Tobacco—and, by extension, nicotine—has a reputation for health harm, but separating the two could lead to breakthroughs in fighting Covid and other illnesses. Cate Montana investigates
The ancient Mayans called it Quáuhyetl. Amazonian shamans call it mapacho. Westerners call it tobacco. By whatever name, Nicotiana rustica and its milder, more modern variety Nicotiana tabacum have played a major cultural role in human life for thousands of years.
Long considered one of Earth’s most sacred plants, tobacco and its smoke have been used as a spiritual purifying agent in medicinal ceremonies in the Amazon and elsewhere around the world. The smoke is blown over the sick bodies of patients come for physical healing, used to cleanse the bodies of spiritual seekers come for enlightenment and blown in the faces of warriors headed into battle.
Smoked, snorted, chewed, drunk and pounded into a paste for topical healing of wounds, skin lesions, ringworm and other skin infections, tobacco in its various forms has been known and enjoyed worldwide for hundreds of years. Soon after it was introduced to Europe in the late 16th century, tobacco became a well-known healing plant prepared by herbalists, sold to physicians in pharmacopeias and used to treat kings, queens, merchants, laborers and farmers alike.
Of course, the most famous—or infamous—component of tobacco is nicotine, a plant alkaloid found in the leaves of the tobacco plant. Alkaloids are naturally occurring organic pharmacologic compounds that contain nitrogen and have a wide variety of effects, from stimulant (nicotine) to anti-asthma (ephedrine) to analgesic (morphine) to antimalarial (quinine).
Nicotine acts on the heart and circulatory system, increasing heart rate and vasoconstriction, as well as on the bladder and gastrointestinal tract, increasing blood glucose levels and metabolic rates. It triggers the production of dopamine, a neurotransmitter and hormone produced in the brain that stimulates pleasure and motivation, and adrenaline, a neurotransmitter and hormone that stimulates the flight-or-flight response in the body. Both stimulate the central nervous system and cardiovascular system, producing the common effect of wakeful alertness.
The latest, most important discoveries regarding the pharmacologic usefulness of nicotine are its neuroprotective, neuro-enhancing and cognitive-enhancing impacts. Nicotine binds to receptors in the brain that are vital to attention, learning and information retention.
It activates these receptors by promoting the flow of sodium, potassium and calcium ions across neuronal cell membranes. This action helps them stay vibrant and healthy and actively produces protective proteins that shield brain cells when they’re under stress or attack.
Nicotine also has an anti-inflammatory effect on the brain, activating the cholinergic anti-inflammatory pathway. By doing so, it effectively reduces the production of cytokines, small proteins important in cell signaling that are produced by several kinds of cells, including immune cells.
As a result of all these positive physiological effects, nicotine is now being clinically studied for therapeutic treatment of neurodegenerative diseases like Parkinson’s and Alzheimer’s, depression, inflammatory diseases such as inflammatory bowel disease and arthritis, and even certain aspects of autism and ADHD.
And yet few substances in common usage on this planet have ever been as demonized as nicotine. It’s labeled and viewed as the one and only addictive substance in cigarettes, and most doctors, researchers, smokers and laypeople consider nicotine as addictive as heroin, possibly worse.
Warning labels are emblazoned across all tobacco product packaging: “Warning: This product contains nicotine. Nicotine is an addictive chemical.” The US Food and Drug Administration (FDA) website declares, “Nicotine is why tobacco products are addictive.”
Study after clinical study cites nicotine as the culprit behind smoking addiction, cancer,1 chronic obstructive pulmonary disease (COPD),2 ruptured aneurysm,3 asthma4 and other health problems. The thousands of studies and their results are seemingly incontrovertible.
Study after study on the dangerous effects of nicotine uses the words tobacco smoke, smoking, cigarettes, tobacco and nicotine interchangeably when talking about the relationship between nicotine and cancer, heart disease, respiratory diseases, strokes, diabetes, addiction and more. They treat nicotine, tobacco, smoking and cigarette smoke as one and the same.
