Nicotine - Older Adults (50+)

Misperceptions

2023: Older age is associated with greater misperception of the relative health risk of e-cigarettes and cigarettes among US adults who smoke

• Adults aged ≥55 are more likely to have misperceptions about the absolute and relative risks of tobacco products, which may contribute to continued smoking. Health communications targeting this age group could modify beliefs about the perceived harms of tobacco products.
  • Citation: Rubenstein D, Denlinger-Apte RL, Cornacchione Ross J, Carroll DM, McClernon FJ. Older age is associated with greater misperception of the relative health risk of e-cigarettes and cigarettes among US adults who smoke. Tob Control. 2024 Nov 10;33(e2):e266-e269. doi: 10.1136/tc-2023-057943. PMID: 37137702; PMCID: PMC10622327.
    • Acknowledgement: Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (award number TL1 TR002555). This work was also funded by the National Institute on Minority Health and Health Disparities (K01MD014795; DMC).

2010: Smokers commonly misperceive that nicotine is a major carcinogen: National survey data

• These findings are concerning since misperceptions about nicotine may result in underutilisation of NRT. Therefore, we aimed to assess these views in New Zealand (NZ) smokers, with the context being a country in which NRT is provided in a heavily subsidised form and widely distributed via the national quitline service.
• When asked if ‘the nicotine in cigarettes is the chemical that causes most of the cancer?’, most smokers in wave 1 (52.6%) said that it was true, 36.7% said it was false (the correct answer) and 10.7% could not say. The proportion answering ‘true’ was fairly similar in wave 2 at 52.1%. In a multivariate model (that adjusted for demographics, socioeconomic position, mental health and smoking-related beliefs and behaviours), certain groups of smokers were significantly more likely to believe that nicotine was carcinogenic. These included older smokers (≥50 vs <35 years); Māori smokers (vs European/other, adjusted OR (aOR)=1.77, 95% CI 1.22 to 2.58); and Asian smokers (vs European/other, aOR=3.25, 95% CI 1.35 to 7.83).
  • Citation: Wilson N, Peace J, Edwards R, et alSmokers commonly misperceive that nicotine is a major carcinogen: National survey dataThorax 2011;66:353-354.
    • Acknowledgement: This study was funded by the Health Research Council of New Zealand (grant 06/453).

Smoking and Smoking Cessation

• See Also: Smokeless Products

2025: Smoking Cessation Treatment Efficacy and Impact on Health Outcomes among Middle-Aged and Older Adults: A Scoping Review

• A scoping review of RCT studies on the effectiveness and health outcomes of smoking cessation interventions in middle-aged (45-64 years) and older adults (65+ years) yielded a total of 44 relevant articles. Results showed that middle-aged and older adult smokers are just as, if not more successful at quitting smoking than their younger counterparts using a combined intervention of counseling and cessation medications. Many of the studies did not explicitly focus on older adults, but instead focused on medical conditions more prevalent within aging populations. Future research on older adults should clarify age definitions and report stratified analyses by age.
  • Citation: Adrienne L Johnson, Jaqueline C Avila, Leslie Christensen, Margaret C Fahey, Jeein Jang, Sarah Jarvis, Alana Rojewski, Dana Rubenstein, Bethea A Kleykamp, Society for Research on Nicotine and Tobacco (SRNT) Treatment Research Network, Smoking Cessation Treatment Efficacy and Impact on Health Outcomes among Middle-Aged and Older Adults: A Scoping Review, Nicotine & Tobacco Research, 2025;, ntaf122, https://doi.org/10.1093/ntr/ntaf122
    • Acknowledgement: Abstract accessed June 18, 2025. The editor of this SNW page does not have access to the full paper and could not view who any possible funders are.

2025: Lost in the Smoke: Underrepresentation of Aging Adults in Nicotine and Tobacco Research

• For some older adults, such as those living below the federal poverty line, smoking prevalence has increased from 13% to 16% between 2011 and 2022. At the same time, older adults are the fastest-growing demographic worldwide, and for the first time in history, their numbers are predicted to exceed those of young people.
  • Citation: Kleykamp BA, Smith H, Dewan M, Kalinowski LM, Parsky J, Kulak JA. Lost in the Smoke: Underrepresentation of Aging Adults in Nicotine and Tobacco Research. Nicotine Tob Res. 2025 Jan 30:ntaf029. doi: 10.1093/ntr/ntaf029. Epub ahead of print. PMID: 39883072.

