Template:Short description Template:About Template:Cs1 config Template:Use dmy dates Template:Main other <templatestyles src="Infobox drug/styles.css"/> {{#invoke:Infobox|infobox}}Template:Template other{{#invoke:TemplatePar |check |template=Template:Infobox_drug |all= |opt= pronounce= pronounce_ref= pronounce_comment= ATC_prefix= ATC_suffix= ATC_supplemental= ATCvet= biosimilars= CAS_number_Ref= CAS_number= CAS_supplemental= ChEBI= ChEBI_Ref= ChEMBL_Ref= ChEMBL= ChemSpiderID= ChemSpiderID_Ref= chirality= class= container_only= DailyMedID= data_page= DrugBank_Ref= DrugBank= Drugs.com= duration_of_action= INN= INN_EMA= IUPAC_name= IUPHAR_ligand= KEGG_Ref= KEGG= MedlinePlus= NIAID_ChemDB= PDB_ligand= PubChemSubstance= PubChem= StdInChIKey_Ref= StdInChIKey= StdInChI_Ref= StdInChI_comment= StdInChI= UNII_Ref= UNII= DTXSID= Verifiedfields= Watchedfields= addiction_liability= alt2= altL= altR= alt= bioavailability= boiling_high= boiling_notes= boiling_point= captionLR= caption= caption2= charge= chemical_formula= chemical_formula_ref= chemical_formula_comment= class1= class2= class3= class4= class5= class6= component1= component2= component3= component4= component5= component6= density= density_notes= dependency_liability= drug_name= elimination_half-life= engvar= excretion= image2= imageL= imageR= image= image_class= image_class2= image_classL= image_classR= Jmol= legal_AU= legal_BR= legal_CA= legal_DE= legal_EU= legal_NZ= legal_UK= legal_UN= legal_US= legal_AU_comment= legal_BR_comment= legal_CA_comment= legal_DE_comment= legal_UK_comment= legal_NZ_comment= legal_US_comment= legal_UN_comment= legal_EU_comment= legal_status= licence_CA= licence_EU= licence_US= license_CA= license_EU= license_US= mab_type= melting_high= melting_notes= melting_point= metabolism= metabolites= molecular_weight= molecular_weight_round= molecular_weight_unit= molecular_weight_ref= molecular_weight_comment= onset= pregnancy_AU= pregnancy_AU_comment= pregnancy_category= protein_bound= routes_of_administration= SMILES= smiles= solubility= sol_units= source= specific_rotation= synonyms= target= tradename= type= vaccine_type= verifiedrevid= width2= widthL= widthR= width= AAN= BAN= JAN= USAN= source_tissues= target_tissues= receptors= agonists= antagonists= precursor= biosynthesis= gt_target_gene= gt_vector= gt_nucleic_acid_type= gt_editing_method= gt_delivery_method= sec_combustion= Ac=Ag=Al=Am=Ar=As=At=Au=B=Ba=Be=Bh=Bi=Bk=Br=C=Ca=Cd=Ce=Cf=Cl=Cm=Cn=Co=Cr=Cs=Cu= D=Db=Ds=Dy=Er=Es=Eu=F=Fe=Fl=Fm=Fr=Ga=Gd=Ge=H=He=Hf=Hg=Ho=Hs=I=In=Ir=K=Kr=La=Li=Lr=Lu=Lv= Mc=Md=Mg=Mn=Mo=Mt=N=Na=Nb=Nd=Ne=Nh=Ni=No=Np=O=Og=Os=P=Pa=Pb=Pd=Pm=Po=Pr=Pt=Pu=Ra=Rb=Re=Rf=Rg=Rh=Rn=Ru=S=Sb=Sc=Se=Sg=Si=Sm=Sn=Sr=Ta=Tb=Tc=Te=Th=Ti=Tl=Tm=Ts=U=V=W=Xe=Y=Yb=Zn=Zr= index_label= index2_label= index_comment= index2_comment= CAS_number2= CAS_supplemental2= ATC_prefix2= ATC_suffix2= ATC_supplemental2= PubChem2= PubChemSubstance2= IUPHAR_ligand2= DrugBank2= ChemSpiderID2= UNII2= KEGG2= ChEBI2= ChEMBL2= PDB_ligand2= NIAID_ChemDB2= SMILES2= smiles2= StdInChI2= StdInChIKey2= CAS_number2_Ref= ChEBI2_Ref= ChEMBL2_Ref= ChemSpiderID2_Ref= DrugBank2_Ref= KEGG2_Ref= StdInChI2_Ref= StdInChIKey2_Ref= UNII2_Ref= DTXSID2= QID= QID2=PLLR= pregnancy_US= pregnancy_US_comment= |cat=Pages using infobox drug with unknown parameters |format=0|errNS=0
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}}{{Infobox drug/maintenance categoriesTemplate:Yesno | drug_name = | INN = | _drugtype =
| _has_physiological_data= | _has_gene_therapy=
| vaccine_type= | mab_type= | _number_of_combo_chemicals={{#invoke:ParameterCount |main |component1 |component2 |component3 |component4|component5|component6 }} | _vaccine_data= | _mab_data= | _mab_vaccine_data= | _mab_other_data=10142c1ncccc1[C@@H]2CCCN2CChiral1S/C10H14N2/c1-12-7-3-5-10(12)9-4-2-6-11-8-9/h2,4,6,8,10H,3,5,7H2,1H3/t10-/m0/s1SNICXCGAKADSCV-JTQLQIEISA-NTemplate:StdinchiciteTemplate:Stdinchicite1.01-79247 | _combo_data= | _physiological_data= | _clinical_data=Template:Drugs.comVery high<ref>Template:Cite book</ref>Physical: Low–moderate<ref>Template:Cite book</ref> Psychological: High<ref name=Dependence-withdrawal/><ref>Template:Cite journal</ref> DInhalation; insufflation; oral – buccal, sublingual, and ingestion; transdermal; rectalNicorette, othersStimulant; Nootropic; EuphoriantN07Template:ATCvet | _legal_data=S7UnscheduledUnscheduledUnscheduledUnscheduled<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>GSLUnscheduledand prescription <ref name="PubChem Nicotine">Template:Cite encyclopedia</ref>OTCIn general legal for all uses for tobacco and nicotine products as electronic cigarettes, OTC for nicotine gums and lozenges.
