Health effects of nicotine

Health effects of nicotine

<Health effects of nicotine: Cardiovascular System>

 

■  Acute Effects

Inhaling aerosols or fumes containing nicotine during regular handling can lead to severe toxic effects, and even a small amount absorbed into the lungs can be deadly. Long-term exposure to nicotine vapors, smoke, or aerosols can cause difficulty breathing and sometimes lead to symptoms like headaches or chest pain (1).

Skin contact with nicotine can also result in serious toxic effects, potentially leading to systemic damage and even death if absorbed into the bloodstream through cuts or lesions. Workers handling wet tobacco leaves may experience "tobacco leaf sickness," with symptoms like paleness, vomiting, and extreme fatigue (1).

Nicotine exposure may cause eye irritation and damage, particularly when vapors are highly concentrated. Proper precautions, including alarms and monitoring for excessive exposure, are necessary for safe work (1).

Ingesting nicotine can lead to adverse effects on muscle tissue, severe irritation of the digestive system, abdominal pain, nausea, vomiting, diarrhea, tremors, convulsions, muscle paralysis, respiratory failure, and death. Symptoms of nicotine poisoning include excessive salivation, nausea, vomiting, diarrhea, abdominal pain, dizziness, delirium, fainting, convulsions, extreme fatigue, confusion, headaches, visual disturbances, and mental disharmony. Overdose may cause central nervous system symptoms followed by convulsions and coma. It can also affect the respiratory system, causing rapid, then slow and unnatural breathing, cyanosis, and temporary irritation and compression of the central nervous system and surrounding nerves. Fatal poisoning may lead to organ hemorrhage, especially in the kidneys, and neuromuscular effects such as muscle spasms, weakness, paralysis, and muscarinic symptoms like inhibition of cardiac activity, vasodilation, saliva and tear secretion, bronchial compression, and gastrointestinal irritation.

 

■   Chronic Effects

 

Brain and Cardiovascular System

Nicotine can accelerate arteriosclerosis by inducing hyperlipidemia, damaging endothelial cells, or promoting thrombosis. It adversely affects systemic hemodynamics by promoting thrombosis, coronary artery constriction, or arrhythmia development, potentially contributing to acute ischemic disease in people with coronary heart disease. Chronic inhalation of nicotine has been shown to increase right ventricular systolic blood pressure and right ventricular wall thickness in rats compared to those not exposed (2-4).

 

Immune and Inflammatory Responses

Nicotine's effects on the immune system are conflicting. Some studies suggest it increases pro-inflammatory cytokines and triggers neutrophil apoptosis, releasing intracellular components that act as autoantigens. Stimulation of sympathetic nerves by nicotine can induce an inflammatory response by stimulating monocyte production. Nicotine's effects have been studied in various autoimmune diseases. Conversely, studies related to nicotine replacement therapy for smoking cessation suggest anti-inflammatory effects, with a decrease in inflammatory markers observed in participants. Stimulation of the α7-nicotinic acetylcholine receptor on macrophages has been reported to prevent sepsis by reducing proinflammatory cytokine production (5, 6).

 

 

■    References

1.  Hansen AM, Mathiesen L, Pedersen M, Knudsen LE (2008). Urinary 1-hydroxypyrene (1-HP) in environmental and occupational studies–a review. Int J Hyg Environ Health, 211: 471–503.

2.  Benowitz, N.L. (1991). Nicotine and Cardiovascular Disease. In: Adlkofer, F., Thurau, K. (eds) Effects of Nicotine on Biological Systems

3.  Dollerup J, Vestbo J, Murray-Thomas T, et al.: Cardiovascular risks in smokers treated with nicotine replacement therapy: a historical cohort study. Clin Epidemiol. 2017; 9: 231–243.

4.  Fried, N. D., Morris, T. M., Whitehead, A., Lazartigues, E., Yue, X., & Gardner, J. D. (2021). Angiotensin II type 1 receptor mediates pulmonary hypertension and right ventricular remodeling induced by inhaled nicotine. American journal of physiology. Heart and circulatory physiology, 320(4), H1526–H1534.

5.  Price, L. R., & Martinez, J. (2019). Cardiovascular, carcinogenic and reproductive effects of nicotine exposure: A narrative review of the scientific literature. F1000Research, 8, 1586. https://doi.org/10.12688/f1000research.20062.2

6.  Lee J, Cooke JP: The role of nicotine in the pathogenesis of atherosclerosis. Atherosclerosis. 2011; 215(2): 281–283.