2025: E-cigarettes and Older Adults who Smoke: A Missed Opportunity to Further Reduce Harm?

• Manufacturers should consider the barriers to e-cigarette use by older adults who are smoking and design products that are appealing to older smokers. Reducing smoking prevalence in this group is a public health priority.

2025: Help for Seniors

• "Several recent government publications including the 2024 Surgeon General’s Report should make us ask if the Department of Health and Human Services and the Centers for Disease Control understand the impact of smoking on health and health care costs for seniors?"
  • Source: Website of Edward Anselm, MD, Public Health Advocate

2024: Use, perceptions, and effectiveness of e-cigarettes for smoking cessation among older adults in England: a population study, 2014–2024

• This study aimed to characterise patterns of tobacco smoking and vaping among older adults (≥ 65 years) in England, to explore harm perceptions of e-cigarettes among those who smoke, and to estimate the real-world effectiveness of e-cigarettes for helping older adults to stop smoking.
• Tobacco smoking prevalence remained relatively unchanged over time among older adults
• Older adults were consistently less likely than younger/middle-aged adults to use e-cigarettes to support attempts to quit smoking
• Older smokers reported greater uncertainty about the harms of e-cigarettes compared with cigarettes
• E-cigarettes appeared to be effective for helping older adults to stop smoking (ORadj = 1.50 [0.96–2.34]); whether effectiveness was lower than for younger/middle-aged adults was inconclusive.
  • Citation: Jackson SE, Brown J, Shahab L, Cox S. Use, perceptions, and effectiveness of e-cigarettes for smoking cessation among older adults in England: a population study, 2014-2024. BMC Med. 2024 Oct 31;22(1):500. doi: 10.1186/s12916-024-03728-x. PMID: 39482655; PMCID: PMC11526569.
    • Acknowledgement: Cancer Research UK (PRCRPG-Nov21\100002) funded the Smoking Toolkit Study data collection and salary for SJ and SC. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

2024: Increased e-cigarette use prevalence is associated with decreased smoking prevalence among US adults

• E-cigarette use prevalence was highest among the younger adult (18–34) subpopulation, and lowest among the older adult (55+) subpopulation...
• It is not surprising that we did not observe an association among older adults in the present study, since older adults have generally not adopted e-cigarettes (e.g., see Figs. 2 and [21, 61]), precluding any effect on their smoking.
  • Citation: Foxon, F., Selya, A., Gitchell, J. et al. Increased e-cigarette use prevalence is associated with decreased smoking prevalence among US adults. Harm Reduct J 21, 136 (2024). https://doi.org/10.1186/s12954-024-01056-0
    • Acknowledgement: The previously-published version of this manuscript [22] was funded by JLI. The present, updated version did not receive any JLI funding, and was self-funded by PinneyAssociates.

2024: Article: In My Vape Shop, I Learned How the VA Lets Veterans Down

• Over the next two weeks, Bob brought in nine of his fellow vets to get my help to quit smoking. They called their vapes “puffing machines.” They’d thought they were too old to benefit from quitting smoking, but as the VA rightly told them, it is never too late. They were surprised to find themselves feeling better once they quit.
  • Source: Kim "Skip" Murray, Filter Magazine

2023: Trends in US Adult Smoking Prevalence, 2011 to 2022

• In this cross-sectional study of 353 555 adults responding to the 2011 to 2022 National Health Interview Surveys, adults younger than 40 years had dramatic declines in smoking prevalence during the last decade, especially among those with higher incomes. In contrast, relatively slow declines were observed among adults aged 40 to 64 years, with no decrease in smoking among those 65 years or older.
  • Citation: Meza R, Cao P, Jeon J, Warner KE, Levy DT. Trends in US Adult Smoking Prevalence, 2011 to 2022. JAMA Health Forum. 2023 Dec 1;4(12):e234213. doi: 10.1001/jamahealthforum.2023.4213. PMID: 38038988; PMCID: PMC10692849.
    • Acknowledgement: This research was supported by grant U54CA229974 from the NCI and FDA Center for Tobacco Products (all authors) and grant U01CA253858 from the NCI (Drs Meza, Cao, Jeon, and Levy).

