#344 – AMA #70: Nicotine: impact on cognitive function, performance, and mood, health risks, delivery modalities, and smoking cessation strategies

We discuss:

• Revisiting the previous AMA on microplastics: low-effort, high-impact changes to significantly reduce microplastic exposure [1:45];
• Overview of episode topics related to nicotine [3:30];
• The current landscape of nicotine research [4:45];
• Addressing the common misconception that nicotine itself is the primary cause of tobacco-related health risks [6:45];
• Peter’s Marlboro-branded apparel is a nostalgic tribute to the Formula One era and not a sign of support for smoking [10:00];
• The limitations of current research on the health risks of nicotine itself [12:15];
• The most common side effects of nicotine [18:15];
• The impact of nicotine on sleep [21:30];
• Nicotine and mood: how nicotine can have both anxiety-inducing and calming effects based on genetics and dosage [25:00];
• The addictive properties of nicotine: factors influencing addiction risk, and why certain people may struggle more than others [29:15];
• The various nicotine products and nicotine delivery methods available: effects, absorption rates, and potential risks [33:45];
• The relative risks of various nicotine products: how differences in nicotine concentration, absorption rates, and presence of contaminants impact their safety [37:00];
• How nicotine exposure during adolescence can negatively impact brain development [47:45];
• Nicotine’s potential to prevent or slow neurodegenerative diseases [50:45];
• Nicotine’s impact on memory, learning, and attention [52:45];
• The interaction between nicotine and other stimulants, particularly caffeine [55:15];
• Nicotine’s potential impact on physical performance [57:15];
• The potential effects of nicotine on fertility, and the challenges of distinguishing the impact of nicotine itself from the effects of smoking [58:30];
• Considerations for people curious about using nicotine for its cognitive benefits [1:01:30];
• How to think about nicotine: weighing cognitive claims, addiction risks, and personal tolerance [1:03:15];
• The prevalence of smoking, the health risks it poses, and the substantial long-term benefits of quitting [1:05:45];
• Effective strategies for smoking cessation including the use of nicotine replacement therapies [1:09:00];
• The reasons behind weight gain after quitting smoking, the role of nicotine in appetite suppression, and strategies to manage weight [1:15:30]; and
• More.

Revisiting the previous AMA on microplastics: low-effort, high-impact changes to significantly reduce microplastic exposure [1:45]

Microplastics AMA: #332 – AMA #67: Microplastics, PFAS, and phthalates: understanding health risks and a framework for minimizing exposure and mitigating risk

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Peter’s Personal Changes regarding microplastics

• 80/20 Approach to Mitigating Exposure:
  • Peter implemented changes aimed at reducing 80% of his microplastics exposure.
  • These changes were chosen because they are low-cost and low-effort but provide high impact.
  • He intentionally avoids stressing over the final 20% of exposure, which:
    • May or may not matter in terms of actual health impact.
    • Would require disproportionate effort, and he believes it’s not worth the trade-off in quality of life.
• Philosophy:
  • Peter uses a sigmoidal cost/effort curve to assess lifestyle changes—targeting the steep part of the curve (maximum benefit for minimal effort).
  • He chooses not to obsess over theoretical or hard-to-measure risks if the lifestyle cost is too high.

Video demonstrating the specific changes Peter made:

Overview of episode topics related to nicotine [3:30]

Previous AMA on nicotine from 2021: #161 – AMA #23: All Things Nicotine: deep dive into its cognitive and physical benefits, risks, and mechanisms of action

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TOPIC: Nicotine

• Episode Focus:
  • This AMA is dedicated entirely to nicotine, a topic that has grown in public interest.
  • The discussion is prompted by a significant increase in nicotine use compared to when Peter and Nick first addressed it in an AMA about four years ago.
• Key Themes of the Episode
  • Nicotine Use Today:
    • Increased popularity and broader public use since the original AMA on the subject.
    • Growing curiosity about nicotine’s potential short-term and long-term benefits.
• Topics to Be Covered:
  • Benefits of Nicotine:
    • Focus on areas like cognition and exercise performance.
  • Risks of Nicotine:
    • Health risks and potential side effects users should be aware of.
  • Forms of Nicotine Use:
    • Different vehicles and methods of delivery (e.g., patches, pouches, gum, vaping, cigarettes).
    • Comparison of pros and cons of each.
  • Smoking Cessation Segment
    • Discuss smoking cessation strategies.
    • Offer advice on how to help loved ones quit or approach the conversation with them.

The current landscape of nicotine research [4:45]

State of Nicotine Research – Then vs. Now

Historical Context of Nicotine Research

• Most research on nicotine has historically been tied to tobacco, particularly its use in cigarettes.
• This linkage complicates understanding the independent effects of nicotine, because:
  • Tobacco products include many harmful compounds beyond nicotine.
  • It’s difficult to isolate nicotine’s effects from those of tobacco smoke or other tobacco-derived components.

Natural vs. Synthetic Nicotine

• A growing distinction in current research and public discourse is between:
  • Tobacco-derived nicotine (even in non-combustible forms like pouches).
  • Synthetic nicotine, which is produced without any use of the tobacco plant.
• This distinction is relevant because:
  • Synthetic nicotine may carry fewer contaminants.
  • It could allow researchers to study nicotine in isolation more accurately.

Challenges in Isolating Nicotine’s Impact

• Many perceived or observed health effects (e.g., infertility) are well-documented in smokers, but not well studied in users of:
  • Vapes
  • Nicotine pouches
  • Other non-combustible or synthetic products
• This limits our ability to draw firm conclusions about nicotine itself, apart from tobacco.

Contrast With the Prior AMA

• Peter notes that this episode will differ from the prior nicotine AMA in key ways:
• The previous discussion focused more on biological mechanisms (e.g., how nicotine acts on receptors).
• This episode will address more practical questions, like risks, benefits, usage methods, and cessation strategies.
• There’s more research now on potential benefits of nicotine than there was four years ago, and those findings will also be explored.

{end of show notes preview}