Nicotine replacement therapy (NRT) is an effective adjunct in the management of withdrawal symptoms and improves the success of cessation programs. Based on the results of all published trials, the effectiveness of nicotine replacement therapy without behavioral intervention and expert supervision remains unproven. Having said that, nicotine is well known to have serious systemic side effects in addition to being highly addictive. It adversely affects the heart, reproductive system, lung, kidney etc. Many studies have consistently demonstrated its carcinogenic potential. Though, IARC monograph has not included nicotine as a carcinogen, there are various studies which show otherwise.
A new study published in Journal of Health Psychology last week showed that Nicotine Replacement Therapy is not as safe as one would imagine. The authors of the study reported that the recent expansion of Nicotine Replacement Therapy to pregnant women and children ignores the fact that nicotine impairs, disrupts, duplicates and/or interacts with essential physiological functions and is involved in tobacco-related carcinogenesis. The main concerns in the present context are its fetotoxicity and neuroteratogenicity that can cause cognitive, affective and behavioral disorders in children born to mothers exposed to nicotine during pregnancy and the detrimental effects of nicotine on the growing organism. Hence, the use of nicotine, whose efficacy in treating nicotine addiction is controversial even in adults, must be strictly avoided in pregnancy, breastfeeding, childhood and adolescence. Please read the attached article.
There are many nicotine preparations (nicotine gums, patches, e cigarettes and inhalational agents) that are freely available in most parts of the world. These products are being heavily promoted and marketed as magical remedies. Nicotine gums are available in 2 mg and 4 mg preparation that deliver around 1 mg and 3 mg nicotine to the blood stream respectively. E-cigarette, a sophisticated nicotine delivery device, delivers nicotine in a vapor form and it closely mimics the act of smoking. Currently, these products constitute approximately 1% of total nicotine consumption and are showing an increasing trend in most countries.
In another publication (attached), Dr Chaturvedi’s team has published another review that showed that nicotine is a harmful drug with several systemic effects. They undertook this review to specifically evaluate the effects of nicotine on the various organ systems. A computer aided search of the Medline and PubMed database was done using a combination of the keywords. All the animal and human studies investigating only the role of nicotine were included. The review showed that the Nicotine poses several health hazards. There is an increased risk of cardiovascular, respiratory, gastrointestinal disorders. There is decreased immune response and it also poses ill impacts on the reproductive health. It affects the cell proliferation, oxidative stress, apoptosis, DNA mutation by various mechanisms which leads to cancer. It also affects the tumor proliferation and metastasis and causes resistance to chemo and radio therapeutic agents.
Dr Pankaj Chaturvedi, Professor and Surgeon at Tata Memorial Hospital said –
‘It is likely that many addicts may use it to counter their withdrawal symptoms when they cannot access cigarettes such as while in flight, public places, meetings, etc. Simultaneous use of synthetic nicotine and tobacco products by the individual can result in serious nicotine overdoses. The aggressive marketing of NRT preparations and its rising unsupervised usage poses a serious threat to society. Nicotine should be used only under supervision of cessation experts. There is an urgent need to prohibit over-the-counter sale of NRT preparations (including E Cigarettes) and curb the advertisement of these products in India. E Cigarettes contain high amount of nicotine and they are becoming very popular. Therefore, E cigarettes should be banned all over India just like the states of Maharashtra and Punjab have done it. All NRT products must carry appropriate warning to share this harmful effects with innocent users.’
Source: The HealthSite