2023: The Impact of Older Age on Smoking Cessation Outcomes After Standard Advice to Quit

• Logistic regressions assessed interactions of age (<60 vs. ≥ 60 years) by predictors in relation to quit attempts and six-month cessation controlling for treatment.
• Conclusion: Well-known predictors of quit success were differentially associated with quitting in older age (≥60 years) after receiving standard cessation care in primary care. Although older adults in this sample were less nicotine dependent than those younger overall, older adults with high nicotine dependence were less likely to make a quit attempt or successfully quit compared to their younger counterparts. Nicotine dependence could be an important consideration in cessation treatment with older populations; such that older adults with higher dependence might need more intensive treatment including proactive approaches to ensure ease of access to nicotine replacement therapy or other cessation pharmacotherapy. Following standard cessation advice, older adults attempted to quit and succeeded at a similar rate as those younger. Further, older adults unmotivated to quit were more likely to quit compared to unmotivated younger adults.
  • Citation: Fahey MC, Dahne J, Wahlquist AE, Carpenter MJ. The Impact of Older Age on Smoking Cessation Outcomes After Standard Advice to Quit. J Appl Gerontol. 2023 Jul;42(7):1477-1485. doi: 10.1177/07334648231158228. Epub 2023 Feb 16. PMID: 36797652; PMCID: PMC10257741.
    • Acknowledgement: Funding for this research was provided by National Institute on Drug Abuse (R01 DA021619), (K23 DA045766), (T32 DA007288). Clinical Trials registration number NCT02096029.

2021: Ignoring our elders: tobacco control’s forgotten health equity issue

• Those who suffer multiple forms of stigmatisation and feel devalued in society find it harder than higher status, socially valued individuals to change health behaviours, lacking resources and social encouragement to do so. The deprioritisation of older smokers is a symptom of institutionalised ageism, which must be addressed systematically to apply the tenets of health equity and inclusion in our work. Across all areas of tobacco control, we must do better by our elders.
  • Citation: McAfee T, Malone RE, Cataldo J, Ignoring our elders: tobacco control’s forgotten health equity issue. Tobacco Control 2021;30:479-480.

2021: Age-Related Interactions on Key Theoretical Determinants of Smoking Cessation: Findings from the ITC Four Country Smoking and Vaping Surveys (2016–2020)

• Younger smokers were more likely to be abstinent for 6 months if they had reported more immediate plans to quit, while older smokers were less likely to be successful if they indicated short-term plans to quit. The age-stratified analysis for smoking abstinence (Table 3) showed that lower HSI [Heaviness of Smoking Index] predicted smoking abstinence in those under 40 but not in those 40 or older. Lower degrees of wanting to quit and to a lesser extent, planning to quit were also associated with abstinence in the older age group with reverse trends, albeit nonsignificant, for younger smokers. Quit efficacy was associated with success in the older age group only. Most associations remained consistent for 6-month smoking abstinence.
  • Citation: Le Grande M, Borland R, Yong HH, McNeill A, Fong G, Cummings KM. Age-Related Interactions on Key Theoretical Determinants of Smoking Cessation: Findings from the ITC Four Country Smoking and Vaping Surveys (2016-2020). Nicotine Tob Res. 2022 Mar 26;24(5):679-689. doi: 10.1093/ntr/ntab230. PMID: 34755869; PMCID: PMC9122748.
    • Acknowledgement: The ITC Four Country Smoking and Vaping Project in Australia, Canada, US, and England was supported by the National Health and Medical Research Council of Australia (APP1106451), US National Cancer Institute (P01CA200512), and Canadian Institutes of Health Research (FDN-148477). GTF was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. GTF has served as an expert witness on behalf of governments in litigation involving the tobacco industry. KMC has been a consultant and received grant funding from the Pfizer Inc. in the past 5 years. K.M.C has also been a paid expert witness in litigation against the tobacco industry. All other authors have no conflicts of interest to declare.

