Help sometimes comes from the most unlikely of sources. Big Tobacco has a long history of misleading politicians and the public about the significant harm caused by smoking and purposefully attempting to hook a new generation of kids on its products. But those same companies have done a lot of potentially important research into a compound that could help with a wide range of conditions, from delaying the onset of Alzheimer’s to improving attention in ADHD-suffering teens and even aiding weight loss. The chemical in question is none other than nicotine, one of the most addictive substances on the planet, but paradoxically one that a deeper understanding of may lead to a more effective treatment for smoking addiction. So is it all hype, or does nicotine really hold all this promise?
The Problems with Researching Nicotine
Nicotine has a bad reputation, and although it is undeniably addictive, much of this bad reputation stems from its presence in cigarettes. Cigarette smoke is a concoction of many different substances, and out of this gruesome list of toxic chemicals, nicotine itself is actually a fairly benign component. The addictiveness of the substance is what draws smokers into the abundant risks, but in order to maximize cigarettes’ addictiveness, tobacco companies add more addictive additives to their products. Nicotine doesn’t quite cut it on its own.
Prior to the wide availability of nicotine patches and gums, doctors had noticed things like fewer smokers suffering from Parkinson’s disease and ulcerative colitis, but it was hardly worth investigating because it wasn’t likely a doctor could advise a patient to start smoking. However, when the safer forms of nicotine surfaced, some researchers became interested in the potential uses for nicotine and went in search of funding. But nobody wanted to fund what they saw as a dangerous product, and its inexorable connection to cigarettes meant that only basic research into its effect on the brain was funded by the government. The only groups willing to cough up the cash to study its potential benefits were Big Tobacco companies.
The Potential Benefits of Nicotine
Pharmacological research has shown that nicotine broadly functions as a cognitive enhancer, and for that reason, one of the main conditions it is being investigated for is Alzheimer’s disease. This isn’t all, though, with the substance also holding promise for attention-deficit disorder (ADD), Parkinson’s, schizophrenia and helping people quit smoking, according to initial studies.
These effects are generally related to nicotine’s interaction with the dopamine system within the brain. The substance latches on to nicotinic cholinergic receptors, which stimulate the release of many brain-chemicals when activated, including dopamine. Dopamine is part of the brain’s “reward” system, and is central to most addictions, but also explains the brain-boosting effects of the drug. Increased dopamine makes nicotine users feel alert, improving short-term memory, motor skills and attention, as well as decreasing reaction times.
The schizophrenia link is important given that over 80 percent of those suffering with the condition smoke, and it may be because nicotine helps to control their condition. Schizophrenia is a dopamine-related condition, and nicotine may help regulate the system in these cases and thereby help sufferers function more effectively.
So Does Nicotine Really Work?
RJ Reynolds, the tobacco company, is responsible for synthesizing every known nicotine compound through its research efforts in conjunction with university scientists in the 90s. The company spawned an independent biotechnology research group called Targacept in 2000, dedicated to investigating nicotine’s medical potential. This was headed by Don DeBethizy, the same researcher who’d been at the helm for the earlier investigations, and it generated a lot of interest and investments at first. It was looking like nicotine-based therapies would be the next big thing.
But the results haven’t really surfaced. An example comes from a phase III trial investigating a nicotine compound for depression. The fact that it reached phase III means it had shown initial positive findings and was ready to be compared to the current standard treatment for depression, so (repeatable) success in the testing would have made it a potential viable option for those affected. The compound was a failure, and DeBethizy resigned shortly after. Other studies looking at nicotine compounds in other conditions such as ADHD have also showed no positive results. For all the promise in animal tests and initial trials, it seems nicotine’s real-world therapeutic effects are quite limited.
What about Treating Addiction?
Perhaps unsurprisingly, RJ Reynolds has stated that they have no interest in using their research into nicotine to develop a treatment for nicotine addiction, but the market is undeniably there. Big Pharma already has a nicotine addiction treatment on the market (Chantix), but concerns about psychological side effects mean that the drug isn’t as successful as it could have been. They have a motive to find that compound, and all of the meticulous groundwork laid by groups like RJ Reynolds might provide the clue pharmacologists have been looking for.
So Big Tobacco isn’t really turning against its own business model (“keep people addicted and make lots of money”) by coming up with a treatment themselves, but the increased understanding of nicotine they’ve been instrumental in establishing might just lead to one. As nicotine researcher at Duke University Medical Center Jed Rose argues, “As our understanding of what nicotine does in the brain improves, the treatments will accelerate.” It might not be ready to hit the shelves any time soon, but it won’t be long until the innovation surfaces. And there’s a chance that the innovation will be built upon the groundwork laid by Big Tobacco. Nicotine might not keep its bad reputation forever.