Nicotine often is villainized by anti-tobacco advocates as being as harmful as smoking combustible cigarettes. Photo credit: PxHere.
The World Health Organization (WHO) accused tobacco companies of trying to get young people addicted to nicotine in their latest report, Hooking the Next Generation. The report is largely focused on WHO’s accusations of how the industry is developing and marketing heated tobacco products (HTP), vapes, and nicotine pouches. “History is repeating, as the tobacco industry tries to sell the same nicotine to our children in different packaging,” Tedros Adhanom Ghebreyesu, WHO director-general, is quoted as saying in the report. It is apparent that once again, WHO is tarring nicotine with the same brush as, well, tar and the other harmful carcinogens and chemical substances that are combustion by-products.
As we know, nicotine often finds itself at the center of discussions about smoking-related health issues, largely painted as the primary villain responsible for a myriad of diseases, including cancer. However, this perception is rooted in misunderstanding, albeit one that is being wielded as a key instrument by the anti-tobacco sector from grassroot levels all the way up to international bodies. Messages from the anti-tobacco advocates regularly equate the risks of nicotine use to those of smoking combustible cigarettes.
Debunking the myth with science
Scientific research challenges the view that nicotine is solely harmful. Nicotine has shown potential benefits in preventing neurodegenerative diseases like Parkinson’s and Alzheimer’s. Additionally, in individuals with Parkinson’s, nicotine intake has been linked to faster processing of complex tasks. Nicotine also positively affects memory by targeting brain regions involved in visual attention and cognitive processing. These benefits are likely due to nicotine’s neuroprotective properties, which stimulate nicotinic cholinergic receptors in the brain. Animal studies suggest that nicotine can protect neurons from degeneration, improve motor skills, and enhance cognitive functions. Moreover, nicotine has been found to enhance wakefulness by increasing brain activity and inducing alpha brainwave patterns, which improves attention, alertness, and creativity. It affects various brain regions associated with arousal and motor activation. Additionally, studies on animals and humans have demonstrated that nicotine can aid in weight loss by suppressing appetite and improving insulin sensitivity and blood sugar levels.
Moving forward: a rational approach to nicotine
In moving forward, a rational approach to nicotine is essential. This involves not only distinguishing it from the harmful effects of tobacco smoke but also exploring its potential benefits under controlled use. The path to a healthier society involves clear, science-based education and regulation, ensuring that individuals have access to safer alternatives and accurate information about the real risks and benefits associated with nicotine.
During a panel discussion at the recent GTNF, panelists emphasized the urgent need for accurate information and education about nicotine, advocating for global efforts to correct misconceptions and effectively promote harm reduction strategies. The panelists unanimously stressed the importance of engaging respectfully with all perspectives in the debate, basing policies on scientific evidence, and maintaining transparency in public health communications.
Jasjit S. Ahluwalia, professor of behavioral and social sciences and professor of medicine at the Center for Alcohol and Addiction Studies at the Brown University School of Public Health and Alpert School of Medicine emphasized the importance of engaging with dissenting viewpoints, highlighting the significant common ground and shared goals in harm reduction efforts. Dave Dobbins, former c.o.o. at the American Legacy Foundation/Truth Initiative, and consultant to Altria, emphasized the significance of listening to all viewpoints in the nicotine debate with empathy.
He criticized current tobacco control initiatives, noting they are often driven by individuals who do not have direct experience with nicotine use. Delon Human, specialist family physician and president of Health Diplomats, criticized WHO for its inconsistent and ambiguous position on nicotine, often conflating tobacco use with nicotine use. He emphasized the importance of WHO and related organizations adhering strictly to scientific evidence.
Human highlighted significant internal opposition to nicotine within WHO, emphasizing that changing this perspective will require considerable time and effort. He also critiqued Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC), which excludes the tobacco industry from discussions. According to Human, this exclusion undermines scientific progress, obstructs policy development, and ultimately leads to unnecessary loss of life. Sudhanshu Patwardhan, nicotine expert and health tech entrepreneur, advocated for a worldwide initiative on nicotine literacy aimed at educating healthcare professionals and aligning public policies with scientific research.
He underscored the crucial role of healthcare providers as advocates for evidence-based practices, especially in effectively communicating safer alternatives to combustible cigarettes. Patwardhan further emphasized the importance of implementing sensible regulations that foster industry collaboration and support.
Nicotine has been unjustly vilified as the primary cause of smoking-related diseases. Effective regulation and public education are essential in shifting the narrative around nicotine and smoking. By focusing on harm reduction, promoting safer alternatives, and providing accurate information, we can better address the public health risks associated with smoking. Understanding nicotine’s role and effects can lead to more effective strategies.