| _other_data=3-[(2S)-1-methylpyrrolidin-2-yl]pyridine
| _image_0_or_2 = File:Nikotin - Nicotine.svg | _image_LR = Nicotine molecule ball from xtal.pngNicotine molecule spacefill from xtal.png
| _datapage = Nicotine (data page) | _vaccine_target={{#ifeq: | vaccine | | _type_not_vaccine }} | _legal_all=S7UnscheduledUnscheduledGSLOTCUnscheduledIn general legal for all uses for tobacco and nicotine products as electronic cigarettes, OTC for nicotine gums and lozenges. | _ATC_prefix_supplemental=N07Template:ATCvet | _has_EMA_link = | CAS_number=54-11-5 | PubChem=89594 | ChemSpiderID=80863 | ChEBI=18723 | ChEMBL=3 | DrugBank=DB00184 | KEGG=D03365 | _hasInChI_or_Key={{#if:1S/C10H14N2/c1-12-7-3-5-10(12)9-4-2-6-11-8-9/h2,4,6,8,10H,3,5,7H2,1H3/t10-/m0/s1SNICXCGAKADSCV-JTQLQIEISA-N |yes}} | UNII=6M3C89ZY6R | _hasJmol02 = |_hasMultipleCASnumbers = |_hasMultiplePubChemCIDs = |_hasMultipleChEBIs =
| _countSecondIDs={{#invoke:ParameterCount |main |CAS_number2 |ATC_prefix2 |PubChem2 |PubChemStructure2 |IUPHAR_ligand2 |DrugBank2 |ChemSpiderID2 |UNII2 |KEGG2 |ChEBI2 |ChEMBL2 |PDB_ligand2 |NIAID_ChemDB2 |SMILES2 |smiles2 |StdInChI2 |StdInChIKey2 |DTXCID2}} | _countIndexlabels={{#invoke:ParameterCount |main |index_label |index2_label}} | _trackListSortletter= |QID = |QID2 = |Verifiedfields= |Watchedfields= |verifiedrevid=}} Template:Tobacco Nicotine is a naturally produced alkaloid in the nightshade family of plants (most predominantly in tobacco and Duboisia hopwoodii)<ref name="FagerströmReview">Template:Cite journal</ref> and is widely used recreationally as a stimulant and anxiolytic. As a pharmaceutical drug, it is used for smoking cessation to relieve withdrawal symptoms.<ref name=SajjaRahman2016>Template:Cite journal</ref><ref name="PubChem Nicotine" /><ref name="IUPHAR nicotine clinical data">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name=Abou-Donia2015>Template:Cite book</ref> Nicotine acts as a receptor agonist at most nicotinic acetylcholine receptors (nAChRs),<ref name=IUPHAR/><ref name=MalenkaNicotine/><ref name="Kishioka_2014">Template:Cite journal</ref> except at two nicotinic receptor subunits (nAChRα9 and nAChRα10) where it acts as a receptor antagonist.<ref name=IUPHAR/>
Nicotine constitutes approximately 0.6–3.0% of the dry weight of tobacco.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Nicotine is also present at ppb concentrations in edible plants in the family Solanaceae, including potatoes, tomatoes, and eggplants,<ref name=SiegmundLeitner1999/> though sources disagree on whether this has any biological significance to human consumers.<ref name=SiegmundLeitner1999/> It functions as an antiherbivore toxin; consequently, nicotine was widely used as an insecticide in the past,<ref>Template:Cite bookTemplate:Page needed</ref><ref name=Ujvary>Template:Cite book</ref> and neonicotinoids (structurally similar to nicotine), such as imidacloprid, are some of the most effective and widely used insecticides.
Nicotine is highly addictive.<ref name="pmid23494236">Template:Cite journal</ref><ref name=Grana2014/><ref name=Siqueira2016/> Slow-release forms (gums and patches, when used correctly) can be less addictive and help in quitting.<ref name="pmid17640334">Template:Cite journal</ref><ref>Template:Cite journal</ref><ref name="assets.publishing.service.gov.uk">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Animal research suggests that monoamine oxidase inhibitors present in tobacco smoke may enhance nicotine's addictive properties.<ref name="RCP" /><ref name="SmithMAO">Template:Cite journal</ref> An average cigarette yields about 2 mg of absorbed nicotine.<ref name=MayerNewLethalDose2013/> The estimated lower dose limit for fatal outcomes is 500–1,000 mg of ingested nicotine for an adult (6.5–13 mg/kg).<ref name="RCP">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name=MayerNewLethalDose2013/> Nicotine addiction involves drug-reinforced behavior, compulsive use, and relapse following abstinence.<ref name="Caponnetto2012">Template:Cite journal</ref> Nicotine dependence involves tolerance, sensitization,<ref name=JainMukherjee2008>Template:Cite journal</ref> physical dependence, and psychological dependence,<ref>Template:Cite journal</ref> which can cause distress.<ref name=Parrott2015/><ref name=psych_addiction>Template:Cite journal</ref> Nicotine withdrawal symptoms include depression, stress, anxiety, irritability, difficulty concentrating, and sleep disturbances.<ref name=Dependence-withdrawal/> Mild nicotine withdrawal symptoms are measurable in unrestricted smokers, who experience normal moods only as their blood nicotine levels peak, with each cigarette.<ref name=Parrott2003/> On quitting, withdrawal symptoms worsen sharply, then gradually improve to a normal state.<ref name=Parrott2003/>
Nicotine use as a tool for quitting smoking has a good safety history.<ref name="Schraufnage2014">Template:Cite journal</ref> Animal studies suggest that nicotine may adversely affect cognitive development in adolescence, but the relevance of these findings to human brain development is disputed.<ref name="2016 SGR">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name="RCP" /> At low amounts, it has a mild analgesic effect.<ref name=Schraufnagel2015>Template:Cite journal</ref> According to the International Agency for Research on Cancer, "nicotine is not generally considered to be a carcinogen".<ref>IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Personal Habits and Indoor Combustions. Lyon (FR): International Agency for Research on Cancer; 2012. (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 100E.) TOBACCO SMOKING.</ref><ref name=IARCCancerStatement/> The Surgeon General of the United States indicates that evidence is inadequate to infer the presence or absence of a causal relationship between exposure to nicotine and risk for cancer.<ref name=SGUS2014/> Nicotine has been shown to produce birth defects in humans and is considered a teratogen.<ref name=Kohlmeier2015>Template:Cite journal</ref><ref name="TOXNET Nicotine entry">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> The median lethal dose of nicotine in humans is unknown.<ref name="ECHA nicotine monograph"/> High doses are known to cause nicotine poisoning, organ failure, and death through paralysis of respiratory muscles,<ref name=SGUS2014/><ref name="Effah2022">Template:Cite journal</ref> though serious or fatal overdoses are rare.<ref name="Lavoie">Template:Cite journal</ref>
UsesEdit
MedicalEdit
The primary therapeutic use of nicotine is treating nicotine dependence to eliminate smoking and the damage it does to health. Controlled levels of nicotine are given to patients through gums, dermal patches, lozenges, inhalers, or nasal sprays to wean them off their dependence. A 2018 Cochrane Collaboration review found high-quality evidence that all current forms of nicotine replacement therapy (gum, patch, lozenges, inhaler, and nasal spray) increase the chances of successfully quitting smoking by Template:Nowrap, regardless of setting.<ref name="Cochrane NRT 2018" />
Combining nicotine patch use with a faster acting nicotine replacement, like gum or spray, improves the odds of treatment success.<ref name=":3">Template:Cite journal</ref>
In contrast to recreational nicotine products, which have been designed to maximize the likelihood of addiction, nicotine replacement products (NRTs) are designed to minimize addictiveness.<ref name="SGUS2014" />Template:Rp The more quickly a dose of nicotine is delivered and absorbed, the higher the addiction risk.<ref name="Parrott2015" />
PesticideEdit
Nicotine has been used as an insecticide since at least 1690, in the form of tobacco extracts or as pure nicotine sulphate<ref name="Ujvary" /><ref name=neonic_mechanisms>Template:Cite journal</ref><ref>Template:Cite bookTemplate:Page needed</ref> (although other components of tobacco also seem to have pesticide effects).<ref name=modern_pesticide>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> It acts on the nicotinic acetylcholine receptor, and gave the receptor its name. Nicotine is in IRAC group 4B. Nicotine insecticides have been banned in the US since 2014,<ref name=epacancel2>Template:Cite journal</ref> including use on organic crops,<ref name=prohibited_dust>US Code of Federal Regulations. 7 CFR 205.602 – Nonsynthetic substances prohibited for use in organic crop production</ref> and caution is recommended for small gardeners.<ref name="homemade_pesticide">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Nicotine pesticides have been banned in the EU since 2009.<ref name=pesticide_contam/> Foods are imported from countries in which nicotine pesticides are allowed, such as China, but foods may not exceed maximum nicotine levels.<ref name=pesticide_contam>Template:Cite journal</ref><ref>Template:Cite journal</ref> Neonicotinoids, such as imidacloprid, which are derived from and structurally similar to nicotine, are widely used as agricultural and veterinary pesticides as of 2016.<ref>Template:Cite journal</ref><ref name=neonic_mechanisms/>
PerformanceEdit
Nicotine-containing products are sometimes used for the performance-enhancing effects of nicotine on cognition.<ref>Template:Cite journal</ref> A 2010 meta-analysis of 41 double-blind, placebo-controlled studies concluded that nicotine or smoking had significant positive effects on aspects of fine motor abilities, alerting and orienting attention, and episodic and working memory.<ref>Template:Cite journal</ref> A 2015 review noted that stimulation of the α4β2 nicotinic receptor is responsible for certain improvements in attentional performance;<ref>Template:Cite journal</ref> among the nicotinic receptor subtypes, nicotine has the highest binding affinity at the α4β2 receptor (ki=1 Template:Abbr), which is also the biological target that mediates nicotine's addictive properties.<ref name="Nicotine IUPHAR">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Nicotine has potential beneficial effects, but it also has paradoxical effects, which may be due to the inverted U-shape of the dose-response curve or pharmacokinetic features.<ref>Template:Cite journal</ref>
RecreationalEdit
Nicotine is used as a recreational drug.<ref name=UbanHorton2018>Template:Cite journal</ref> It is widely used, highly addictive and hard to discontinue.<ref name="Siqueira2016">Template:Cite journal</ref> Nicotine is often used compulsively,<ref name=addictive>Template:Cite journal</ref> and dependence can develop within days.<ref name=addictive/><ref name="Wilder2016">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Recreational drug users commonly use nicotine for its mood-altering effects.<ref name=Parrott2015>Template:Cite journal</ref> Recreational nicotine products include chewing tobacco, cigars,<ref name=ElSayedSylvester2007/> cigarettes,<ref name=ElSayedSylvester2007/> e-cigarettes,<ref name=Rahman2014>Template:Cite journal</ref> snuff, pipe tobacco,<ref name=ElSayedSylvester2007>Template:Cite journal</ref> snus, and nicotine pouches.
