“Nicotine”, 2011-05-09 (; backlinks):
On the benefits and lack of demerits of nicotine (research up to 2015)
In 201113ya, I became curious about nicotine gum/patches as a possible alternative stimulant to modafinil: its much shorter half-life makes it more useful for evenings or scenarios like needing a quick alert on a long drive. I looked briefly into the nicotine/tobacco research to see whether there was convincing evidence that nicotine on its own, without any tobacco or smoke-related delivery mechanism, is either more harmful than most stimulants or likely to lead to severe addiction to tobacco as a ‘gateway drug’.
The psychological effects of nicotine as a stimulant are long established by a scattershot literature, so there are possible benefits.
Cost-wise, much of the nicotine/tobacco literature willfully conflates the two, leading to misleading attribution of the harm of tobacco to nicotine; many associations with harm are confounded by past or present tobacco use (eg. et al 2020), but when pure nicotine is examined, as in patch/GUM NRT, the harms appeared minimal: like all stimulants, nicotine may raise blood pressure somewhat, and is addictive to some degree, but the risks do not appear much more strikingly harmful than caffeine or modafinil (and certainly appear less than the many commonly-used amphetamines). Animal experiments are, like usual, highly ambiguous, of low quality, and of doubtful relevance to humans. There is little evidence from the NRT literature that ‘never-smokers’ like myself are all that likely to become highly addicted, and minimal epidemiological evidence of harm from NRT use over the past 3 decades it has been available.
‘Vaping’ is another story: few experiments have been done, and its popularity is recent enough that any harms are poorly understood other than it can’t possibly be remotely as harmful as tobacco smoking, and its delivery mechanism plausibly is much more addictive than gum/patch delivery would be.
Overall, I am personally comfortable using nicotine gum (but not vaping) once in a while; as of 2024, I have done so since 201113ya, at frequencies ranging from daily to monthly, using gum/patch/spray forms, and can stop for weeks or months without a problem.