TL;DR: All tobacco products are highly addictive, cause cancer, and damage your entire body when smoked. Nicotine alone doesn’t cause cancer, but messes up your brain chemistry for months and is highly addictive.
Introduction
Tobacco is one of the most commonly used recreational drugs worldwide, with an estimated 1.27 billion users [6]. According to some sources, it is the leading cause of preventable cancers and accounts for about 5.5 million deaths yearly. In 2003, an international treaty was signed by 170 countries to reduce the use of tobacco products. Currently, the annual world-wide market is estimated at $932 Billion USD and is growing at a rate of 1.8% per year [12].
1949 cigarette ad, before heavy regulation of marketing
The main psychoactive compound in tobacco is nicotine, which is a stimulant drug. It is highly addictive and affects essentially every system in the body. This article will discuss what nicotine is, how it affects the brain, the health effects of its different forms, addiction, and it’s one silver lining.
What is Nicotine?
Left: The chemical formula for nicotine. Right: a bottle of pure nicotine
Nicotine is a stimulant drug, naturally made in nightshade plants, and is used recreationally across the planet. It is highly addictive. It is found in the highest concentrations in the tobacco plant, at 0.6 – 3.0% of dry weight, and in insignificant amounts of around 0.0001% in nightshades like potatoes, tomatoes, etc. Smoking tobacco, including cigarettes, is by far the most common source of nicotine, which has its own health risks and effects.
Nicotine is a plant defense compound designed to stop herbivores from eating it. It is classified as a poison, but there don’t appear to be strong links to cancer or poisoning in humans, except when handling tobacco leaves for long periods of time. Nicotine causes birth defects in some animals, but not others. It also appears that nicotine disrupts adolescent development.
| Method of ingestion | Smoking, nicotine patch, chewing gum, vaporizer, hookah etc. |
| Typical dose | 1 – 10mg (2mg of absorbed nicotine in the average cigarette) [1] |
| Lethal dose | 500 – 1,000 mg for the average adult (6.5 – 13 mg/kg) |
| Half-life | 1 – 2 hours |
| Timing of peak | Inhaling: peak nicotine blood levels are reached in secondsPatches: 5-10 hours after application [2] |
| How does it feel? | Increased alertness, focus, feeling good, and relaxation for frequent usersNew users experience a “buzz” for less than a minute with lightheadedness, and may experience some of the short term side-effects belowUsers feel relatively “normal”, no hallucinations or psychological impairment |
| Addiction potential | High – similar to morphine. More addicting than caffeine or alcohol. |
| Short term side-effects | May include nausea and loss of appetite, headache, dry mouth, coughing, dizziness, nervousness, sleep disturbances, increased alertness and cognitive performance, elevated blood pressure and heart rate [1] |
| Long term side-effects | Cigarettes cause disease of every system in the body including cancers, heart disease, stroke, lung disease, diabetes, and COPD. Tar eventually coats the lungs, teeth, and throat. An estimated 16 million Americans (5%) live with a disease caused by smoking. [3] Half of those who start smoking die from it [4]. According to www.cancer.org, in the US roughly 1 in 5 deaths are from tobacco products [8]. Many studies have shown that nicotine alone acts as a carcinogen and that it adversely affects the heart, reproductive system, lungs, kidneys, and nervous system. It increases oxidative stress and death of neurons, DNA damage, and reactive oxygen species – all of which accelerate aging. There is also some evidence that it changes adolescent brain development affecting intelligence. [6] |
| Uses | Nicotine patches to wean off of cigarettes (limited evidence of success)Pesticide on crops (more common historically)RecreationStimulation and enhanced cognitionLooking cool |
| Summary | Nicotine is highly addictive, has a short half life of an hour or two, gives you a short term feeling of alertness and feeling good, affects a huge range of systems in the body, and is deadly long-term when smoked in the form of tobacco. |
How Does Nicotine Affect Your Brain?
Inhaled tobacco smoke, which is partially nicotine, is absorbed through our lungs into our bloodstream and the nicotine reaches the receptors in our brain in less than 10 seconds. From here it activates receptors actually designed for acetylcholine.
Acetylcholine is a critical neurotransmitter responsible for attention and focus. Every cell type in the brain has a receptor for it. This is likely why it has such a diverse range of effects on every system in our body. Acetylcholine receptors are also found in cells outside of the brain and nervous system.
One such type of cell are dopaminergic neurons in a region of the brain called the nucleus accumbens. When nicotine activates the acetylcholine receptors on them, they release dopamine, which in the short-term makes us feel good. Dopamine release is involved in all addictive drugs – it is a key reward signal our bodies use to tell us to do more of something.
GABA and serotonin are also released, making us feel more relaxed and happy. In the hippocampus, and prefrontal cortex, glutamate and acetylcholine are released – these are important for learning, memory, and concentration.