Alcohol infused with nicotine is called nicotini.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
ContraindicationsEdit
Nicotine use for tobacco cessation has few contraindications.<ref name="nrt_safety">Template:Cite journal</ref>
It is not known whether nicotine replacement therapy is effective for smoking cessation in adolescents, as of 2014.<ref name="pharmacotherapy">Template:Cite journal</ref> It is therefore not recommended to adolescents.<ref name="adolescents">Template:Cite journal</ref> It is not safe to use nicotine during pregnancy or breastfeeding, although it is safer than smoking. The desirability of NRT use in pregnancy is therefore debated.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>Template:Cite journal</ref><ref name="pregnancy_controversy">Template:Cite journal</ref>
Randomized trials and observational studies of nicotine replacement therapy in cardiovascular patients show no increase in adverse cardiovascular events compared to those treated with placebo.<ref name="ACC Consensus">Template:Cite journal</ref> Using nicotine products during cancer treatment may be contraindicated, as nicotine may promote tumour growth, but temporary use of NRTs to quit smoking may be advised for harm reduction.<ref name="carcinogenicity">Template:Cite journal</ref>
Nicotine gum is contraindicated in individuals with temporomandibular joint disease.<ref name="Nicotine AHFS monograph" /> People with chronic nasal disorders and severe reactive airway disease require additional precautions when using nicotine nasal sprays.<ref name="adolescents"/> Nicotine in any form is contraindicated in individuals with a known hypersensitivity to nicotine.<ref name="Nicotine AHFS monograph" /><ref name="adolescents"/>
Adverse effectsEdit
Nicotine is classified as a poison,<ref>Template:Cite book Extract of page 525</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> and it is "extremely hazardous".<ref name=":4">Template:Citation</ref> However, at doses typically used by consumers, it presents little if any hazard to the user.<ref name="RCP_report">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> A 2018 Cochrane Collaboration review lists nine main adverse events related to nicotine replacement therapy: headache, dizziness, lightheadedness, nausea, vomiting, gastrointestinal symptoms, insomnia, abnormal dreams, non-ischemic palpitations and chest pain, skin reactions, oral/nasal reactions, and hiccups.<ref name="Cochrane NRT 2018_AEs">Template:Cite journal</ref> Many of these were also common in the placebo group without nicotine.<ref name="Cochrane NRT 2018_AEs" /> Palpitations and chest pain were deemed "rare" and there was no evidence of an increased number of serious cardiac problems compared to the placebo group, even in people with established cardiac disease.<ref name="Cochrane NRT 2018" /> The common side effects from nicotine exposure are listed in the table below. Serious adverse events due to the use of nicotine replacement therapy are extremely rare.<ref name="Cochrane NRT 2018" /> At low amounts, it has a mild analgesic effect.<ref name="Schraufnagel2015" /> However, at sufficiently high doses, nicotine may result in nausea, vomiting, diarrhea, salivation, bradycardia, and possibly seizures, hypoventilation, and death.<ref name="England2015">Template:Cite journal</ref>
| Route of administration | Dosage form | Associated side effects of nicotine | Sources | ||
|---|---|---|---|---|---|
| Buccal | Nicotine gum | Indigestion, nausea, hiccups, traumatic injury to oral mucosa or teeth, irritation or tingling of the mouth and throat, oral mucosal ulceration, jaw-muscle ache, burping, gum sticking to teeth, unpleasant taste, dizziness, lightheadedness, headache, and insomnia. | <ref name="Cochrane NRT 2018" /><ref name="Nicotine AHFS monograph" /> | ||
| Lozenge | Nausea, dyspepsia, flatulence, headache, upper respiratory tract infections, irritation (i.e., a burning sensation), hiccups, sore throat, coughing, dry lips, and oral mucosal ulceration. | <ref name="Cochrane NRT 2018" /><ref name="Nicotine AHFS monograph" /> | |||
| Transdermal | Transdermal patch |
Application site reactions (i.e., pruritus, burning, or erythema), diarrhea, dyspepsia, abdominal pain, dry mouth, nausea, dizziness, nervousness or restlessness, headache, vivid dreams or other sleep disturbances, and irritability. | <ref name="Cochrane NRT 2018" /><ref name="Nicotine AHFS monograph" /><ref name="FDA transdermal patch">{{#invoke:citation/CS1|citation | CitationClass=web
}}</ref> | |
| Intranasal | Nasal spray | Runny nose, nasopharyngeal and ocular irritation, watery eyes, sneezing, and coughing. | <ref name="Cochrane NRT 2018" /><ref name="Nicotine AHFS monograph" /><ref name="Nicotrol NS">{{#invoke:citation/CS1|citation | CitationClass=web | |
| Oral inhalation | Inhaler | Dyspepsia, oropharyngeal irritation (e.g., coughing, irritation of the mouth and throat), rhinitis, and headache. | <ref name="Cochrane NRT 2018" /><ref name="Nicotine AHFS monograph">{{#invoke:citation/CS1|citation | CitationClass=web
}}</ref><ref name="Nicotrol">{{#invoke:citation/CS1|citation |
CitationClass=web
}}</ref> |
| All (nonspecific) | Peripheral vasoconstriction, tachycardia (i.e., fast heart rate), elevated blood pressure, increased alertness and cognitive performance. | <ref name="Nicotine AHFS monograph" /><ref name="Nicotrol NS" /> | |||
SleepEdit
Nicotine reduces the amount of rapid eye movement (REM) sleep, slow-wave sleep (SWS), and total sleep time in healthy nonsmokers given nicotine via a transdermal patch, and the reduction is dose-dependent.<ref name=GarciaSalloum2015/> Acute nicotine intoxication has been found to significantly reduce total sleep time and increase REM latency, sleep onset latency, and non-rapid eye movement (NREM) stage 2 sleep time.<ref name=GarciaSalloum2015>Template:Cite journal</ref><ref name="Neuropharmacology review">Template:Cite journal</ref> Depressive non-smokers experience mood and sleep improvements under nicotine administration; however, subsequent nicotine withdrawal has a negative effect on both mood and sleep.<ref name=Jaehne2009>Template:Cite journal</ref>
Cardiovascular systemEdit
Nicotine exerts several significant effects on the cardiovascular system. Primarily, it stimulates the sympathetic nervous system, leading to the release of catecholamines. This activation results in an increase in heart rate and blood pressure, as well as enhanced myocardial contractility, which raises the workload on the heart. Additionally, nicotine causes systemic vasoconstriction, including constriction of coronary arteries, which can reduce blood flow to the heart. Long-term exposure to nicotine may impair endothelial function, potentially contributing to atherosclerosis. Furthermore, nicotine has been associated with the development of cardiac arrhythmias, particularly in individuals who already have underlying heart disease.<ref name="Benowitz 2016" />