2021: Intensive Longitudinal Study of the Relationship Between Cigalike E-cigarette Use and Cigarette Smoking Among Adult Cigarette Smokers Without Immediate Plans to Quit Smoking

• Smokers older than 45 and those who started smoking at a younger age rated e-cigarettes as less satisfying (ps < .05). Participants with greater than the median reported satisfaction were 6.5 times more likely to use an e-cigarette at follow-up.
  • Citation: Pearson JL, Zhou Y, Smiley SL, Rubin LF, Harvey E, Koch B, Niaura R, Abrams DB. Intensive Longitudinal Study of the Relationship Between Cigalike E-cigarette Use and Cigarette Smoking Among Adult Cigarette Smokers Without Immediate Plans to Quit Smoking. Nicotine Tob Res. 2021 Feb 16;23(3):527-534. doi: 10.1093/ntr/ntaa086. Erratum in: Nicotine Tob Res. 2024 Dec 23;27(1):163. doi: 10.1093/ntr/ntae234. PMID: 32421191; PMCID: PMC7885790.
    • Acknowledgement: The research reported in this publication was supported by the National Institute on Drug Abuse (grant number 1R21DA036472) of the National Institutes of Health under grant number 5R21DA036472. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Disclosures

2020: Tobacco, hypertension, and vascular disease: Risk factors for renal functional decline in an older population

• The finding of an association between current cigarette use and an increase in serum creatinine suggests that even in older individuals, smoking cessation is of significant importance in preserving health.
  • Citation: Bleyer AJ, Shemanski LR, Burke GL, Hansen KJ, Appel RG. Tobacco, hypertension, and vascular disease: risk factors for renal functional decline in an older population. Kidney Int. 2000 May;57(5):2072-9. doi: 10.1046/j.1523-1755.2000.00056.x. PMID: 10792626.
    • Acknowledgement: This study was supported by Contract N01-HC-85079-85086 from the National Heart, Lung, and Blood Institute (Bethesda, MD, USA).

2019: Article: Older Smokers Are the Forgotten Victims of Our Vaping Wars

• I’ve since discovered that older smokers, like all of us, have a lot to learn about smoking. Older people are more likely than younger smokers to think that the evidence about the harms of smoking has been exaggerated, and that smoking is something they can do little to change. They are also more likely to inaccurately believe that nicotine is the primary disease-causing ingredient in cigarettes, and that cigarettes without nicotine are safer than those with nicotine.
  • Source: Annie Kleykamp, Filter Magazine

2018: Video: Rethinking nicotine across the lifespan: What about the older smoker?

• GFN: Annie Kleykamp, PhD

2017: Article: Some Older Smokers Turn to Vaping. That May Not Be a Bad Idea.

• A retired secretary in her 70s, she’s often the oldest customer in the shop. Not that she cares. What matters is that after ignoring decades of doctors’ warnings and smoking two packs a day, she hasn’t lit up a conventional cigarette in four years and four months...But while the proportion of Americans who smoke continues to decrease — down to 15.1 percent in 2015 — the decline has stalled among older adults.
• Archived Link
  • Source: Paula Span, The New York Times

2017: Article: Vaping Becoming Popular Among Older Smokers

• Public health officials, however, are divided over vaping’s benefits for older smokers. Some say it reduces the harm of smoking and it's better than doing nothing...“Old policies need to be supplemented with policies that encourage substituting e-cigarettes for the far more deadly cigarettes,” said David Levy, a professor of oncology at Georgetown University's School of Medicine and the leader of the study.
  • Source: Beth Brophy, AARP

2011: The Older Smoker

• Understanding how these age-related differences impact smoking-related outcomes (eg, tobacco withdrawal, acute effects of smoking, treatment efficacy) is limited because research examining older smokers is lacking. In a systematic review of tobacco withdrawal symptoms, the mean (SD) age of participants across 15 studies, chosen for their scientific rigor, was 37.8 (8.1) years.
• PDF Full Paper
  • Citation: Kleykamp, B. A., & Heishman, S. J. (2011). The Older Smoker. JAMA, 306(8). doi:10.1001/jama.2011.1221

Smokeless Products

• See also: Smoking and Smoking Cessation

ENDS (NVP, E-Cigarettes, E-Cigs, Vapes)

2023: Vaping prevalence and trends: key findings in the 2022-23 NZ Health Survey

• However, the revised framework should also encourage and support people who smoke, particularly those from older age groups, who cannot or do not want to stop using nicotine products, to switch completely to vaping.
  • Authors: Prof Richard Edwards, Dr Janine Nip, Prof Janet Hoek, Assoc Prof Andrew Waa
    • Acknowledgement: All authors are members of ASPIRE Aotearoa and the Department of Public Health, University of Otago, Wellington.

