Nicotine

Nicotine is a stimulant and potent parasympathomimetic alkaloid that is naturally

produced in the nightshade family of plants. It is used for the treatment of tobacco use

disorders as a smoking cessation aid and nicotine dependence for the relief

of withdrawal symptoms.[4][6][7] Nicotine acts as a receptor agonist at most nicotinic

acetylcholine receptors (nAChRs),[8][9][10] except at two nicotinic receptor

subunits (nAChRα9 and nAChRα10) where it acts as a receptor antagonist.[8]

Nicotine constitutes approximately 0.6–3.0% of the dry weight of tobacco.[11] Usually

consistent concentrations of nicotine varying from 2–7 µg/kg (20–70 millionths of a

percent wet weight) are found in the edible family Solanaceae, such

as potatoes, tomatoes, and eggplant.[12] Some research indicates that the contribution of

nicotine obtained from food is substantial in comparison to inhalation of second-hand

smoke.[12] Others consider nicotine obtained from food to be trivial unless exceedingly

high amounts of certain vegetables are eaten.[12] It functions as an antiherbivore

chemical; consequently, nicotine was widely used as an insecticide in the

past,[13][14] and neonicotinoids, such as imidacloprid, are widely used.

Nicotine is highly addictive.[15][16][17] It is one of the most commonly abused drugs.[18] An

average cigarette yields about 2 mg of absorbed nicotine; high amounts can be more

harmful.[19] Nicotine addiction involves drug-reinforced behavior, compulsive use, and

relapse following abstinence.[20] Nicotine dependence involves tolerance,

sensitization,[21] physical dependence, and psychological dependence.[22] Nicotine

dependence causes distress.[23][24] Nicotine withdrawal symptoms include depressed

mood, stress, anxiety, irritability, difficulty concentrating, and sleep disturbances.[2] Mild

nicotine withdrawal symptoms are measurable in unrestricted smokers, who experience

normal moods only as their blood nicotine levels peak, with each cigarette.[25] On quitting,

withdrawal symptoms worsen sharply, then gradually improve to a normal state. [25]

Nicotine use as a tool for quitting smoking has a good safety history.[26] Nicotine itself is

associated with some health harms.[27] Youth are especially sensitive to the effects of

nicotine.[28] Nicotine is potentially harmful to non-users.[28] At low amounts, it has a

mild analgesic effect.[28] The Surgeon General of the United States indicates that nicotine

does not cause cancer.[29] Nicotine has been shown to produce birth defects in some

animal species, but not others.[30] It is considered a teratogen in humans.[31] Nicotine

can harm adolescent brain development.[32] The median lethal dose of nicotine in

humans is unknown,[33] but high doses are known to cause nicotine poisoning
 Overdose

It is unlikely that a person would overdose on nicotine through smoking alone. The

US Food and Drug Administration (FDA) stated in 2013 that there are no significant safety

concerns associated with the use of more than one form of over-the-

counter (OTC) nicotine replacement therapy at the same time, or using OTC NRT at the

same time as another nicotine-containing product, like cigarettes.[96] The median lethal

dose of nicotine in humans is unknown.[33][19] Nevertheless, nicotine has a relatively

high toxicity in comparison to many other alkaloids such as caffeine, which has an LD50 of

127 mg/kg when administered to mice.[97] At sufficiently high doses, it is associated with

nicotine poisoning,[29] which, while common in children, rarely results in significant

morbidity or death.[30]

The initial symptoms of a nicotine overdose typically include nausea, vomiting,

diarrhea, hypersalivation, abdominal pain, tachycardia (rapid heart

rate), hypertension (high blood pressure), tachypnea (rapid breathing), headache,

dizziness, pallor (pale skin), auditory or visual disturbances, and perspiration, followed

shortly after by marked bradycardia (slow heart rate), bradypnea (slow breathing),

and hypotension (low blood pressure).[30] Respiratory stimulation (i.e., tachypnea) is one

of the primary signs of nicotine poisoning.[30] At sufficiently high

doses, somnolence (sleepiness or drowsiness), confusion, syncope (loss of

consciousness from fainting), shortness of breath, marked weakness, seizures,

and coma may occur.[5][30] Lethal nicotine poisoning rapidly produces seizures, and

death – which may occur within minutes – is believed to be due to respiratory paralysis