Understanding nicotine
Nicotine is a chemical compound produced in the nightshade family of plants like potatoes, eggplants, tobacco plants, etc. It is found in the leaves of Nicotiana tabacum.1
However, the amount of nicotine produced in the tobacco plant is maximum compared to other nightshade varieties of plants.
Nightshades contain alkaloids which are chemicals containing nitrogen, known to affect the human body if taken beyond limits.
Where can we get nicotine?
Nicotine is available in all tobacco products that includes cigarettes, hookahs, cigars, chewing tobacco, snuffing tobacco, etc. The percentage of nicotine is the maximum in cigarettes. However, it varies from brand to brand.
What are the effects of nicotine on our body (Pros and Cons)
According to the statistics of the World Health Organization (WHO), tobacco kills more than 8 million people every year.2 More than 7 million deaths are due to direct tobacco use whereas, around 1.2 million deaths are due to exposure to smoking among non-smokers (passive smokers.)
McNeill says. "Smoking a tobacco cigarette is one of the best ways of getting nicotine to the brain - it's faster even than intravenous injection."
Nicotine is highly addictive, adversely affects human organs like the lungs, kidneys, brain, and reproductive system and contains carcinogenic properties.
- Effect on the respiratory system- Exposure to nicotine through smoking causes emphysema in smokers.3 Emphysema is a lung condition where there the air (alveoli) present in the lungs get damaged and gradually ruptures restricting the flow of oxygen going inside. Smokers find it difficult to breathe
- Effect on the gastrointestinal system- There is an increased incidence of GERD (Gastroesophageal Reflux Disease) and peptic ulcer among nicotine users. Nicotine causes smooth muscle relaxation. The reduced gut motility and decreased pressure of the lower oesophageal sphincter might be the reason behind this
- Effect on the immunological system- This system is compromised in smokers. One of the main reasons why tuberculosis and smoking are related. Nicotine use causes a decrease in the number of T cells in the body which is considered to be the first one to fight against tuberculosis. In tuberculosis, these T cells become dysfunctional
- Effect on the renal system- The risk is high in smokers and is related to increase mortality in patients with chronic kidney disease
- Effect on the reproductive system- In males, chronic nicotine use might cause loss of penile erections and erection dysfunction.3 In females, an irregular menstrual cycle, and the decreased blood flow to oviducts cause impaired fertilization. Maternal smoking has some dangerous effects on the fetus or the newbor
- Effect on metabolism- Nicotine affects insulin resistance thereby increasing the chance of diabetes mellitus in smokers
- Effect on the cardiovascular system- Heart disease is common among smokers. There is altered blood pressure, and heart rate in chronic smokers
Coming to the pros of nicotine, nicotine releases neurotransmitter (that keeps the brain functioning) like catecholamines and serotonin and causes:
- Positive or negative4 reinforcement
- Reduction in body weight
- Protects against Parkinson’s Disease, Alzheimer’s Disease, Tourette’s Disease, and sleep apnea
- The reliability of these effects varies greatly
Is nicotine addictive?
Yes, nicotine is very addictive.
Cigarette smoking→enters the lungs→absorbed in the blood→delivers to the brain.
The release of endorphins after inhalation of nicotine produces a rewarding effect. Smoking produces pleasurable effects, improving cognition and memory in the acute stage,5 making the person more addicted to nicotine to let the rewarding effect last longer.
