Nicotine Patchwork: The Solution to Smoking?

On one hand our union health minister, Ambumani Ramadoss is on a one-man-mission to ban smoking on screen, which many believe increases the number of smokers in the society. On the other hand, researchers are of the opinion that nicotine and related compounds (present in tobacco products like tambaku, cigars, bidis, etc) have therapeutic uses.

The interest in nicotine’s therapeutic potential started in the 1980s. Several population based studies found that smokers had lower rates of Parkinson’s disease as compared to non-smokers. And not only Parkinson’s disease, scientists are also testing nicotine and related drugs as treatment for Alzheimer’s disease, Attention Deficit Hyperactivity Disorder (ADHD), schizophrenia, depression, anxiety disorders, etc.

Cigarettes send nicotine straight into the lungs where it is absorbed by the blood, carried to the heart and pumped into the brain. This nicotine on reaching the brain triggers a reaction in the brain’s reward system, the structure responsible for giving us pleasurable sensations. More specifically and scientifically, the drug intensifies the activity of the neurotransmitter dopamine in the part of the brain called nucleus accumbius. Drugs like cocaine and amphetamines do much the same thing. Nicotine is tame in comparison. It’s not just nicotine, but the pleasurable sensation it confers on behaviour associated with smoking that makes nicotine so addictive.

Researchers have been talking about nicotine related drugs for decades but none are in the market yet. Why? This is because nicotine related compounds often have a fairly narrow therapeutic index. There isn’t much difference between a dose that is helpful and one that’s toxic. That isn’t insurmountable, but it slows down the clinical development.

Investigators are seeing if the effectiveness of nicotine patch therapy in non-smoking patients diagnosed with depression.

In 2004, a magazine reported that high smoking rate among adolescents and adults with ADHD could be explained by their discovering that nicotine improves aspects of their mental functioning.

An especially promising area of research involves cognitive impairments that are precursors to Alzheimer’s disease. Also Duke University researchers published a small study on the effect of the nicotine patch in people with impairments. They reported significant improvement in decision-making ability and attention in eleven subjects.

The biggest problem in recommending nicotine patches is that the researchers still don’t have enough data to do so. But everyone is excited at the prospects and the strategy which looks pretty promising.

Lee Wie Mien Jackson

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