AMA #70: Nicotine: impact on cognitive function, performance, and mood, health risks, delivery modalities, and smoking cessation strategies

**Peter Attia** (0:10)
Hey, everyone, welcome to a sneak peek, Ask Me Anything, or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com/subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything AMA episode number 70 For today's AMA, we're discussing a topic that has been gaining significant attention in both the scientific community and among the public, and that is nicotine. This is a topic that we get a lot of questions about, not only from our audience, but also from my patients. In this episode, we discuss the distinction between nicotine and tobacco, understanding why nicotine itself is not the primary driver of the major health risks associated with smoking. We discuss the risks of nicotine use, including addiction, sleep disturbances, cardiovascular effects, and its impact on mood and anxiety. We talk about the various delivery methods of nicotine, from traditional cigarettes, which I think everybody would agree are bad, to pouches, gums, and synthetic options, ranking them from least to most harmful. The role of nicotine in physical performance, cognitive enhancement, fertility, and its interaction with other stimulants, such as caffeine. We touch on the guidance for those interested in minimizing the risks while still using nicotine. And we end this podcast by looking at smoking cessation and considerations for those trying to quit smoking, which often involves using nicotine replacement. If you're a subscriber and you want to watch the full video of this podcast, you can find it on the show notes page. And if you're not a subscriber, you can watch the sneak peek of this video on our YouTube page. So without further delay, I hope you enjoy AMA number 70

**Nick** (2:06)
Peter, welcome to another AMA. How are you doing?

**Peter Attia** (2:09)
I'm doing really well. Thank you for having me back.

**Nick** (2:11)
I mean, we're always happy to have you whenever you would like. And again, it'd be very awkward if you weren't here. I think we do need to follow up based on one of our recent AMAs is, do you still have a liquid of some form in front of you? I do. What kind of cup is that in?

**Peter Attia** (2:28)
You know, I'm actually drinking it in a glass.

**Nick** (2:32)
Did you listen to our microplastics AMA, and that's why you made that change?

**Peter Attia** (2:36)
Nick, I have made several changes following the AMA on microplastics. I believe that they are all in the spirit of 80-20. So I'm really low on the sigmoidal curve of cost and energy, with one exception. And yeah, I think I'm just taking what I think are the relatively easy steps to hopefully mitigate like 80% of my exposure. And I'm going to spend no more time worrying about the last 20%, which A, I have no idea if it matters. And even if it does, I don't think I could live my life and be concerned with it.

**Nick** (3:12)
That's great to hear. Two things. First is, by the time this comes out, we'll most likely have a short video on what those changes were. So we'll link to that. If we don't have that video, something terribly went wrong. So we should have it. The second is, are you just so happy that you continue to join us for these AMAs? Otherwise, you would still be living so foolishly in your microplastic life.

**Peter Attia** (3:37)
I am looking forward to the day when someone else hosts an AMA for me.

**Nick** (3:41)
Maybe an avatar.

**Peter Attia** (3:42)
That would be awesome.

**Nick** (3:43)
We could just have AI Peter, and it's just an ongoing AMA that never ends.
Well, today's AMA is not going to be that. It will be you live, and it is on a single topic. We get asked a lot about there's so much more use of it. We initially did an AMA on it, I think, like four years ago, and at the time, you didn't see as much use as you do now, and that's nicotine. So we are going to talk all things nicotine today. This is going to look at benefits, short-term, long-term, around everything from cognition, exercise, whatever it may be, risks of nicotine and things that people need to be aware of. We are going to look at different ways and vehicles that people can use nicotine and what are the pros and cons. And then we are also going to end this with something that we get asked a lot about every now and then when it comes to smoking cessation. And I think we often say a lot of people in our audience most likely are not smoking because if you are, you are probably not opting into this deep content, but some people are. But also we hear from people where it's, hey, my parents, significant other, children, friends, whatever it may be, are still doing this. How can I talk to them about quitting? So we'll cover that as well. So all that said, anything you want to say before we get rolling? Nope. This is a great insight that you added right there. So thank you for that. All right, start out. Can you explain just where the field of nicotine research currently stands and what's new and distinct from when we talked about this four years ago?