But nicotine, cigarettes and smoking are not the same thing. One study was even forced to admit it while still demonizing the compound: “Nicotine in tobacco brings illness and death to millions of people. Yet nicotine in its pure form has the potential to be a valuable pharmaceutical agent.”5
Nicotine is a plant alkaloid—one thing. Compare that to the total ingredient list of commercial cigarettes, which, aside from the tobacco leaf itself, today includes at least 600 chemical additives, many of which have been proven carcinogenic.6 These are a few:
Cigarette smoke is a toxic mixture of more than 7,000 chemicals, many of which are carcinogenic.7 Even “no additive” tobacco products can contain hazardous substances, like cadmium and lead from the soil where the tobacco plants are grown. Chemical fertilizers used on the plants contain ammonium sulfate, ammonium nitrate, potassium chloride and other chemicals that remain in the tobacco leaf and are inhaled when it’s smoked.
And yet, if we can separate nicotine from these delivery methods, “there could be potential medicinal uses of nicotine if it was dosed carefully and appropriately and in a thoughtful way,” says Dr Paul Newhouse, director of the Center for Cognitive Medicine in the Department of Psychiatry at Vanderbilt University Medical Center. “But even in clinical research we can’t separate in our heads nicotine from smoking. And yet nicotine is a plant alkaloid, and we’ve used plant alkaloids for medicines for thousands of years.”
Yes, one drop of pure lab-extracted nicotine is lethal if swallowed or even placed on the skin. And nicotine used to be the major ingredient in Black Flag insect control products and is still used in pesticides today.
But, given that nobody in their right mind is going to spray a can of pesticide into their mouth, perhaps nicotine isn’t as dangerous as it’s been made out to be for the last 70 years? Well, maybe not directly.
But it’s still one of the most addictive substances on the planet . . . as addictive as heroin. Right? It’s what forces people to keep smoking dangerous commercial cigarettes that kill them and those who breathe their secondhand smoke. Right?
Maybe not. Yes, nicotine stimulates the production of feel-good neurotransmitters in the brain, like dopamine, that can lead to wanting more. But is nicotine the major addictive substance in cigarettes that it’s made out to be? A little-known and well-buried Harvard study in 2016 on pyrazines indicates it is not.
Pyrazines are a class of organic compounds of the “heterocyclic series” that form a ring structure containing four atoms of carbon and two of nitrogen. Because of their “chemosensory and pharmacological effects,” they were incorporated into the first “full-flavor, low-tar” commercial tobacco products developed in the late 1960s and have been used ever since. Deliberately designed to act synergistically with nicotine, the study found, they’re highly effective for “increasing product appeal, easing smoking initiation, discouraging cessation and promoting relapse.”6
In other words, pyrazines are highly effective at creating rapid addiction, which is one reason they’re also used as additives in ultra-processed food products. And what other heterocyclic compound is highly addictive? Heroin—the alkaloid derivative of morphine that drives most of the illicit narcotics trade around the world today.
There are other indicators nicotine might not be the addiction-forming demon it’s been portrayed as. For starters, there are addictive factors around smoking—the repetitive nature of the act itself, visual stimulus, oral gratification, positive social associations and other powerful substance associations, like alcohol. All these combine to make smoking a pleasurably addictive experience.
And then there are the studies showing that very-low-nicotine cigarettes do not have lower addictiveness than regular cigarettes.8 And what about transdermal patches? How many people are addicted to nicotine patches?
There aren’t any studies at all on the subject. And yet supposedly the nicotine in cigarettes and the nicotine in the patches are interchangeable.
When you smoke a cigarette, you inhale the equivalent of about 1 mg of nicotine. Nicotine patches deliver 5–25 mg daily. So, one nicotine patch can deliver the same amount of nicotine as an entire pack of cigarettes. But how many teens are out buying nicotine patches on the street to get high?
The recidivism rate for smokers using transdermal nicotine patches to replace nicotine is also revealing: It hovers around 80 percent. Even after six months of use, patches rarely help more than one in five smokers stop.9
Much of this is now being understood as the result of delivery mechanisms. “The effects of nicotine on the brain seem very dependent on the route and the rate of administration,” says Newhouse.