2016: Patterns of Electronic Cigarette Use Among Adults in the United States

• Note: "Older adults" refers to individuals aged 25-64 years.
• Results: Current e-cigarette use is extremely low among never cigarette smokers (0.4%) and former smokers who quit cigarettes 4 or more years ago (0.8%). Although e-cigarette experimentation is most common among current cigarette smokers and young adults, daily use is highest among former smokers who quit in the past year (13.0%) and older adults. Compared to daily cigarette smokers, recently quit smokers were more than four times as likely to be daily users of e-cigarettes.
• Conclusion: Extremely low e-cigarette use among never-smokers and longer term former smokers suggest that e-cigarettes neither promote widespread initiation nor relapse among adults. Recognition of the heterogeneity of smokers, including the time since quitting, is critical to draw accurate conclusions about patterns of e-cigarette use at the population level and its potential for public health benefit or harm.
• PDF Version
  • Citation: Delnevo CD, Giovenco DP, Steinberg MB, Villanti AC, Pearson JL, Niaura RS, Abrams DB. Patterns of Electronic Cigarette Use Among Adults in the United States. Nicotine Tob Res. 2016 May;18(5):715-9. doi: 10.1093/ntr/ntv237. Epub 2015 Nov 2. Erratum in: Nicotine Tob Res. 2024 Dec 23;27(1):163. doi: 10.1093/ntr/ntae234. PMID: 26525063; PMCID: PMC5896829.
    • Acknowledgement: This research was supported in part by funding from the National Institutes of Health (R01CA19044 [CDD and MBS] and K01DA037950 [JLP]). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.

Snus

2021: Swedish snuff (snus) and risk of cardiovascular disease and mortality: prospective cohort study of middle-aged and older individuals

• In this middle-aged and elderly Swedish population, current Swedish snus use was not associated with the risk of major heart and valvular diseases, abdominal aortic aneurysm, or CVD mortality in the entire study population, but was linked to an increased risk of stroke in never smokers.
  • Citation: Titova OE, Baron JA, Michaëlsson K, Larsson SC. Swedish snuff (snus) and risk of cardiovascular disease and mortality: prospective cohort study of middle-aged and older individuals. BMC Med. 2021 May 7;19(1):111. doi: 10.1186/s12916-021-01979-6. PMID: 33957912; PMCID: PMC8103653.
    • Acknowledgements: Work of the authors is supported by grants from the Geriatric Foundation, research for healthy aging, and Börjeson, Emil and Ragna Foundation (to O.E.T.), the Swedish Research Council for Health, Working Life and Welfare (Forte; grant number 2018-00123) (to S.C.L.), the Swedish Research Council (Vetenskapsrådet; grant number 2016-01042 and 2019-00977) (to S.C.L.), and the Swedish Heart-Lung Foundation (Hjärt-Lungfonden; grant number 20190247) (to S.C.L.). The study was also supported by additional grants from the Swedish Research Council (https://www.vr.se; grant no 2015-03257, 2017-00644 and 2017-06100 to KM). SIMPLER receives funding through the Swedish Research Council under the grant no 2017-00644 (to Uppsala University and KM). SNIC is financially supported by the Swedish Research Council. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Open Access funding provided by Uppsala University.

Therapeutic Benefits

Auditory

2021 Task-dependent effects of nicotine treatment on auditory performance in young-adult and elderly human nonsmokers

• The present study evaluated acute effects of oral nicotine treatment on three auditory tasks in young adult and elderly, healthy, non-smoking individuals. All had normal hearing within the frequency range of the stimuli presented for the three tasks. Compared to pre-treatment performance, nicotine improved frequency discrimination. Compared to placebo, nicotine produced no overall effects on the two frequency related tasks, but significantly improved intensity discrimination, with more improvement obtained for those who had lower baseline performance. The present results support the hypothesis that nicotine enhances auditory processing, but this enhancement is task-dependent.
• PDF Version
  • Citation: Sun, S., Kapolowicz, M.R., Richardson, M. et al. Task-dependent effects of nicotine treatment on auditory performance in young-adult and elderly human nonsmokers. Sci Rep 11, 13187 (2021). doi: 10.1038/s41598-021-92588-z

Memory and Cognitive Ability

MIND (Memory Improvement through Nicotine Dosing) Study

• The MIND Study is by far the largest and longest-running study of its kind, testing whether nicotine can improve memory loss.

