Key Nicotine Findings.pdf
Nicotine vs. tobacco smoke
The main adverse effect of nicotine is addiction, which sustains tobacco use. Because most smokers are nicotine-dependent, they continue to expose themselves to toxicants from tobacco. Tobacco, not nicotine, is responsible for most of the adverse health effects.1 a
Nicotine is not a significant risk factor for cardiovascular events. The benefit of nicotine replacement therapy outweighs the risks of nicotine medication, even in smokers with cardiovascular disease.1 b
Nicotine per se is not a substantial cause of cancer. Any cancer-related risks during short-term nicotine therapy to aid smoking cessation are insignificant compared to the risks of smoking.1 d
Nicotine is a potential foetal teratogen based on studies in animals and might contribute to sudden infant death syndrome and neurobehavioral deficits in the offspring. However these effects are dose-related in animals, and NRT products have not been demonstrated to be teratogenic in humans.2
While nicotine replacement therapy during pregnancy is potentially hazardous, it is likely that nicotine therapy is less hazardous than cigarette smoking, which exposes both the mother and foetus to both nicotine and a myriad of other toxicants.2
Concomitant use and harm reduction
Electronic Nicotine Delivery Devices (ENDD
, also called electronic-cigarettes or e-cigarettes) are becoming popular, but their safety and efficacy as cigarette substitutes have not been adequately tested
. Until these studies are conducted, their marketing poses health and safety concerns, particularly because the many products on the market are not regulated and no oversight of quality control is operated. At this time ENDD are not recommended as an aid to smoking cessation
Strength of Evidence: Each key finding has been rated according the strength of evidence supporting it.
1 Multiple well-designed, randomized clinical trials yielded a consistent pattern of findings.
2 Some evidence from randomized clinical trials but the scientific support was not optimal.
3 Limited evidence indicative of a possible effect but not sufficient to support a recommendation.