“Inhaling smoke is a rapid way to get nicotine to the brain, and it has immediate reinforcing effects that are very different from those of patches. So, patches are not a good substitute for the act of smoking.”
Last but not least, why would shamans and healers consider tobacco one of Earth’s most sacred plants, using it effectively for healing and ceremonial purposes for thousands of years, if it promoted disease and addiction? And here’s the kicker: South American shamans, and medicine women and men in general, traditionally use wild Nicotiana rustica, which has nine times as much nicotine as the commercial Nicotiana tabacum used to make modern cigarettes.
Nicotine administration can improve cognitive impairment in Alzheimer’s disease by inhibiting a stress-responsive protein, which decreases brain cells’ self-destruction and improves their survival. It also enhances activity of the protein kinase B, stimulating cell signaling that controls learning and memory processes.
Nicotine may activate thyroid receptor signaling pathways as well, improving memory impairment that results from hypothyroidism. It even improves memory issues caused by sleep deprivation.10 In patches, it’s been found to reduce concentration issues and “core symptoms” in patients with ADHD.11
“It’s clear that attention and to some extent memory and learning are affected by blocking nicotinic receptor functions,” says Newhouse. “In the early clinical studies that I conducted on nicotine way back in the 1980s and early ’90s, there were very clearly rapid beneficial effects from single doses in people who are functioning poorly for one reason or another. Psychomotor speed also seems to be affected.”
Researchers have long noted the negative correlation between Parkinson’s disease and smoking, and with good reason. The pharmacological and neuroprotective effects of nicotine delivered via transdermal patches have been shown to improve motor scores and reduce dopaminergic effects leading to impaired movement, cognition and executive function in Parkinson’s patients.12
One study even shows that Solanaceae plants are edible sources of nicotine that may protect against Parkinson’s disease. This flowering plant family, commonly known as the nightshades, includes tomatoes, eggplant, potatoes and peppers.13
Though it’s an anti-inflammatory alkaloid, nicotine strangely has pro-inflammatory mechanisms, too. Because it regulates immune cells, the vagus nerve and acetylcholinergic anti-inflammatory pathways, nicotine is being recognized as a possible adjunct treatment for ulcerative colitis, arthritis, sepsis, endotoxemia, rheumatoid arthritis and myocarditis.
Nicotine also effectively reduces inflammatory cytokine levels in the heart, liver and spleen after burn trauma.14
It’s known to exacerbate oral inflammation in diseases such as periodontitis and gingivitis. However, bacteria in the mouth may regulate this effect, and the dosage may also be a key factor.15 Interestingly, ancient people used powdered tobacco mixed with chalk or lime as a tooth whitener, and tobacco toothpaste is still sold in India today.16
Nicotine also inhibits cytokine storms in the lungs and has been shown to prevent or lessen the severity of Covid-19 infection.17 This answers some of the most puzzling phenomena of the pandemic, namely the unexpectedly low number of smokers who contracted the virus in the first place and the unexpectedly low number of smokers hospitalized with infection.18
It was the antithesis of the response researchers and the medical community feared at the outset of the pandemic—a shocking response that led to a flurry of clinical studies on how nicotine affects the SARS-CoV-2 spike protein. Researchers discovered that the virus’s spike protein targets the exact same nicotinic acetylcholine receptors in the body that nicotine binds to.19
They hypothesized that the nicotine molecule could displace the Covid virus from these receptors and conducted a small study to find out. It treated four non-smokers suffering symptoms of long Covid—weakness, memory lapses, pain, and shortness of breath—for 14 days with a 7 mg nicotine patch application.
One patient mistakenly used 15 mg patches and dropped out of the study after experiencing some nausea and dizziness. The remaining three patients experienced immediate and substantial cessation of long-haul Covid symptoms and complete remission in a matter of days.