It takes 6-12 weeks of abstinence to return to a normal level of nicotinic receptors (any receptor triggered by nicotine)
Tolerance develops because acetylcholine receptors desensitize to the bombardment of nicotine. At the same time, the brain adapts by creating more acetylcholine receptors, which may have to do with the notorious withdrawal symptoms. So, there are more receptors that are less sensitive. [11]
All of these neurotransmitters are essential for us and releasing more might seem like a good thing. However, the effects fade fast and we are left with desensitized receptors and the physical and psychological desire for more to get us back to the high we momentarily experienced. This, in addition to the negative health effects discussed suggest that nicotine harms the brain and entire body.
Is Tobacco or Nicotine Bad For You?
Yes, smoking tobacco stresses almost every system in the body, increasing the risk of dozens of diseases. Nicotine, which is the active ingredient in tobacco, appears to be much less harmful by itself, but still has negative long term effects. Cigarettes, a common form of smoking tobacco, are extremely harmful. There doesn’t appear to be any healthy way of smoking tobacco.
Cigarettes
[a]
According to the National Cancer Institute, cigarettes contain more than 250 harmful chemicals, 69 of which are known carcinogens including arsenic, formaldehyde, nickel, carbon monoxide, and cyanide. [3] According to another source, smoking exposes users to over 7,000 chemicals [9].
Cigarettes cause disease of every system in the body causing cancers, heart disease, stroke, lung disease, diabetes, and COPD. Tar eventually coats the lungs, teeth, and throat. An estimated 16 million Americans (5%) live with a disease caused by smoking. [3] Half of those who start smoking die from it [4].
Secondhand smoke also causes stroke, lung cancer, and coronary heart disease in adults. In children, it increases the risk of sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory problems and slower lung growth. [3]
Reading the appetizing Wikipedia description of how they’re made brings the point home [7]:
“Most commercial cigarettes contain a reconstituted tobacco product known as sheet, which consists of “recycled [tobacco] stems, stalks, scraps, collected dust, and floor sweepings”, to which are added glue, chemicals and fillers; the product is then sprayed with nicotine that was extracted from the tobacco scraps, and shaped into curls.”
[g]
Looking at how commercial cigarettes are made, one might wonder why not just smoke pure tobacco cigarettes if you can? You would think this would help, however according to cancer.org, those who smoke hand-rolled cigarettes throughout their lives show even higher cancers of the throat and mouth compared to commercial cigarettes. Perhaps people who roll their own cigarettes are likely to smoke more, but the bottom line is that there doesn’t appear to be a healthy form of tobacco smoking [9].
Tobacco-Specific Nitrosamines (TSNAs) are a group of some of the most potent carcinogens known. They are present in unprocessed tobacco and rise to high levels after the curing and drying process.
Furthermore, smoking of any kind is harmful. One reason for this is that we inhale carbon monoxide, a toxic by-product of incomplete combustion of carbon-based fuels like tobacco or any other plant [10]. Fine particles and carbon dioxide are also risks. For more on a similar topic, read our article on cannabis.
Other Tobacco Forms
[d]
Hookah smoke contains 36 times the tar, 15 times the carbon monoxide, and 70% more nicotine than cigarette smoke does. An hour of average hookah smoking is equivalent to smoking 40 to 400 cigarettes. It seems easier to smoke more with a hookah than other forms. [9]
Cigars contain tobacco that has been dried, aged, and fermented in stages resulting in chemical and bacterial changes. This is what makes it different from cigarettes, described above. Some cigars have the equivalent amount of nicotine as an entire pack of cigarettes – the average cigar contains roughly 100 – 200mg.
Nicotine Vaporizers
The Juul nicotine vape [e]
Nicotine vapes, like the Juul, have become popular in recent years, especially with teenagers. According to a 2017 survey, almost 3 million US high school students and 670,000 middle school students use tobacco products. 2.1 million of these are e-cigarettes. [5] In addition, use in 2019 more than doubled over 2018 [11].
Although vaporizers may not contain the 250 harmful chemicals that cigarettes do, there are thousands of flavours that use chemicals untested for toxicity when vaped [5]. Long term effects of vaporizers may be unknown for many more years.
Vapes and e-cigarettes have faced backlash due to harm and potential harm to young users. Juul alone has faced several lawsuits pertaining to potentially misleading marketing. [5]
Pure Nicotine – Patches and Gums
[f]
Almost all of the negative effects of cigarettes come from smoking of tobacco, and not the nicotine itself. Nicotine patches and gums don’t have these additives and release nicotine much more slowly than cigarettes.
Still, many studies have shown that nicotine alone acts as a carcinogen and that it adversely affects the heart, reproductive system, lungs, kidneys, and nervous system. It increases oxidative stress and death of neurons, DNA damage, and reactive oxygen species – all of which accelerate aging. There is also some evidence that it changes adolescent brain development affecting intelligence. [6]
This makes sense after all as nicotine is a poison designed by plants like the tobacco plant to prevent consumption, and has even been used as a pesticide since the 17th century [6].
Click here for a meta-analysis of 90 studies on the effects of pure nicotine on your body.
