.5% with few side effects. Increasing nicotine to 2mg increases side effects for most people and increased the response point-estimate to 9.8%, but I understand that wasn’t significant given the sample size of the above study.
So, mainstream medicine seems to indicate gum or patches for those who want to take nicotine in a relatively safe way. I tend to buy mint gum anyway for the mornings that I don’t brush my teeth, and it seems to be a less socially detectable tool. The action of chewing gum, even without nicotine, improves alertness and burns calories. So I seem to lean that way among the two options.
Lastly, I would be remiss if I did not sprinkle some economics on top of the information described above. Everyone faces a tradeoff between quality and quantity of life. Qua economist, some people will be better off using nicotine because they have a set of preferences that indicate some drug improves the quality of life, and they are willing to trade marginal quantity for quality.
While the above argument works for essentially any drug, there is an additional argument from productivity we can make for nicotine, and other drugs within the general categories of uppers and nootropics. Such drugs improve productivity in some manner, in contrast to downers and hallucinogens. On the economic view, rather than the medical view, it can hardly be claimed that trading marginal health for marginal productivity is always or even usually a bad choice.