The effects of nicotine can be differentiated between short-term and long-term use. Short-term nicotine use, such as that associated with nicotine replacement therapy (NRT) for smoking cessation, appears to pose little cardiovascular risk, even for patients with known cardiovascular conditions. In contrast, longer-term nicotine use may not accelerate atherosclerosis but could contribute to acute cardiovascular events in those with pre-existing cardiovascular disease. Many severe cardiovascular effects traditionally associated with smoking may not be solely attributable to nicotine itself. Cigarette smoke contains numerous other potentially cardiotoxic substances, including carbon monoxide and oxidant gases.<ref name="Benowitz 2016" />
A 2016 review of the cardiovascular toxicity of nicotine concluded, "Based on current knowledge, we believe that the cardiovascular risks of nicotine from e-cigarette use in people without cardiovascular disease are quite low. We have concerns that nicotine from e-cigarettes could pose some risk for users with cardiovascular disease."<ref name="Benowitz 2016">Template:Cite journal</ref>
A 2018 Cochrane review found that, in rare cases, nicotine replacement therapy can cause non-ischemic chest pain (i.e., chest pain that is unrelated to a heart attack) and heart palpitations, but does not increase the incidence of serious cardiac adverse events (i.e., myocardial infarction, stroke, and cardiac death) relative to controls.<ref name="Cochrane NRT 2018">Template:Cite journal</ref>
Blood pressureEdit
In the short term, nicotine causes a transient increase in blood pressure. Long term, epidemiological studies generally show increased blood pressure and hypertension among nicotine users.<ref name="Benowitz 2016" />
Reinforcement disordersEdit
Template:See also Template:Annotated image 4
Nicotine is highly addictive but paradoxically has quite weak reinforcing property compared to other drugs of abuse in various animals.<ref name=Grana2014>Template:Cite journal</ref><ref name=Siqueira2016/><ref>Template:Cite journal</ref><ref name="Belluzzi Wang Leslie 2005">Template:Cite journal</ref> Its addictiveness depends on how it is administered and also depends upon form in which nicotine is used.<ref name="assets.publishing.service.gov.uk"/> Animal research suggests that monoamine oxidase inhibitors, acetaldehyde<ref name="Belluzzi Wang Leslie 2005"/><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> and other constituents in tobacco smoke may enhance its addictiveness.<ref name="RCP" /><ref name="SmithMAO"/> Nicotine dependence involves aspects of both psychological dependence and physical dependence, since discontinuation of extended use has been shown to produce both affective (e.g., anxiety, irritability, craving, anhedonia) and somatic (mild motor dysfunctions such as tremor) withdrawal symptoms.<ref name="Dependence-withdrawal">Template:Cite journal</ref> Withdrawal symptoms peak in one to three days<ref name=DasProchaska2017>Template:Cite journal</ref> and can persist for several weeks.<ref name="HKS2010">Template:Cite journal</ref> Even though other drugs of dependence can have withdrawal states lasting 6 months or longer, this does not appear to occur with cigarette withdrawal.<ref>Template:Cite journal</ref>
Normal between-cigarettes discontinuation, in unrestricted smokers, causes mild but measurable nicotine withdrawal symptoms.<ref name=Parrott2003/> These include mildly worse mood, stress, anxiety, cognition, and sleep, all of which briefly return to normal with the next cigarette.<ref name=Parrott2003/> Smokers have a worse mood than they typically would have if they were not nicotine-dependent; they experience normal moods only immediately after smoking.<ref name=Parrott2003/> Nicotine dependence is associated with poor sleep quality and shorter sleep duration among smokers.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref>
In dependent smokers, withdrawal causes impairments in memory and attention, and smoking during withdrawal returns these cognitive abilities to pre-withdrawal levels.<ref name=Bruijnzeel2012>Template:Cite journal</ref> The temporarily increased cognitive levels of smokers after inhaling smoke are offset by periods of cognitive decline during nicotine withdrawal.<ref name=Parrott2003/> Therefore, the overall daily cognitive levels of smokers and non-smokers are roughly similar.<ref name=Parrott2003>Template:Cite journal</ref>
Nicotine activates the mesolimbic pathway and induces long-term ΔFosB expression (i.e., produces phosphorylated ΔFosB isoforms) in the nucleus accumbens when inhaled or injected frequently or at high doses, but not necessarily when ingested.<ref name="Nestler 2013Rev">Template:Cite journal</ref><ref name="Addiction molecular neurobiology">Template:Cite journal</ref><ref name="RouteDFosB Primary">Template:Cite journal</ref> Consequently, high daily exposure (possibly excluding oral route) to nicotine can cause ΔFosB overexpression in the nucleus accumbens, resulting in nicotine addiction.<ref name="Nestler 2013Rev"/><ref name="Addiction molecular neurobiology"/>
CancerEdit
Contrary to popular belief, nicotine itself does not cause cancer in humans,<ref name=IARCCancerStatement>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>Template:Cite magazine</ref> although it is unclear whether it functions as a tumor promoter Template:As of.<ref>Template:Cite journal</ref> A 2018 report by the US National Academies of Sciences, Engineering, and Medicine concludes, "Template:Wj[w]hile it is biologically plausible that nicotine can act as a tumor promoter, the existing body of evidence indicates this is unlikely to translate into increased risk of human cancer."<ref>Template:Cite book</ref>
Although nicotine is classified as a non-carcinogenic substance, it can still promote tumor growth and metastasis. It induces several processes that contribute to cancer progression, including cell cycle progression, epithelial-to-mesenchymal transition, migration, invasion, angiogenesis, and evasion of apoptosis.<ref name="Schaal_2014">Template:Cite journal</ref> These effects are primarily mediated through nicotinic acetylcholine receptors (nAChRs), particularly the α7 subtype, and to a lesser extent, β-adrenergic receptors (β-ARs). Activation of these receptors triggers several signaling cascades crucial in cancer biology, notably the MAPK/ERK pathway, PI3K/AKT pathway, and JAK-STAT signaling.<ref name="Schaal_2014" />
Nicotine promotes lung cancer development by enhancing proliferation, angiogenesis, migration, invasion, and epithelial–mesenchymal transition (EMT) via nAChRs, which are present in lung cancer cells.<ref name=Merecz-SadowskaSitarek2020>Template:Cite journalTemplate:CC-notice</ref> Additionally, nicotine-induced EMT contributes to drug resistance in cancer cells.<ref>Template:Cite journal</ref>
Nicotine in tobacco can form carcinogenic tobacco-specific nitrosamines through a nitrosation reaction. This occurs mostly in the curing and processing of tobacco. However, nicotine in the mouth and stomach can react to form N-nitrosonornicotine,<ref name=":1">Template:Cite journal</ref> a known type 1 carcinogen,<ref name=":2">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> suggesting that consumption of non-tobacco forms of nicotine may still play a role in carcinogenesis.<ref>Template:Cite journal</ref>
GenotoxicityEdit