Addiction
Nicotine is one of the most addictive recreational drugs around – about on par with even morphine, making it more addictive than cocaine, alcohol, caffeine, and THC. Heroin is the only common recreational drug we see that is more addictive.
Nicotine’s high addiction potential causes it to have an especially strong effect on developing brains. 90% of smokers start smoking before the age of 18 [5].
Can Nicotine Be Used Constructively?
According to Wikipedia, “A 2010 meta-analysis of 41 double-blind, placebo-controlled studies concluded that nicotine or smoking had significant positive effects on aspects of fine motor abilities, alerting and orienting attention, and episodic and working memory.”
Seeing as this meta-study contained 41 well controlled studies, the results are quite statistically significant. Nicotine does enhance mental performance, though considering the half-life of 1-2 hours, nicotine will have to be taken frequently to maintain the effects unless a patch is used for extended release. Seeing as it is highly addictive, there are likely better alternatives for mental enhancement. See our article on smart drugs here, and an article dedicated to modafinil specifically here.
As nicotine becomes less tied to the negative image of cigarettes, there appears to be some potential to use it therapeutically. Some research shows that nicotine may help with cognitive and motor performance in Parkinson’s disease. Other research is looking into what benefits it may have in easing symptoms of ADHD [4]. Perhaps nicotine isn’t all bad.
Conclusion
Nicotine and tobacco products are quite unhealthy. They increase the risk of cancers, and damage every organ system in our body. Cigarette smoke exposes users and second hand users to thousands of chemicals, 69 of which are known carcinogens. No form of tobacco smoking appears healthy, and pure nicotine alone is harmful to many systems in the body, though it doesn’t have the same negative health effects as smoking.
Tobacco is one of the most widely used drugs in the world and is responsible for millions of deaths each year. Tobacco contains nicotine, a psychoactive stimulant drug that binds to receptors designed for the acetylcholine neurotransmitter. This stimulates the release of dopamine, GABA, acetylcholine, and serotonin, which makes us feel good and temporarily gives us better memory and focus. However, this also makes it highly addictive and leaves us with desensitised neurotransmitters that take months to return to normal – in addition to strong withdrawal symptoms.
References
[1] https://en.wikipedia.org/wiki/Nicotine
[2]https://www.discountnicotinegum.com/nicotrol_patches/faq.asp#:~:text=How%20long%20does%20does%20it,10%20hours%20after%20correct%20application.
[3] https://www.cdc.gov/tobacco/basic_information/health_effects/index.htm
[4] https://www.scientificamerican.com/article/is-nicotine-all-bad/
[5] https://www.healthline.com/health-news/heres-how-nicotine-affects-the-body#More-teens-interested-in-e-cigarettes-
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363846/
[7]https://en.wikipedia.org/wiki/Cigarette#:~:text=Most%20commercial%20cigarettes%20contain%20a,from%20the%20tobacco%20scraps%2C%20and
[8] https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/is-any-type-of-smoking-safe.html#:~:text=There’s%20no%20proof%20they%20are,including%20tar%20and%20carbon%20monoxide.
[9] https://www.medicinenet.com/hookahs_vs_cigarettes_addiction_and_health_dangers/article.htm
[10] https://www.verywellmind.com/the-health-hazards-of-roll-your-own-cigarettes-2825284#:~:text=Many%20smokers%20believe%20that%20rolling,rolled%20cigarettes%20are%20no%20exception.
[11] https://elemental.medium.com/your-brain-on-nicotine-668c0b6a079e
[12] https://www.grandviewresearch.com/industry-analysis/tobacco-market
Images
[a] https://consumer.healthday.com/media-library/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzYzMTY0My9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNDA1NjcxMX0.5rLDFFRoON3YEfLB5AsbcOcvUCv-IHMOhq6uT6odX-g/image.jpg?width=1245&quality=85&coordinates=0%2C74%2C0%2C75&height=700
[b] https://teens.drugabuse.gov/blog/post/why-nicotine-so-addictive
[c] https://image.made-in-china.com/2f0j00pgbYauqcuIkz/99-9-1000mg-Ml-Liquid-Nicotine-Pure-Nic.jpg
[d] https://cdn.the-scientist.com/assets/articleNo/65286/aImg/30158/tobacco-plants-l.jpg
[e] https://www.ft.com/__origami/service/image/v2/images/raw/http%3A%2F%2Fcom.ft.imagepublish.upp-prod-us.s3.amazonaws.com%2F6b1f4d88-b69e-11e9-8a88-aa6628ac896c?fit=scale-down&source=next&width=700
[f] https://www.nicodermcq.com/amp/img/nd-prod-dosage-mb.png
[g] https://www.illinoispoisoncenter.org/CMSPages/GetAzureFile.aspx?path=~\ipc\media\illinois-poison-center\mca%20images\istock-1133345196.jpg&hash=4cfaa16c10688bf24eb1b7947e8b1977914c7be783aff62d23b77aa33d6e95f1
[h] https://archives.drugabuse.gov/sites/default/files/images/colorbox/receptors.jpg
