A PANEL of doctors and tobacco harm reduction (THR) experts argued that nicotine alone does not cause smoking-related diseases and called for more research into its potential therapeutic applications.

“I have never, in all my career as a doctor, seen nicotine alone, nicotine absent of tobacco, and nicotine causing illness,” said specialist Dr. Garrett McGovern. He noted that nicotine rarely leads to health issues when used independently.

Dr. Andrew Manson, a nicotine scientist, echoed this sentiment, saying that the demonization of smoking has overshadowed nicotine’s potential benefits. “Stress management, weight management, mood management, and the ability to focus on tasks are clear conscious and subconscious benefits for people using nicotine,” he said at the Global Forum on Nicotine.

A panel of experts tackled the complexities of nicotine use and its potential therapeutic benefits during the forum. Moderated by Clive Bates, the panel included neuroscientist Dr. Paul Newhouse, harm reduction specialist Dr. McGovern, Australian general practitioner Dr. Carolyn Beaumont, and THR advocate Mark Oates.

Tobacco harm reduction, or THR, is a public health strategy aimed at reducing the health risks associated with tobacco products. Smoke-free nicotine alternatives, such as heated tobacco products (HTPs), vapes, and oral nicotine pouches, are considered part of THR. These products eliminate the burning process and do not produce smoke.

Dr. Alex Wodak, a general practitioner from Australia, noted the importance of helping nicotine consumers switch from smoking to less risky alternatives.

“We all know eight million people, thereabouts, die from smoking-related diseases around the world every year. That’s equivalent to the population of Switzerland every year. Reducing that number as fast as possible should be the paramount objective of everyone,” Dr. Wodak said. “To paraphrase Michael Russell, people smoke for the nicotine, but they die from the hostility to harm reduction.”

Dr. Beaumont shared insights from her interactions with Australian smokers, revealing that many turned to vaping as a less harmful alternative to smoking. She noted the significant improvements in health and quality of life that her patients reported after switching to vaping.

Mr. Oates, speaking from a consumer and advocacy standpoint, said no country has successfully ended nicotine consumption. “I found no evidence of any society that started using nicotine and then just stopped and got to that nicotine-free society,” he said.

Dr. Newhouse of the Vanderbilt University Medical Center in the US stressed the need to better understand nicotine’s effects on the brain and its potential therapeutic applications.

“I think nicotine is a highly complex substance that has a panoply of effects on the brain,” Dr. Newhouse said. “The long-term or short-term effects of nicotine on brain function are very state-and condition-dependent. We have to acknowledge and agree that no simple yes or no, black or white, up or down, good or bad characterization is going to help us.”

“We understand that nicotine stimulates receptor systems in the brain that are important for regulation of mood, cognition, and a variety of neural functions. It changes the nature of neural circuitry in the brain. It turns out that the effects are very state-dependent. They’re age-dependent, may even be sex-dependent. For many people, they will never want or need to use nicotine. But for some people, it may be useful,” Dr. Newhouse said.

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