Nicotine causes DNA damage in several types of human cells as judged by assays for genotoxicity such as the comet assay, cytokinesis-block micronucleus test and chromosome aberrations test. In humans, this damage can happen in primary parotid gland cells,<ref>Template:Cite journal</ref> lymphocytes,<ref>Template:Cite journal</ref> and respiratory tract cells.<ref>Template:Cite journal</ref>
Pregnancy and breastfeedingEdit
Nicotine has been shown to produce birth defects in some animal species, but not others;<ref name="TOXNET Nicotine entry" /> consequently, it is considered to be a possible teratogen in humans.<ref name="TOXNET Nicotine entry"/> In animal studies that resulted in birth defects, researchers found that nicotine negatively affects fetal brain development and pregnancy outcomes;<ref name="TOXNET Nicotine entry"/><ref name=SGUS2014>Template:Cite book</ref> the negative effects on early brain development are associated with abnormalities in brain metabolism and neurotransmitter system function.<ref>Template:Cite journal</ref> Nicotine crosses the placenta and is found in the breast milk of mothers who smoke as well as mothers who inhale passive smoke.<ref name=Chapman2015>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
Nicotine exposure in utero is responsible for several complications of pregnancy and birth: pregnant women who smoke are at greater risk for both miscarriage and stillbirth and infants exposed to nicotine in utero tend to have lower birth weights.<ref name=Holbrook2016>Template:Cite journal</ref> A McMaster University research group observed in 2010 that rats exposed to nicotine in the womb (via parenteral infusion) later in life had conditions including type 2 diabetes, obesity, hypertension, neurobehavioral defects, respiratory dysfunction, and infertility.<ref>Template:Cite journal</ref>
OverdoseEdit
{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}}
It is unlikely that a person would overdose on nicotine through smoking alone. The US Food and Drug Administration (FDA) stated in 2013 that there are no significant safety concerns associated with the use of more than one form of over-the-counter (OTC) nicotine replacement therapy at the same time, or using OTC NRT at the same time as another nicotine-containing product, like cigarettes.<ref name=FDANRTLabels>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> The median lethal dose of nicotine in humans is unknown.<ref name="ECHA nicotine monograph">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name=MayerNewLethalDose2013>Template:Cite journal</ref> Nevertheless, nicotine has a relatively high toxicity in comparison to many other alkaloids such as caffeine, which has an LD50 of 127 mg/kg when administered to mice.<ref>Toxicology and Applied Pharmacology. Vol. 44, Pg. 1, 1978.</ref> At sufficiently high doses, it is associated with nicotine poisoning,<ref name=SGUS2014/> which, while common in children (in whom poisonous and lethal levels occur at lower doses per kilogram of body weight<ref name=Schraufnagel2015/>) rarely results in significant morbidity or death.<ref name="TOXNET Nicotine entry" /> The estimated lower dose limit for fatal outcomes is 500–1,000 mg of ingested nicotine for an adult (6.5–13 mg/kg).<ref name="RCP"/><ref name=MayerNewLethalDose2013/>
The initial symptoms of a nicotine overdose typically include nausea, vomiting, diarrhea, hypersalivation, abdominal pain, tachycardia (rapid heart rate), hypertension (high blood pressure), tachypnea (rapid breathing), headache, dizziness, pallor (pale skin), auditory or visual disturbances, and perspiration, followed shortly after by marked bradycardia (slow heart rate), bradypnea (slow breathing), and hypotension (low blood pressure).<ref name="TOXNET Nicotine entry" /> An increased respiratory rate (i.e., tachypnea) is one of the primary signs of nicotine poisoning.<ref name="TOXNET Nicotine entry" /> At sufficiently high doses, somnolence (sleepiness or drowsiness), confusion, syncope (loss of consciousness from fainting), shortness of breath, marked weakness, seizures, and coma may occur.<ref name="inchem" /><ref name="TOXNET Nicotine entry" /> Lethal nicotine poisoning rapidly produces seizures, and death – which may occur within minutes – is believed to be due to respiratory paralysis.<ref name="TOXNET Nicotine entry" />
ToxicityEdit
Today nicotine is less commonly used in agricultural insecticides, which was a main source of poisoning. More recent cases of poisoning typically appear to be in the form of Green Tobacco Sickness (GTS),<ref name="TOXNET Nicotine entry" /> accidental ingestion of tobacco or tobacco products, or ingestion of nicotine-containing plants.<ref name="Schep"/><ref name="Smolinske">Template:Cite journal</ref><ref name="Furer">Template:Cite journal</ref> People who harvest or cultivate tobacco may experience GTS, a type of nicotine poisoning caused by dermal exposure to wet tobacco leaves. This occurs most commonly in young, inexperienced tobacco harvesters who do not consume tobacco.<ref name=Schep>Template:Cite journal</ref><ref>Template:Cite journal</ref> People can be exposed to nicotine in the workplace by breathing it in, skin absorption, swallowing it, or eye contact. The Occupational Safety and Health Administration (OSHA) has set the legal limit (permissible exposure limit) for nicotine exposure in the workplace as 0.5 mg/m3 skin exposure over an 8-hour workday. The US National Institute for Occupational Safety and Health (NIOSH) has set a recommended exposure limit (REL) of 0.5 mg/m3 skin exposure over an 8-hour workday. At environmental levels of 5 mg/m3, nicotine is immediately dangerous to life and health.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Template:Clear right
Drug interactionsEdit
PharmacodynamicEdit
- Potential interaction with sympathomimetic drugs (adrenergic agonists) and sympatholytic drugs (alpha-blockers and beta-blockers).<ref name="Nicotine AHFS monograph"/>
PharmacokineticEdit
Nicotine and cigarette smoke both induce the expression of liver enzymes (e.g., certain cytochrome P450 proteins) which metabolize drugs, leading to the potential for alterations in drug metabolism.<ref name="Nicotine AHFS monograph" />
- Smoking cessation may decrease the metabolism of acetaminophen, beta-blockers, caffeine, oxazepam, pentazocine, propoxyphene, theophylline, and tricyclic antidepressants, leading to higher plasma concentrations of these drugs.<ref name="Nicotine AHFS monograph" />
- Possible alteration of nicotine absorption through the skin from the transdermal nicotine patch by drugs that cause vasodilation or vasoconstriction.<ref name="Nicotine AHFS monograph" />
- Possible alteration of nicotine absorption through the nasal cavity from the nicotine nasal spray by nasal vasoconstrictors (e.g., xylometazoline).<ref name="Nicotine AHFS monograph" />
- Possible alteration of nicotine absorption through oral mucosa from nicotine gum and lozenges by food and drink that modify salivary pH.<ref name="Nicotine AHFS monograph"/>
PharmacologyEdit
PharmacodynamicsEdit
Nicotine acts as a receptor agonist at most nicotinic acetylcholine receptors (nAChRs),<ref name="IUPHAR"/><ref name=MalenkaNicotine>Template:Cite book</ref> except at two nicotinic receptor subunits (nAChRα9 and nAChRα10) where it acts as a receptor antagonist.<ref name=IUPHAR>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Such antagonism results in mild analgesia.
