People’s Pharmacy | Will nicotine boost brain power?
Americans have made relatively few lifestyle changes to improve their health. The CDC estimates that over 70 percent of us are overweight or obese.
We also sit too much. About one out of four Americans gets no significant physical exercise.
Where we have improved, however, is quitting smoking. During the 1950s, nearly half of American adults were smokers. In 2025 fewer than one in ten smokes.
Tobacco smoke is clearly bad for our health. But there is growing interest in nicotine as a cognitive enhancer. Researchers have been studying the impact of nicotine on the brain for decades. These days, influencers on social media are promoting the use of nicotine patches or pouches for improving concentration.
Readers of this column have shared their experiences with a variety of nicotine products. Most were responding to the idea that patches might help make people feel sharper. They report mixed results.
One man is enthusiastic: “Absolutely the patches help! When I was recently widowed, I moved closer to my daughter. I was worried that my thinking and memory were declining, but I didn’t know if it was stress or possibly age. Some days I would talk myself through driving, ‘watch the traffic light,’ ‘signal your turn,’ etc.
“I started using nicotine patches in hopes they would help the brain fog. When I increased the dose, I became nauseated, but at the lower dose I felt clear-headed. My daughter noticed I was saying ‘I don’t remember’ less often. I am still using a 3.5 mg patch daily and pleased with the results.”
Another person was extremely disappointed. “I’m a sad retired physician and have been experiencing short-term memory issues. I decided to try low-dose nicotine patches. On day 1, I immediately noted disappearance of mid-day exhaustion with a 6 mg patch and felt encouraged. On day 2, I developed severe night-time leg cramps that were excruciating. Pickle juice provided temporary relief, but the cramps kept me up all night. When I looked into this, I found a large body of information documenting this phenomenon. Nicotine causes vasoconstriction with decreased blood flow. It’s irresponsible to recommend this treatment without discussing the downside of using transdermal nicotine.”
Another doctor had better luck: “I’m a physician in my late 70s and had seen some studies on the use of the nicotine patch for multiple disorders including memory. Since it is a naturally occurring substance both in the body and in many foods, I decided to give it a try.
“I started with 3.5 mg, half of a 7 mg patch, and over the last couple months I’ve noticed a distinct difference in both my short term and partial photographic memory: They have both returned to what I had 15 years ago!
“I also have ADHD, so short-term memory has always been a little handicapped, and executive function problems make it hard to start an activity. These have both significantly improved. I’ve never taken meds for the ADHD, but finding a natural aid has been very exciting.”
There is some data to support the use of nicotine for cognitive function (Acta Neurologica Scandinavica, Aug. 2021). But there are also contradictory results from a large clinical trial. Far more research will need to be done before it’s clear whether nicotine helps memory problems or brain fog. Adverse reactions may include sleep disruption, nausea, rapid heart rate, vasoconstriction, hypertension and dependence.
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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: www.PeoplesPharmacy.com.