2013: Nicotine Prevents Synaptic Impairment Induced by Amyloid-β Oligomers Through α7-Nicotinic Acetylcholine Receptor Activation

• Animal Study
• Taken together, these results demonstrate that nicotine prevents memory deficits and synaptic impairment induced by Aβ oligomers. In addition, nicotine improves memory in young APP/PS1 transgenic mice before extensive amyloid deposition and senile plaque development, and also in old mice where senile plaques have already formed.
• PDF Version
  • Citation: Inestrosa, N.C., Godoy, J.A., Vargas, J.Y. et al. Nicotine Prevents Synaptic Impairment Induced by Amyloid-β Oligomers Through α7-Nicotinic Acetylcholine Receptor Activation. Neuromol Med 15, 549–569 (2013). doi: 10.1007/s12017-013-8242-1
    • Acknowledgements: We thank Dr. Rodrigo Varas for his help with the electrophysiological studies of the α7-nAChR. This work was supported by a grant from FONDECYT No 120156 to N.C.I; predoctoral fellowships from CONICYT to G.G.F., M.S.A. F.G.S., J.A.R. and from Fundación Gran Mariscal de Ayacucho to J.Y.V. The Basal Center of Excellence in Science and Technology CARE was funded by CONICYT/PFB 12/2007.

2012: Nicotine treatment of mild cognitive impairment

• MCI diagnosis utilized the generally accepted criteria for amnestic MCI: age 55+...
• The secondary outcome measures showed significant nicotine-associated improvements in attention, memory, and psychomotor speed, and improvements were seen in patient/informant ratings of cognitive impairment.
  • Citation: Newhouse P, Kellar K, Aisen P, White H, Wesnes K, Coderre E, Pfaff A, Wilkins H, Howard D, Levin ED. Nicotine treatment of mild cognitive impairment: a 6-month double-blind pilot clinical trial. Neurology. 2012 Jan 10;78(2):91-101. doi: 10.1212/WNL.0b013e31823efcbb. PMID: 22232050; PMCID: PMC3466669.
    • Disclosures

2010 Nicotine's effect on neural and cognitive functioning in an aging population

• Recent advances in nicotine research have pointed to a number of cognitive and neurological benefits that have been linked to the ingestion of nicotine.
• This article examines cognitive decline in the elderly and looks at nicotine's potential role in ameliorating this decline.
• Nicotine’s effects on cognitive functioning have shown it to increase perception, visual attention,and arousal as well as improving the speed and accuracy of motor functioning while decreasing reaction time and inhibiting declines in efficiency. In addition, research has shown nicotine to improve long-term and short-term memory, and to increase the ability to withhold inappropriate responses.
• Research has revealed that chronic exposure to nicotine produces an unusual up-regulation of the nicotinic receptor sites. This increase in receptor sites is thought to provide some protection against neuro-degenerative disorders such as Alzheimer’s disease.
• PDF Version
  • Citation: K. N. Murray & N. Abeles (2002) Nicotine's effect on neural and cognitive functioning in an aging population, Aging & Mental Health, 6:2, 129-138, DOI: 10.1080/13607860220126808

2002 Nicotinic receptors in aging and dementia

• Nicotine and nicotinic agonists have been shown to improve cognitive function in aged or impaired subjects.
• Acute nicotine administration can improve performance of patients with AD on cognitive tasks, including verbal learning and memory, attention in a continuous performance task, and accuracy in a visual attention task.
• In addition to its ability to reverse cognitive deficits following aging, nicotine has been shown to protect against neurotoxic insult in vitro and in vivo. This suggests that nicotine has a dual effect on brain function following aging or injury, such that it can rescue function of remaining neurons, as well as saving neurons that might otherwise undergo cell death.
• PDF Version
  • Citation: Picciotto MR, Zoli M. Nicotinic receptors in aging and dementia. J Neurobiol. 2002 Dec;53(4):641-55. doi: 10.1002/neu.10102. PMID: 12436427.