Central nervous systemEdit
By binding to nicotinic acetylcholine receptors in the brain, nicotine elicits its psychoactive effects and increases the levels of several neurotransmitters in various brain structures – acting as a sort of "volume control".<ref name=Pomerleau1984>Template:Cite journal</ref><ref>Template:Cite journal</ref> Nicotine has a higher affinity for nicotinic receptors in the brain than those in skeletal muscle, though at toxic doses it can induce contractions and respiratory paralysis.<ref>Template:Cite book</ref> Nicotine's selectivity is thought to be due to a particular amino acid difference on these receptor subtypes.<ref name="pmid19252481">Template:Cite journal</ref> Nicotine is unusual in comparison to most drugs, as its profile changes from stimulant to sedative with increasing dosages, a phenomenon known as "Nesbitt's paradox" after the doctor who first described it in 1969.<ref>Nesbitt P (1969). Smoking, physiological arousal, and emotional response. Unpublished doctoral dissertation, Columbia University.</ref><ref name=Parrott1998>Template:Cite journal</ref> At very high doses it dampens neuronal activity.<ref name=Wadgave2016>Template:Cite journal</ref> Nicotine induces both behavioral stimulation and anxiety in animals.<ref name="inchem" /> Research into nicotine's most predominant metabolite, cotinine, suggests that some of nicotine's psychoactive effects are mediated by cotinine.<ref>Template:Cite journal</ref>
Nicotine activates nicotinic receptors (particularly α4β2 nicotinic receptors, but also α5 nAChRs) on neurons that innervate the ventral tegmental area and within the mesolimbic pathway where it appears to cause the release of dopamine.<ref name="Nicotine reinforcement and euphoria">Template:Cite book</ref><ref name="Cholinergic-dopaminergic reward link" /> This nicotine-induced dopamine release occurs at least partially through activation of the cholinergic–dopaminergic reward link in the ventral tegmental area.<ref name="Cholinergic-dopaminergic reward link">Template:Cite journal</ref><ref name="Picciotto2014">Template:Cite journal</ref> Nicotine can modulate the firing rate of the ventral tegmental area neurons.<ref name="Picciotto2014"/> These actions are largely responsible for the strongly reinforcing effects of nicotine, which often occur in the absence of euphoria;<ref name="Nicotine reinforcement and euphoria" /> however, mild euphoria from nicotine use can occur in some individuals.<ref name="Nicotine reinforcement and euphoria" /> Chronic nicotine use inhibits class I and II histone deacetylases in the striatum, where this effect plays a role in nicotine addiction.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref>
Sympathetic nervous systemEdit
Nicotine also activates the sympathetic nervous system,<ref>Template:Cite journal</ref> acting via splanchnic nerves to the adrenal medulla, stimulating the release of epinephrine. Acetylcholine released by preganglionic sympathetic fibers of these nerves acts on nicotinic acetylcholine receptors, causing the release of epinephrine (and norepinephrine) into the bloodstream.
Adrenal medullaEdit
By binding to ganglion type nicotinic receptors in the adrenal medulla, nicotine increases flow of adrenaline (epinephrine), a stimulating hormone and neurotransmitter. By binding to the receptors, it causes cell depolarization and an influx of calcium through voltage-gated calcium channels. Calcium triggers the exocytosis of chromaffin granules and thus the release of epinephrine (and norepinephrine) into the bloodstream. The release of epinephrine (adrenaline) causes an increase in heart rate, blood pressure and respiration, as well as higher blood glucose levels.<ref name="Marieb" >Template:Cite bookTemplate:Page needed</ref>
PharmacokineticsEdit
As nicotine enters the body, it is distributed quickly through the bloodstream and crosses the blood–brain barrier reaching the brain within 10–20 seconds after inhalation.<ref name="pmid12971663">Template:Cite journal</ref> The elimination half-life of nicotine in the body is around two hours.<ref>Template:Cite journal</ref><ref name="pmid7077531">Template:Cite journal</ref> Nicotine is primarily excreted in urine and urinary concentrations vary depending upon urine flow rate and urine pH.<ref name="inchem" />
The amount of nicotine absorbed by the body from smoking can depend on many factors, including the types of tobacco, whether the smoke is inhaled, and whether a filter is used. However, it has been found that the nicotine yield of individual products has only a small effect (4.4%) on the blood concentration of nicotine,<ref name="Russell_1980">Template:Cite journal</ref> suggesting "the assumed health advantage of switching to lower-tar and lower-nicotine cigarettes may be largely offset by the tendency of smokers to compensate by increasing inhalation".
Nicotine has a half-life of 1–2 hours. Cotinine is an active metabolite of nicotine that remains in the blood with a half-life of 18–20 hours, making it easier to analyze.<ref>Template:Cite journal</ref>
Nicotine is metabolized in the liver by cytochrome P450 enzymes (mostly CYP2A6, and also by CYP2B6) and FMO3, which selectively metabolizes (S)-nicotine. A major metabolite is cotinine. Other primary metabolites include nicotine N-oxide, nornicotine, nicotine isomethonium ion, 2-hydroxynicotine and nicotine glucuronide.<ref name="pmid15734728">Template:Cite journal</ref> Under some conditions, other substances may be formed such as myosmine.<ref name="Petrick_2011">Template:Cite journal</ref><ref>Template:Cite news</ref>
Glucuronidation and oxidative metabolism of nicotine to cotinine are both inhibited by menthol, an additive to mentholated cigarettes, thus increasing the half-life of nicotine in vivo.<ref>Template:Cite journal</ref>
MetabolismEdit
Nicotine decreases hunger and as a consequence food consumption, alongside increasing energy expenditure.<ref>Template:Cite journal</ref><ref name=HuYang2018>Template:Cite journal</ref> The majority of research shows that nicotine reduces body weight, but some researchers have found that nicotine may result in weight gain under specific types of eating habits in animal models.<ref name=HuYang2018 /> Nicotine effect on weight appears to result from nicotine's stimulation of α3β4 nAChR receptors located in the POMC neurons in the arcuate nucleus and subsequently the melanocortin system, especially the melanocortin-4 receptors on second-order neurons in the paraventricular nucleus of the hypothalamus, thus modulating feeding inhibition.<ref name="Picciotto2014" /><ref name=HuYang2018/> POMC neurons are a precursor of the melanocortin system, a critical regulator of body weight and peripheral tissue such as skin and hair.<ref name=HuYang2018/>
ChemistryEdit
Nicotine is a hygroscopic, colorless<ref name=":4" /> to yellow-brown, oily liquid, that is readily soluble in alcohol, ether or light petroleum. It is miscible with water in its neutral amine base form between 60 °C and 210 °C. It is a dibasic nitrogenous base, having Kb1=1×10−6, Kb2=1×10−11.<ref name="metcalf"/> It readily forms ammonium salts with acids that are usually solid and water-soluble. Its flash point is 95 °C and its auto-ignition temperature is 244 °C.<ref name=SLMSDS>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Nicotine is readily volatile (vapor pressure 5.5 Pa at 25 °C)<ref name="metcalf"/> On exposure to ultraviolet light or various oxidizing agents, nicotine is converted to nicotine oxide, nicotinic acid (niacin, a B3 vitamer), and methylamine.<ref name="library.sciencemadness.org"/>
Nicotine is chiral and hence optically active, having two enantiomeric forms. The naturally occurring form of nicotine is levorotatory with a specific rotation of [α]D=–166.4° ((−)-nicotine). The dextrorotatory form, (+)-nicotine is physiologically less active than (−)-nicotine. (−)-nicotine is more toxic than (+)-nicotine.<ref>Template:Cite book</ref> The salts of (−)-nicotine are usually dextrorotatory; this conversion between levorotatory and dextrorotatory upon protonation is common among alkaloids.<ref name="library.sciencemadness.org"/> The hydrochloride and sulfate salts become optically inactive if heated in a closed vessel above 180 °C.<ref name="library.sciencemadness.org">Template:Cite book</ref> Anabasine is a structural isomer of nicotine, as both compounds have the molecular formula Template:Chem2.
