Nicotine 321Drug interactions.Nicotine interacts with commonly used medical drugs.
Antipsychotic drugs and the anti–blood clot medicine heparin flush from the
body faster if a person uses nicotine. Nicotine also reduces the sedative effect
of benzodiazepines and reduces pain relief from various opioids. Cigarette
smoke acts as a monoamine oxidase inhibitor (MAOI), a type of chemical
found in some antidepressants and that can have serious adverse effects when
used simultaneously with some medicines (though acute danger from ciga-
rette interactions may be small).Caffeineseems to make nicotine more plea-
surable. Rat studies show that nicotine increases alcohol’s appeal and worsens
pancreas inflammation caused by both drugs. Birth control pills increase the
boost that nicotine gives to pulse rate, and some researchers speculate that
such increase is related to the elevated risk of heart disease found among
smokers who use birth control pills.
Cancer.Tests indicate that pure nicotine (as opposed to smoke containing
nicotine) does not cause cancer.
Pregnancy.Smoking reduces female fertility according to most studies of
the topic, and studies of Canadian farm couples and of men in the Netherlands
found an apparent reduction in male fertility as well. Pregnant women who
smoke tobacco increase the chance of miscarriage, premature birth, smaller
full-term infants, and sudden infant death syndrome (SIDS or “crib death”).
The children are more likely to have muscle tone abnormalities. Smoking
harms male and female gametes, damages chromosomes, and can change
DNA in ways linked with childhood cancer. Nicotine usage by a pregnant
woman changes movements and heart action of a fetus. One researcher warns
that nicotine patches or chewing gum may deliver even more nicotine to a
fetus than smoking would. Nicotine enters the milk of nursing mothers. Rat
experiments indicate that fetal exposure to nicotine combined with newborn
exposure to nicotine in milk increases the risk of offspring developing lung
trouble similar to emphysema. Human birth defects have been attributed to
tobacco smoking. Although a study of teenage tobacco smokers did not see
any increased incidence of birth defects in their infants, research based on
animal experimentation and published in 1998 declared that nicotine causes
defects in fetal brain development leading to problems in thinking and learn-
ing that may not become apparent until years after birth. The children tend
to have lower scores on psychological measurements, somewhat reminiscent
of “cocaine babies,” deficits that continue for years. Some investigators see a
link between pregnant smokers and offspring with psychological problems.
Investigators tracking mothers and daughters for three decades found that
daughters were more likely to take up smoking if their mothers smoked dur-
ing pregnancy.
Additional information. Scientific studies find that “passive smoking”
threatens health of bystanders who inhale smoke from tobacco products and
exhalations of smokers. A study of spontaneous abortions found them more
likely in pregnant nonsmoking women who inhale environmental smokeand
use a lot of caffeine or a moderate amount of alcohol. Infants from nonsmoker
women who were exposed to tobacco smoke during pregnancy are more likely
to have lower birth weight and persistent pulmonary hypertension. Offspring
also exhibit the same kinds of lower psychological test scores that are seen in