How does nicotine affect the muscle growth
Smoking leads to multiple organ dysfunction. The effect of nicotine on skeletal muscle is unknown. However, some evidence showed that smoking might impair physical function causing the wasting of muscles (sarcopenia).7
- Bone: Nicotine reduces bone density leading to osteoporosis in chronic smokers. Osteoporosis makes the bones more susceptible to fracture
- Age: Smoking alters protein metabolism leading to loss of independence and disability as age progresses
- Muscle growth: With impaired protein synthesis in smokers, there is an increased expression of myostatin (muscle growth inhibitor) causing atrophy or wasting of muscles
- Protein synthesis: Comparative study findings showed that basal protein synthesis has markedly reduced in middle to old-aged heavy smokers than those who had never smoked of the same age groups. The impaired protein synthesis could be due to the direct effect of nicotine or the indirect intake of other toxic byproducts like alcohol, cigarettes, lifestyle diseases, etc
- Blood vessels: Arteries and veins regulates blood pressure and oxygenate the tissues.6 Smoking increases smooth muscle proliferation in the arteries causing the building up of plaques in the blood vessels
Sarcopenia was present even after lifestyle modification, changing physical activities etc. suggesting sarcopenia is due to smoking or the indirect effects of smoking.
Lowering nicotine intake
There is no safe level of cigarette smoking or intake of nicotine-based products. If you are a chronic smoker, stopping abruptly might show withdrawal symptoms like increased blood pressure, anxiety, lack of sleep, arrogant behaviour, etc.
Instead, try quitting it by cutting down the number each day.
Set goals to stop quitting by a fixed date- setting a goal always helps and makes the journey determined.
Switching to a walk or getting busy with something you like the most when the craving rises.
Nicotine replacement therapies
- The US Food and Drug Administration (FDA) has approved 5 forms of NRT:8 It is advised to read all the instructions carefully before using NRTs. NRTs are safe for adults except for teens and pregnant women
- Patch
- Gum
- Inhalers and Nasal spray (a prescription is mandatory)
- Lozenges
- Many people switch to vaping or E-cigarettes / e-juices/ vape juices because it is cheaper than traditional ones
All these have got side effects but it is a good way that helps you quit nicotine. However, smoking and vaping are equally bad for health and not the best aid for smoking cessation. Vaping causes inhalation of aerosol which is toxic to your health.
Summary
Nicotine intake affects millions of people worldwide and the industry is blooming. A common misconception about nicotine is that it is the primary reason for smoking-related diseases. Whereas, nicotine is toxic when it is burnt in the form of cigarettes, hookahs, etc. produces carbon monoxide, tars, and toxic chemicals, that cause serious damage to the body. The cost to treat disease results from nicotine-related drugs is enormous. Taking a piece of advice from your doctor for smoking cessation and incorporating self-awareness, and modifying lifestyle activities will help you to live a nicotine-free life.
References
- Products C for T. Nicotine is why tobacco products are addictive. FDA [Internet]. 2022 Sep 27 [cited 2022 Oct 7]; Available from: https://www.fda.gov/tobacco-products/health-effects-tobacco-use/nicotine-why-tobacco-products-are-addictive
- Tobacco [Internet]. [cited 2022 Oct 7]. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco
- Mishra A, Chaturvedi P, Datta S, Sinukumar S, Joshi P, Garg A. Harmful effects of nicotine. Indian J Med Paediatr Oncol [Internet]. 2015 [cited 2022 Oct 7];36(1):24–31. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363846/
- Jarvik ME. Beneficial effects of nicotine. Br J Addict. 1991 May;86(5):571–5.
- Abuse NI on D. Is nicotine addictive? [Internet]. National Institute on Drug Abuse. -- [cited 2022 Oct 7]. Available from: https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/nicotine-addictive
- Hafen BB, Shook M, Burns B. Anatomy, smooth muscle. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Oct 7]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK532857
- Petersen AMW, Magkos F, Atherton P, Selby A, Smith K, Rennie MJ, et al. Smoking impairs muscle protein synthesis and increases the expression of myostatin and MAFbx in muscle. American Journal of Physiology-Endocrinology and Metabolism [Internet]. 2007 Sep [cited 2022 Oct 7];293(3):E843–8. Available from: https://journals.physiology.org/doi/full/10.1152/ajpendo.00301.2007
- Nicotine replacement therapy to help you quit tobacco [Internet]. [cited 2022 Oct 7]. Available from: https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking/nicotine-replacement-therapy.html