Nicotine that is found in natural tobacco is primarily (99%) the S-enantiomer.<ref name="Enantiomeric composition of nicotin">Template:Cite journal</ref> Conversely, the most common chemistry synthetic methods for generating nicotine yields a product that is approximately equal proportions of the S- and R-enantiomers.<ref>Template:Cite journal</ref> This suggests that tobacco-derived and synthetic nicotine can be determined by measuring the ratio of the two different enantiomers, although means exist for adjusting the relative levels of the enantiomers or performing a synthesis that only leads to the S-enantiomer. There is limited data on the relative physiological effects of these two enantiomers, especially in people. However, the studies to date indicate that (S)-nicotine is more potent than (R)-nicotine and (S)-nicotine causes stronger sensations or irritation than (R)-nicotine. Studies have not been adequate to determine the relative addictiveness of the two enantiomers in people.
Pod mod electronic cigarettes use nicotine in the form of a protonated nicotine, rather than free-base nicotine found in earlier generations.<ref name=JenssenBoykan2019>Template:Cite journalTemplate:CC-notice</ref>
PreparationEdit
The first laboratory preparation of nicotine (as its racemate) was described in 1904.<ref name=Pictet>Template:Cite journal</ref> File:Nicotine synthesis 1904.svg The starting material was an N-substituted pyrrole derivative, which was heated to convert it by a [1,5] sigmatropic shift to the isomer with a carbon bond between the pyrrole and pyridine rings, followed by methylation and selective reduction of the pyrrole ring using tin and hydrochloric acid.<ref name=Pictet/><ref>Template:Cite journal</ref> Many other syntheses of nicotine, in both racemic and chiral forms have since been published.<ref>Template:Cite journal</ref>
BiosynthesisEdit
The biosynthetic pathway of nicotine involves a coupling reaction between the two cyclic structures that comprise nicotine. Metabolic studies show that the pyridine ring of nicotine is derived from nicotinic acid the pyrrolidine is derived from N-methyl-Δ1-pyrrollidium cation.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> Biosynthesis of the two component structures proceeds via two independent syntheses, the NAD pathway for nicotinic acid and the tropane pathway for N-methyl-Δ1-pyrrollidium cation.
The NAD pathway in the genus Nicotiana begins with the oxidation of aspartic acid into α-amino succinate by aspartate oxidase (AO). This is followed by a condensation with glyceraldehyde-3-phosphate and a cyclization catalyzed by quinolinate synthase (QS) to give quinolinic acid. Quinolinic acid then reacts with phosphoribosyl pyrophosphate catalyzed by quinolinic acid phosphoribosyl transferase (QPT) to form nicotinic acid mononucleotide (NaMN). The reaction now proceeds via the NAD salvage cycle to produce nicotinic acid via the conversion of nicotinamide by the enzyme nicotinamidase.Template:Citation needed
The N-methyl-Δ1-pyrrollidium cation used in the synthesis of nicotine is an intermediate in the synthesis of tropane-derived alkaloids. Biosynthesis begins with decarboxylation of ornithine by ornithine decarboxylase (ODC) to produce putrescine. Putrescine is then converted into N-methyl putrescine via methylation by SAM catalyzed by putrescine N-methyltransferase (PMT). N-methyl putrescine then undergoes deamination into 4-methylaminobutanal by the N-methyl putrescine oxidase (MPO) enzyme, 4-methylaminobutanal then spontaneously cyclize into N-methyl-Δ1-pyrrollidium cation.Template:Citation needed
The final step in the synthesis of nicotine is the coupling between N-methyl-Δ1-pyrrollidium cation and nicotinic acid. Although studies conclude some form of coupling between the two component structures, the definite process and mechanism remains undetermined. The current agreed theory involves the conversion of nicotinic acid into 2,5-dihydropyridine through 3,6-dihydronicotinic acid. The 2,5-dihydropyridine intermediate would then react with N-methyl-Δ1-pyrrollidium cation to form enantiomerically pure (−)-nicotine.<ref name=plant-meta>Template:Cite bookTemplate:Page needed</ref>
Detection in body fluidsEdit
Nicotine can be quantified in blood, plasma, or urine to confirm a diagnosis of poisoning or to facilitate a medicolegal death investigation. Urinary or salivary cotinine concentrations are frequently measured for the purposes of pre-employment and health insurance medical screening programs. Careful interpretation of results is important, since passive exposure to cigarette smoke can result in significant accumulation of nicotine, followed by the appearance of its metabolites in various body fluids.<ref>Template:Cite book</ref><ref>Template:Cite book</ref> Nicotine use is not regulated in competitive sports programs.<ref>Template:Cite journal</ref>
Methods for analysis of enantiomersEdit
Methods for measuring the two enantiomers are straightforward and include normal-phase liquid chromatography,<ref name="Enantiomeric composition of nicotin"/> liquid chromatography with a chiral column.<ref>Template:Cite journal</ref> However, since methods can be used to alter the two enantiomers, it may not be possible to distinguish tobacco-derived from synthetic nicotine simply by measuring the levels of the two enantiomers. A new approach uses hydrogen and deuterium nuclear magnetic resonance to distinguish tobacco-derived and synthetic nicotine based on differences the substrates used in the natural synthetic pathway performed in the tobacco plant and the substrates most used in synthesis.<ref>Template:Cite journal</ref> Another approach measures the carbon-14 content which also differs between natural and laboratory-based tobacco.<ref>Template:Cite journal</ref> These methods remain to be fully evaluated and validated using a wide range of samples.
Analogues and derivativesEdit
Analogues and derivatives of nicotine are known.<ref name="Breining2004">Template:Cite journal</ref><ref name="VaggChapman2005">Template:Cite journal</ref><ref name="PogockiRumanDanilczuk2007">Template:Cite journal</ref><ref name="PandaAlbano2021">Template:Cite journal</ref><ref name="EffahSunLin2025">Template:Cite journal</ref> Examples include altinicline, anabasine, anatabine, altinicline, arecoline, 6-chloronicotine, cotinine, cytisine, dianicline, epibatidine, levamisole, RJR-2429, TC-1698, UB-165, and varenicline, among others.<ref name="BoidoTassoBoido2003">Template:Cite journal</ref><ref name="Breining2004" />
Natural occurrenceEdit
Nicotine is a secondary metabolite produced in a variety of plants in the family Solanaceae, most notably in tobacco Nicotiana tabacum, where it can be found at high concentrations of 0.5 to 7.5%.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Nicotine is also found in the leaves of other tobacco species, such as Nicotiana rustica (in amounts of 2–14%). Nicotine production is strongly induced in response to wounding as part of a jasmonate-dependent reaction.<ref>Template:Cite journal</ref> Specialist insects on tobacco, such as the tobacco hornworm (Manduca sexta), have a number of adaptations to the detoxification and even adaptive re-purposing of nicotine.<ref>N.d. Natural history-driven, plant-mediated RNAi-based study reveals CYP6B46's role in a nicotine-mediated antipredator herbivore defense | PNAS.</ref> Nicotine is also found at low concentrations in the nectar of tobacco plants, where it may promote outcrossing by affecting the behavior of hummingbird pollinators.<ref>Template:Cite journal</ref>
Nicotine occurs in smaller amounts (varying from 2–7 μg/kg, or 20–70 millionths of a percent wet weight<ref name=SiegmundLeitner1999/>) in other Solanaceaeous plants, including some crop species such as potatoes, tomatoes, eggplant, and peppers,<ref name=SiegmundLeitner1999/><ref name=Domino1993>Template:Cite journal</ref> as well as non-crop species such as Duboisia hopwoodii.<ref name="metcalf">Template:Citation</ref> The amounts of nicotine in tomatoes lowers substantially as the fruit ripens.<ref name=SiegmundLeitner1999/> A 1999 report found "In some papers it is suggested that the contribution of dietary nicotine intake is significant when compared with exposure to ETS [environmental tobacco smoke] or by active smoking of small numbers of cigarettes. Others consider the dietary intake to be negligible unless inordinately large amounts of specific vegetables are consumed."<ref name=SiegmundLeitner1999/> The amount of nicotine eaten per day is roughly around 1.4 and 2.25 μg/day at the 95th percentile.<ref name=SiegmundLeitner1999/> These numbers may be low due to insufficient food intake data.<ref name=SiegmundLeitner1999>Template:Cite journal</ref> The concentrations of nicotine in vegetables are difficult to measure accurately, since they are very low (parts per billion range).<ref name=MoldoveanuScott2016>Template:Cite journal</ref> Pure nicotine tastes "terrible".<ref name=":4" />
