Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. This week I’m going to talk about NICOTINE, the dreaded substance that’s been linked to tobacco for years. Although you may think there is nothing more to say, there’s another side to the story that needs to be told.  

Let’s dive in!




Unfortunately, nicotine has been doomed because of its association with smoking. Nicotine is the most “famous” part of tobacco, which links it to all the harms of smoking: 

  • Heart Disease
  • Emphysema 
  • Cancer

But the truth is, the nicotine in tobacco is the only thing that doesn’t cause these diseases. Nicotine actually has benefits, especially with neurodegenerative diseases. It is good for the brain! 


How it Works


Nicotine binds to acetylcholine (receptors in your brain) and stimulates the cholinergic system in your body. This neurotransmitter called acetylcholine controls muscle contraction, and also works with the immune system. Nicotine regulates inflammation and stimulates other neurotransmitters like: serotonin, epinephrine, norepinephrine, and most importantly dopamine (that reward neurotransmitter that we talk about all the time). That’s why it’s so addictive, especially when smoked. 

Note: Dopamine helps people focus. It relaxes them. It delivers pleasure. Dopamine helps Parkinson’s Disease (a disease of dopamine depletion). In fact, those who smoke have a lot less incidence of Parkinson’s, most likely because of nicotine. 

When you smoke, nicotine hits your brain in about 8 seconds. It makes you want more! Personally, I never could figure out why people wanted to smoke. It must be because of the nicotine. People who smoke know they are gumming their lungs up and causing all kinds of problems, yet they smoke anyway.  

I have patients who come see me who are overweight, have multiple other problems, and are nit picky about their hormone levels. Then, I find out they smoke two packs of cigarettes per day, and wonder why? I often tell them if you continue to smoke, this other stuff doesn’t matter at all. There’s nothing you can do to help your health if you’re smoking, which is true. Smoking is definitely the worst thing you could ever do for your health. 

Point being, I’m totally against smoking or dipping snuff. Dipping snuff causes oral cancers, ruins your teeth, and in my opinion, stinks. It’s just not common sense. But, let’s go back to “another side of the story”.  


Crazy Health Facts About Nicotine 


Can nicotine be good for you? How ironic, yet interesting.

  1. Nicotine is neuro protective. Some researchers believe it’s the most reliable cognitive enhancer that we have. Studies from the Vanderbilt Center for Cognitive Medicine found that it’s as effective as ritalin for ADHD. Think about that. 
  2. Nicotine helps (some people) regain their taste and smell after Covid. Some of my patients told me after chewing Nicotine gum 4x a day, it helped them recover their taste and smell. Note: it doesn’t work for everyone. Remember we are unique individuals.
  3. Nicotine helps you burn fat. That’s one reason why when people quit smoking they gain weight. Nicotine activates thermogenesis (the burning of fat). 
  4. Nicotine helps your short term memory
  5. Nicotine helps reaction time and can actually improve athletic performance. That’s why you see some athletes using snuff (and it’s legal). 
  6. Nicotine helps people with schizophrenia. Many patients with schizophrenia smoke because it helps them.
  7. Nicotine may delay or even prevent mild cognitive impairment (MCI) from developing into Alzheimer’s Disease, according to Researchers at Vanderbilt. There are lots of studies going on right now with that.  
  8. Nicotine can also be anti estrogenic. Estrogen is good for women, and not so good for men. Both need the right levels and those levels are different for men and women. So for men, nicotine almost acts like an aromatase inhibitor. It may help your testosterone from turning into estrogen. 
  9. Nicotine, as a drug class, is a stimulant that causes decreased appetite, heightened mood, and helps your memory and your alertness.  

Note: with that being said, nicotine may also increase your heart rate and blood pressure. Other side effects include: 

  • Nausea 
  • Diarrhea 
  • Headaches 
  • Sleep problems 


Nicotine Gum and Nicotine Patches 


As you have figured, I hate smoking. The gum and patches are less addictive if for some reason you have to try it. Definitely try the gum and patches if you are wanting to QUIT smoking. Note: I highly recommend QUIT SMOKING. 

The patches are my favorite (having a longer half life). You may, also, want to try the gum for getting your taste and smell back if you have Long Covid. If you use the gum, start at 2mg. If you use the patch (they come in 24mg). You can even cut them up in quarters. You put the patch on in the morning and if it causes sleep problems, take it off at night. It’s definitely helpful for smoke cessation. There’s no doubt about that. 


Crazy Ending


As crazy as it sounds, nicotine in smokers may inhibit the penetration and spread of Covid-19 and have a prophylactic effect. BUT, it’s ridiculous to say you should smoke to prevent Covid-19, because definitely people with terrible lung function (which you will get from smoking) do much worse and usually have more severe cases of Covid. 

Note: it is interesting that there were less Covid hospitalizations in smokers than in non smokers. 

I hope this Note opens your eyes a bit about nicotine. I think we need to study it more and weigh the risks versus the benefits when it comes to using it for prevention and treatment of disease. I’ll say it again, if you are a smoker, definitely try the gum or patch to QUIT. Besides being obese and inactive, it is the worst thing you can do for your health. 

Till next week.