Researchers summarized the study thus: “Based on the results of this case study, this treatment option . . . seems far superior to the time-consuming, often underwhelming or disappointing, costly and complex rehabilitation measures currently available to these patients.”20 See below for the details of their protocol.
Dr Susan Levine, an allergist/immunologist in New York specializing in diseases affecting the immune system and noted for her work with patients suffering from chronic fatigue syndrome, says she has patients who successfully used nicotine patches to mitigate symptoms of long Covid.
“Nicotine patches have helped individuals, especially those working part or full time, to focus,” she says. “Some who start this treatment feel better in the first few weeks. And it addresses the consequences of immune activation. However, it’s difficult to know without pursuing a clinical trial whether a particular intervention, like the nicotine patch or anything else, works over a long stretch of time.”
I never got vaccinated for Covid and managed to dodge it completely until March 2024. I went down like a ton of bricks and ran a fever of around 101°F (38.3°C) for four days. Not surprisingly, I tested positive.
Aches and pains and utter exhaustion followed for about another week, and then it was over—except the fatigue lingered. And lingered. And lingered.
By July I was desperate to get my energy back. So, I revisited information about nicotine from Dr Bryan Ardis, a researcher and retired chiropractor, certified acupuncturist and nutritionist from Texas (healingfortheages.com). I’d heard a podcast interview with him back in 2022 in which he made some astonishing claims about Covid, snake venoms and nicotine.
On the show he recommended using nicotine patches to both ward off Covid and deal with the symptoms of long Covid. He cited Italian research showing the protective effects of nicotine on receptor sites in the brain affected by SARS-CoV-2, but at the time, I didn’t pay much attention.
As an ex-smoker (two packs a day!), I was terrified of possible nicotine addiction. Frankly, the incessantly repeated messaging from doctors, the government and the media about the addictive qualities of nicotine made me seriously doubt Ardis’s claims that, as a single substance, nicotine is not addictive.
But by July 2024, I was both better informed and desperate. I went to the local pharmacy and bought nicotine patches. But because I was still hesitant about nicotine and addiction even though I’d done some research, I did not follow Ardis’s recommendation of using one 7 mg patch daily for a week.
I bought 14 mg patches, cut them into six pieces each and applied a fresh 2.3 mg piece to my skin every day for 12 days. (This is the protocol he advises for protecting against Covid variant exposure.)
On the morning of Day 10, I was driving into town to get groceries, and suddenly it was like a light switch got flipped and all my old energy came surging back. It was almost electrifying. I couldn’t believe how good I felt and how exhausted I’d felt in comparison for so long.
Since then, my energy levels have maintained. In addition, I have taken Ardis’s advice and used 2 mg nicotine patches for a couple of weeks at a time when traveling to mitigate the risk of any exposure to Covid.
Not only have I not gotten sick again (even though I’ve been exposed a couple of times), I have definitely not formed an addiction to nicotine by wearing the patches. Nor have I experienced any negative side effects.
Nicotine patches
Here is the protocol recommended by Dr Bryan Ardis and Dr Marco Lietzke, who conducted the four-person long Covid study described above.20
Recommended brand: Rugby
Ardis says nicotine gum will work as well as patches. Do not use any dosage higher than 2 mg.
Recommended brands: Rugby, Lucy
Nicotine functions as an efficient defense in nature, serving as a natural bug repellant in plants. In highly concentrated doses, it makes an excellent pesticide.
Between that and nicotine’s unsavory public reputation, it’s not surprising that a lot of culinary websites spend time reassuring cooks and gourmands alike that, no, eating eggplant parmesan will not get you hooked on nicotine and have you eating more than you should. Eating (and drinking) lots of the foods below won’t have you running to the local pharmacy after dinner to buy patches or gum either.
After all, to equal the 2 mg dose you’d get from a piece of nicotine gum, you’d have to eat about 44 lb (20 kg) of eggplant (aubergine), which has the most of any known food source—and absorb it all. So, even if nicotine were confirmed addictive on its own, you can see why the small doses in these foods are unlikely to cause a problem.
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