History, society and cultureEdit
Nicotine was originally isolated from the tobacco plant in 1828 by chemists Wilhelm Heinrich Posselt and Karl Ludwig Reimann from Germany, who believed it was a poison.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> Its chemical empirical formula was described by Melsens in 1843,<ref>Template:Cite journal [Note: The empirical formula that Melsens provides is incorrect because at that time, chemists used the wrong atomic mass for carbon (6 instead of 12).]</ref> its structure was discovered by Adolf Pinner and Richard Wolffenstein in 1893,<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref><ref>Template:Cite journal</ref>Template:Clarify and it was first synthesized by Amé Pictet and A. Rotschy in 1904.<ref name=Pictet/><ref>Template:Cite magazine</ref>
Nicotine is named after the tobacco plant Nicotiana tabacum, which in turn is named after the French ambassador in Portugal, Jean Nicot de Villemain, who sent tobacco and seeds to Paris in 1560, presented to the French King,<ref name="Rang H. P 2007, page 598">Template:Cite book</ref> and who promoted their medicinal use. Smoking was believed to protect against illness, particularly the plague.<ref name="Rang H. P 2007, page 598"/>
Tobacco was introduced to Europe in 1559, and by the late 17th century, it was used not only for smoking but also as an insecticide. After World War II, over 2,500 tons of nicotine insecticide were used worldwide, but by the 1980s the use of nicotine insecticide had declined below 200 tons. This was due to the availability of other insecticides that are cheaper and less harmful to mammals.<ref name=Ujvary/>
The nicotine content of popular American-brand cigarettes has increased over time, and one study found that there was an average increase of 1.78% per year between the years of 1998 and 2005.<ref>Template:Cite journal</ref>
Although methods of production of synthetic nicotine have existed for decades,<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> it was believed that the cost of making nicotine by laboratory synthesis was cost prohibitive compared to extracting nicotine from tobacco.<ref>Template:Cite news</ref> However, recently synthetic nicotine started to be found in different brands of e-cigarettes and oral pouches and marketed as "tobacco-free."<ref>Template:Cite news</ref>
The US FDA is tasked with reviewing tobacco products such as e-cigarettes and determining which can be authorized for sale. In response to the likelihood that FDA would not authorize many e-cigarettes to be marketed, e-cigarette companies began marketing products that they claimed to contain nicotine that were not made or derived from tobacco, but contained synthetic nicotine instead, and thus, would be outside FDA's tobacco regulatory authority.<ref>Template:Cite journal</ref> Similarly, nicotine pouches that claimed to contain non-tobacco (synthetic) nicotine were also introduced. The cost of synthetic nicotine has decreased as the market for the product increased. In March 2022, the U.S. Congress passed a law (the Consolidated Appropriations Act, 2022) that expanded FDA's tobacco regulatory authority to include tobacco products containing nicotine from any source, thereby including products made with synthetic nicotine.
Legal statusEdit
Template:Further In the United States, nicotine products and nicotine replacement therapy products like Nicotrol are only available to people 18 and above; proof of age is required; not for sale in vending machine or from any source where proof of age cannot be verified. As of 2019, the minimum age to purchase tobacco in the US is 21 at the federal level.<ref>Template:Cite journal</ref>
In the European Union, the minimum age to purchase nicotine products is 18. However, there is no minimum age requirement to use tobacco or nicotine products.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
In the United Kingdom, the Tobacco and Related Products Regulations 2016 implemented the European directive 2014/40/EU, amended by Tobacco Products and Nicotine Inhaling Products (Amendment etc.) (EU Exit) Regulations 2019 and the Tobacco Products and Nicotine Inhaling Products (Amendment) (EU Exit) Regulations 2020. Additionally other regulations limit advertising, sale and display of tobacco products and other products containing nicotine for human consumption. The Sunak government proposed banning disposable vapes to limit their appeal and affordability for children and to reduce the amount of waste generated.
In mediaEdit
Template:External media In some anti-smoking literature, the harm that tobacco smoking and nicotine addiction does is personified as Nick O'Teen, represented as a humanoid with some aspect of a cigarette or cigarette butt about him or his clothes and hat.<ref name="HEC">Template:Cite journal</ref> Nick O'Teen was a villain that was created for the Health Education Council. The character was featured in three animated anti-smoking public service announcements in which he tries to get kids addicted to cigarettes before being foiled by the DC Comics character Superman.<ref name="HEC" />
Nicotine was often compared to caffeine in advertisements in the 1980s by the tobacco industry, and later in the 2010s by the electronic cigarettes industry, in an effort to reduce the stigmatization and the public perception of the risks associated with nicotine use.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
ResearchEdit
Central nervous systemEdit
While acute/initial nicotine intake causes activation of neuronal nicotinic receptors, chronic low doses of nicotine use leads to desensitization of those receptors (due to the development of tolerance) and results in an antidepressant effect, with early research showing low dose nicotine patches could be an effective treatment of major depressive disorder in non-smokers.<ref name="pmid20965579">Template:Cite journal</ref>
Though tobacco smoking is associated with an increased risk of Alzheimer's disease,<ref name="pmid19105840">Template:Cite journal</ref> there is evidence that nicotine itself has the potential to prevent and treat Alzheimer's disease.<ref name=pmid19184661>Template:Cite book</ref>
Smoking is associated with a decreased risk of Parkinson's disease; however, it is unknown whether this is due to people with healthier brain dopaminergic reward centers (the area of the brain affected by Parkinson's) being more likely to enjoy smoking and thus pick up the habit, nicotine directly acting as a neuroprotective agent, or other compounds in cigarette smoke acting as neuroprotective agents.<ref>Template:Cite journal</ref>
Nicotine may partly attenuate sensory gating and attentional deficits associated with schizophrenia. Short-term use of transdermal nicotine was found to improve subjects’ reaction time and alertness in given tasks. Nicotine was not found to improve negative, positive, or other cognitive symptoms of schizophrenia.<ref>Template:Cite journal</ref>
Immune systemEdit
Immune cells of both the innate immune system and adaptive immune systems frequently express the α2, α5, α6, α7, α9, and α10 subunits of nicotinic acetylcholine receptors.<ref name=":0">Template:Cite journal</ref> Evidence suggests that nicotinic receptors which contain these subunits are involved in the regulation of immune function.<ref name=":0" />
OptopharmacologyEdit
A photoactivatable form of nicotine, which releases nicotine when exposed to ultraviolet light with certain conditions, has been developed for studying nicotinic acetylcholine receptors in brain tissue.<ref name="pmid29578537">Template:Cite journal</ref>
Oral healthEdit
Several in vitro studies have investigated the potential effects of nicotine on a range of oral cells. A recent systematic review concluded that nicotine was unlikely to be cytotoxic to oral cells in vitro in most physiological conditions but further research is needed.<ref>Template:Cite journal</ref> Understanding the potential role of nicotine in oral health has become increasingly important given the recent introduction of novel nicotine products and their potential role in helping smokers quit.<ref>Template:Cite journal</ref>
See alsoEdit
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- Chemical Hazards monograph for Nicotine from the National Institute for Occupational Safety and Health
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