2002 Nicotinic treatment for cognitive dysfunction

• For development of nicotinic treatments we are fortunate to have a well characterized lead compound, nicotine. Transdermal nicotine patches offer a way to deliver measured doses of nicotine in a considerably safer fashion than the more traditional means of administration, tobacco smoking. We have found that transdermal nicotine significantly improves attentional function in people with Alzheimer's disease, schizophrenia or ADHD as well as normal nonsmoking adults.
  • Citation: Levin ED, Rezvani AH. Nicotinic treatment for cognitive dysfunction. Curr Drug Targets CNS Neurol Disord. 2002 Aug;1(4):423-31. doi: 10.2174/1568007023339102. PMID: 12769614.

Mental and Behavorial Health

2020 Regulation of aggressive behaviors by nicotinic acetylcholine receptors: Animal models, human genetics, and clinical studies

• Human and Animal Studies
• Clinical trials and case series report anti-aggressive effects of nicotine. Here we argue that the nAChR system, the molecular basis for the global public health problem of tobacco smoking, may also be a key target for modulation of aggressive behaviors. Future research should aim to clarify which forms of aggression are most strongly affected by nAChR modulation, identify the nAChR subtypes, circuits, and neurobiological mechanisms of nicotine action, and determine whether more selective nAChR-active agents can replicate or improve the serenic effects of nicotine, especially with chronic dosing. Given the prevalence of aggressive behaviors across neuropsychiatric disorders affecting the very young to the very old, these studies have the potential to have a significant impact on public health.
• PDF Version
  • Citation: Alan S. Lewis, Marina R. Picciotto, Regulation of aggressive behaviors by nicotinic acetylcholine receptors: Animal models, human genetics, and clinical studies, Neuropharmacology, Volume 167, 2020, 107929, ISSN 0028-3908, doi: 10.1016/j.neuropharm.2019.107929.
    • Acknowledgements: This work was supported by National Institutes of Health grants MH116339 (A.S.L.), MH077681 and DA14241 (M.R.P.).

2018 Nicotine and networks: Potential for enhancement of mood and cognition in late-life depression

• Nicotine improves cognitive performance in clinical and preclinical studies.
• Nicotine may also benefit depressive symptoms and depressive behavior.
• Cognitive and mood benefits may be mediated by nicotinic effect on neural networks.
• Nicotine’s effects on networks may reverse network changes seen in depression.
• Improvement to mood and cognition may particularly benefit older depressed adults.
• Both preclinical and clinical studies support that nicotine and other nAChR agonists can improve depressive behavior, mood, and cognitive performance. nAChR agonists also demonstrate neuropharmacologic effects that oppose the intrinsic network alterations reported in MDD. Through modulation of intrinsic functional networks, nAChR agonists may reduce depressive symptoms, enhance emotional regulation ability, and improve cognitive deficits common in LLD. For these reasons, we propose nAChR agonists as a potential novel treatment for the mood and cognitive symptoms of LLD.
• PDF Version
  • Citation: Gandelman, J. A., Newhouse, P., & Taylor, W. D. (2018). Nicotine and networks: Potential for enhancement of mood and cognition in late-life depression. Neuroscience & Biobehavioral Reviews, 84, 289–298. doi:10.1016/j.neubiorev.2017.08.0
    • Acknowledgement: Supported by NIH grants K24 MH110598 and CTSA award UL1TR000445 from the National Center for Advancing Translational Sciences.

Very Low Nicotine Content Cigarettes

2021: Responses to Gradual and Immediate Reduction of Nicotine in Cigarettes in Young Versus Older Adult Smokers

• Note: "Older" adults were 25+ (Some, maybe all, were not in the age group this page is compiling information on.)
• These results indicate that an immediate reduction in nicotine would result in beneficial effects in both young and older adults. Young adults show less positive subjective effects of smoking following switching to VLNC cigarettes relative to older adults.
  • Citation: Cassidy RN, Tidey JW, Cao Q, Colby SM, McClernon FJ, Smith TT, Dermody S, Koopmeiners JS, Jensen JA, Strayer LG, Donny EC, Hatsukami D. Responses to Gradual and Immediate Reduction of Nicotine in Cigarettes in Young Versus Older Adult Smokers. Nicotine Tob Res. 2021 Aug 18;23(9):1559-1566. doi: 10.1093/ntr/ntab049. PMID: 33754156; PMCID: PMC8372658.
    • Acknowledgements: The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Food and Drug Administration. Research supported by a grant from the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products (U54DA031659; Donny/Hatsukami). Manuscript preparation supported by NCI K01CA189300 (PI Cassidy), K01DA047433 (Smith), and NIDA P50DA036114.