Howstuffworks "How can nicotine be good for me?"

By now the health hazards of smoking and tobacco use are well known. Smoking is the chief preventable cause of death in the United States and a major contributor to many types of cancer, heart disease and other serious or potentially fatal conditions. Cigarettes are also expensive, addictive and they leave a bad odor. However, medical researchers have begun to show interest in one of the most reviled components of cigarettes -- nicotine. And they're interested in this potent, powerfully addictive substance for its health benefits.

Over the past decade, new research has taught us more about how nicotine affects the brain and the body. Some of it is good news -- for example, a lower incidence of Alzheimer's disease in smokers. Research has pointed to a compound called acetylcholine as the reason. Nicotine is structurally similar to acetylcholine, a naturally-occurring compound that serves as a neurotransmitter. Nicotine binds to nerve receptors and makes nerve cells fire more frequently. In one study, a group of Alzheimer's patients were given nicotine patches, while another received a placebo. Those with nicotine patches maintained their cognitive abilities longer and sometimes even recovered lost cognitive function. A follow-up study indicated that nicotine may also boost cognitive abilities in elderly people who aren't suffering from Alzheimer's but who are experiencing the typical mental decline associated with old age.

Photographer: Sascha Dunkhorst | Agency: Dreamstime
Nicotine is the highly addictive substance found in tobacco that gives users a buzz. It may also have some
health benefits.

The transformation with nicotine happened when the nicotine patch was introduced. Intended to help smokers quit, the nicotine patch also opened up a whole new way of studying the drug. Suddenly scientists had a reliable delivery system -- one without the numerous carcinogens found in cigarettes -- that could be standardized across various studies. A 1982 study revealed that patients with ulcerative colitis had fewer flare-ups when taking nicotine. However, side effects proved nicotine to be a poor long-term treatment.

In 2000, a study performed at Stanford revealed surprising results about nicotine's effects on blood vessels. Contrary to popular opinion, the study showed that nicotine actually boosts the growth of new blood vessels. The discovery may lead to new treatments for diabetes. Many people with severe diabetes experience poor circulation, which can lead to gangrene and ultimately, limb amputation.

Researchers from the Scripps Research Institute published a study in 2002 that revealed a connection between nornicotine -- a chemical found in tobacco and also created when the body breaks down nicotine -- and a reduction of Alzheimer's symptoms. However, nornicotine is toxic, pointing to the need for a nontoxic substitute.

Video Gallery: Nicotine and Tobacco
Smokeless tobacco poses some of the same health threats as regular tobacco. Watch this video about the effects of smokeless tobacco on oral health on HowStuffWorks.

In 2006, Duke scientists found that people with depression who were treated with nicotine patches reported a decrease in their depressive feelings. The results were perhaps not surprising for a drug associated with imparting a "buzz." However, the research also showed a direct link between nicotine and an increase in the release of dopamine and serotonin, two vital neurotransmitters. A lack of dopamine or serotonin is a common cause of depression.

These studies point to potentially positive aspects of nicotine, but what can we do with this information? Surely people shouldn't start smoking for their health. Read on to find out about drug research associated with nicotine.

Nicotine and Drug Research

Image courtesy Dreamstime
When the nicotine patch was introduced, researchers began studying nicotine in a
new way.

Nicotine may carry some health benefits with it, but the problem has been "the delivery system," says Don deBethizy. DeBethizy is the CEO of Targacept, a biotech company spun off from R.J. Reynolds Tobacco Company and dedicated to researching nicotine-related drugs [Source: Wired]. No one should take up smoking, chewing tobacco or the patch for their health, especially those suffering from pre-existing medical conditions. The challenge is for scientists to find a way to derive medications from nicotine or to find a safe substitute for compounds like nornicotine.

We've already mentioned that nicotine's promotion of blood vessel growth may help diabetes patients. The pharmaceutical company CoMentis is testing a nicotine gel that's applied to needed areas in order to boost circulation and blood vessel development.

Targacept is currently running clinical trials for two nicotine-related drugs. One is designed to boost cognitive function in schizophrenia and Alzheimer's patients; the other is a pain reliever to be taken after having teeth pulled. These two vastly different treatments, both derived from nicotine.

While no nicotine-derived drugs are available yet, many are in the development or testing phases. The variety of conditions being studied reflects the excitement felt in the scientific community for the potential of nicotine: anxiety, depression, Alzheimer's, Tourette Syndrome, ADHD, Parkinson's disease, diabetes and schizophrenia. Many of these conditions are psychological in nature. Researchers point out that it's probably no coincidence that 50 percent of smokers have mental health problems and that depressed people are twice as likely as non-depressed people to be smokers. Dr. Ed Levin, a prominent nicotine researcher at Duke University, calls it a form of self-medicating [Source: Wired]. (It's also frequently more difficult for depressed people to quit smoking.)

It may be years before we see any nicotine-derived drugs on the market. Taking a drug from research to market can take hundreds of millions of dollars and years of work -- not to mention many trial stages and governmental approval. Even so, one day we may look at nicotine like we do opium, foxglove and nightshade. In one form, they're highly dangerous substances; in another, they're vital, even life-saving, medical treatments.

For more information about nicotine, drug research and related topics, please check out the links on the next page.

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Sources

"Nicotine 'reduces Alzheimer's symptoms.'" BBC News. June 16, 2003. http://news.bbc.co.uk/2/hi/health/2994304.stm
"Deadly Night Shade." Toxins to Treatments. University of Edinburgh. http://www.portfolio.mvm.ed.ac.uk/studentwebs/
session2/group13/index.html
"Digitalis purpurea (Foxglove)." Poisonous Plants Homepage. Animal Science at Cornell University. Oct. 28, 2003.
http://www.ansci.cornell.edu/plants/digitalis.html
"Nicotine shows potential medical benefits." Medical Research News. Sept. 12, 2006.
http://www.news-medical.net/?id=20091
"On the Patch." ACF Newsource. Apr. 2, 2006.
http://www.acfnewsource.org/science/on_the_patch.html
"Study Shows Nicotine By-Product Reacts with Proteins." The Scripps Research Institute. Nov. 4, 2002.
http://www.scripps.edu/newsandviews/e_20021104/nicotine.html
Braus, Patricia. "Research spurs new views of nicotine." American College of Physicians. Feb. 1997.
http://www.acponline.org/journals/news/feb97/nicotine.htm
Graham, Marty. "Researchers Light Up for Nicotine, the Wonder Drug." WIRED. June 20, 2007.
http://www.wired.com/science/discoveries/news/2007/06/nicotine