The Metabolic Classroom with Dr. Ben Bikman Separating Nicotine from Smoking: Myths, Metabolism, and Medicine
Jan 12, 2026
Nicotine might not be the villain it's often portrayed to be. When isolated from cigarettes, it displays intriguing benefits like anti-inflammatory effects and potential therapeutic roles in ADHD, autism, and cognitive decline. The discussion reveals that nicotine isn't the main addictive factor; additives like pyrazines amplify addiction. Moreover, it activates pathways that may help conditions like ulcerative colitis. However, caution is advised, as prolonged use may lead to insulin resistance. The importance of more research and professional consultation is emphasized.
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Nicotine Isn't The Whole Addiction Story
- Nicotine alone is not highly reinforcing and likely isn't the sole cause of cigarette addiction.
- Tobacco additives called pyrazines amplify sensory appeal and dopamine, making cigarettes far more addictive than nicotine by itself.
A Nervous System Pathway Controls Inflammation
- The vagus nerve uses acetylcholine to limit inflammation via the alpha-7 nicotinic receptor.
- Nicotine activates the same receptor and can mimic this cholinergic anti-inflammatory pathway to reduce cytokine release.
Nicotine Raises Energy Use But Risks Insulin Resistance
- Nicotine increases energy expenditure, thermogenesis, and fat oxidation, contributing to lower body weight in smokers.
- But it can also induce insulin resistance and impair muscle glucose uptake through sustained mTOR activation.