Medical experts are studying the broader applications of nicotine on human health amid changing public perceptions and the rise of harm reduction products such as vapes, heated tobacco and nicotine pouches.
Nicotine has gained recognition for its potential therapeutic uses, and participants in a panel discussion at the recent Global Forum on Nicotine caution against continuous demonization of the substance as the sole cause of tobacco-related diseases.
Mark Oates, director of consumer groups We Vape and the Snus Users Association, said there is a continuing public misconception that nicotine itself causes smoking-related illnesses. “The media are incredibly scared to discuss this issue, which is a huge shame. And science also lacks the ability to research it because funding is hard to come by,” Oates said.
Dr. Garrett McGovern, a general practitioner specializing in addiction medicine, said the increasing popularity of e-cigarettes, significantly safer than combustible tobacco, has sparked renewed interest in nicotine’s effects.
“I’m pretty sure before electronic cigarettes arrived, we never heard of nicotine and the developing brain,” he said. “It’s time to explore the potential benefits of nicotine rather than scapegoating it for everything.”
Despite the promising potential of harm reduction, the global reality of 1.1 billion smokers remains a significant concern. Panel moderator Clive Bates, director of Counterfactual Consulting Limited, said, “there are still 1.1 billion smokers in the world”.
“Eight million die each year from smoking-related causes, and hundreds of thousands are ill. We have the means to address this,” he said, referring to available harm reduction products.
Dr. Carolyn Beaumont, an Australian general practitioner, shared her experience of prescribing nicotine to smokers transitioning to vaping. Her research indicated that over half of her patients who switched to vaping were men aged 30 to 50, showing a preference for safer alternatives before experiencing long-term smoking effects.
She also found that over half of those who disclosed medical conditions reported pre-existing mental health issues. Around 80 percent of her vaping patients expressed concerns about returning to smoking if e-cigarettes were no longer available.
Dr. Alex Wodak, former director of the Alcohol and Drug Service at St. Vincent’s Hospital in Sydney, underscored the urgency of reducing the annual death toll of 8 million. “That’s equivalent to the population of Switzerland each year. Our primary objective should be reducing this number as rapidly as possible,” he said.
“People smoke because of nicotine, but they die due to the resistance to harm reduction,” Dr. Wodak said. “Our challenge is to develop strategies that not only work but work better than existing approaches.”
Dr. Paul Newhouse, director of the Vanderbilt Center for Cognitive Medicine, described nicotine as a complex substance with diverse effects on the brain. He noted the dual nature of nicotine use, noting both its recreational and potential therapeutic purposes.
“For many individuals, nicotine may never be desired or needed. However, for some, it could be useful, potentially benefiting cognitive performance, mood regulation, or anxiety management,” Dr. Newhouse said. “We must acknowledge that nicotine has beneficial effects for certain individuals and brains.”
Oates said there is no evidence of any society completely ceasing nicotine use once it starts. “We’ve only seen countries like Sweden transition to safer versions. Public health officials and policymakers must recognize this fact and understand that the path forward is through safer products,” he said.
