Nicotine: Sporting Friend or Foe? A Review of Athlete Use, Performance Consequences and Other Considerations

Toby Mündel, Toby Mündel

Abstract

Nicotine use amongst athletes is high and increasing, especially in team sports. This narrative review examines the rationale behind its use and evidence of its effect on physical performance, and considers important factors that should determine future research efforts. To date, ten studies have assessed muscular strength and power, sub- or maximal endurance and high-intensity exercise when nicotine (medication) or smokeless tobacco was used as an intervention. Two studies observed an ergogenic effect, one an ergolytic with the remaining seven reporting no change. These studies have notable limitations and confounding factors that include participant tolerance to nicotine, interindividual responses, the nicotine delivery system used and failure to adhere to rigorous experimental/scientific design. Further research is encouraged to address these limitations and determine the extent to which anti-doping and governing bodies should consider promoting, coordinating and monitoring any effort against nicotine and nicotine-containing substances in sports.

Conflict of interest statement

For his nicotine-related research, Toby Mündel has received competitive scientific research funding from the World Anti-Doping Agency and financial travel support to present this research at conferences from The Physiological Society and The Maurice and Phyllis Paykel Trust.

References

    1. Alaranta A, Alaranta H, Patja K, Palmu P, Prättälä R, Martelin T, Helenius I. Snuff use and smoking in Finnish olympic athletes. Int J Sports Med. 2006;27:581–586. doi: 10.1055/s-2005-865826.
    1. Ashton H, Stepney R. Smoking psychology and pharmacology. New York: Tavistock & Methuen; 1982.
    1. Baldini FD, Skinner JS, Landers DM, O’Connor JS. Effects of varying doses of smokeless tobacco at rest and during brief, high-intensity exercise. Mil Med. 1992;157(2):51–55.
    1. Benowitz NL. Pharmacology of nicotine: addiction, smoking-induced disease, and therapeutics. Annu Rev Pharmacol Toxicol. 2009;49:57–71. doi: 10.1146/annurev.pharmtox.48.113006.094742.
    1. Benowitz NL, Burbank AD. Cardiovascular toxicity of nicotine: implications for electronic cigarette use. Trends Cardiovasc Med. 2016;26(6):515–523. doi: 10.1016/j.tcm.2016.03.001.
    1. Benowitz NL, Jacob P, 3rd, Jones RT, Rosenberg J. Interindividual variability in the metabolism and cardiovascular effects of nicotine in man. J Pharmacol Exp Ther. 1982;221(2):368–372.
    1. Benowitz NL, Hukkanen J, Jacob P., 3rd Nicotine chemistry, metabolism, kinetics and biomarkers. Handb Exp Pharmacol. 2009;192:29–60. doi: 10.1007/978-3-540-69248-5_2.
    1. Benowitz NL, Lessov-Schlaggar CN, Swan GE, Jacob P., 3rd Female sex and oral contraceptive use accelerate nicotine metabolism. Clin Pharmacol Ther. 2006;79(5):480–488. doi: 10.1016/j.clpt.2006.01.008.
    1. Benowitz NL, Pomerleau OF, Pomerleau CS, Jacob P., 3rd Nicotine metabolite ratio as a predictor of cigarette consumption. Nicotine Tob Res. 2003;5:621–624. doi: 10.1080/1462220031000158717.
    1. Boutrel B, Koob GF. What keeps us awake: the neuropharmacology of stimulants and wakefulness-promoting medications. Sleep. 2004;27(6):1181–1194. doi: 10.1093/sleep/27.6.1181.
    1. Chagué F, Guenancia C, Gudjoncik A, Moreau D, Cottin Y, Zeller M. Smokeless tobacco, sport and the heart. Arch Cardiovasc Dis. 2015;108(1):75–83. doi: 10.1016/j.acvd.2014.10.003.
    1. Christen AG, McDaniel RK, Doran JE. Snuff dipping and tobacco chewing in a group of Texas college athletes. Tex Dent J. 1979;97(2):6–10.
    1. Connolly GN, Orleans CT, Kogan M. Use of smokeless tobacco in major-league baseball. N Engl J Med. 1988;318(19):1281–1285. doi: 10.1056/NEJM198805123181918.
    1. Cooper KH, Gey GO, Bottenberg RA. Effects of cigarette smoking on endurance performance. JAMA. 1968;203(3):189–192. doi: 10.1001/jama.1968.03140030021006.
    1. Corrigall WA, Cohen KM, Adamson KL. Self administered nicotine activates the mesolimbic dopamine system through the ventral tegmental area. Brain Res. 1994;653:278–284. doi: 10.1016/0006-8993(94)90401-4.
    1. Digard H, Proctor C, Kulasekaran A, Malmqvist U, Richter A. Determination of nicotine absorption from multiple tobacco products and nicotine gum. Nicotine Tob Res. 2013;15(1):255–261. doi: 10.1093/ntr/nts123.
    1. Domino EF, Hornbach E, Demana T. The nicotine content of common vegetables. N Engl J Med. 1993;329(6):437. doi: 10.1056/NEJM199308053290619.
    1. Druyan A, Atias D, Ketko I, Cohen-Sivan Y, Heled Y. The effects of smoking and nicotine ingestion on exercise heat tolerance. J Basic Clin Physiol Pharmacol. 2016
    1. Eckstein JW, Horsley AW. Responses of the peripheral veins in man to the intravenous administration of nicotine. Ann N Y Acad Sci. 1960;90:133–137. doi: 10.1111/j.1749-6632.1960.tb32625.x.
    1. Edwards SW, Glover ED, Schroeder KL. The effects of smokeless tobacco on heart rate and neuromuscular reactivity in athletes and nonathletes. Phys Sportsmed. 1987;15(7):141–147. doi: 10.1080/00913847.1987.11702037.
    1. Escher SA, Tucker AM, Lundin TM, Grabiner MD. Smokeless tobacco, reaction time, and strength in athletes. Med Sci Sports Exerc. 1998;30(10):1548–1551. doi: 10.1097/00005768-199810000-00013.
    1. Fogt DL, Levi MA, Rickards CA, Stelly SP, Cooke WH. Effects of acute vaporized nicotine in non-tobacco users at rest and during exercise. Int J Exerc Sci. 2016;9(5):607–615.
    1. Glover ED, Edmundson EW, Edwards SW, Schroeder KL. Implications of smokeless tobacco use among athletes. Phys Sportsmed. 1986;14(12):95–105. doi: 10.1080/00913847.1986.11716465.
    1. Haass M, Kübler W. Nicotine and sympathetic neurotransmission. Cardiovasc Drugs Ther. 1997;10(6):657–665. doi: 10.1007/BF00053022.
    1. Heishman SJ, Kleykamp BA, Singleton EG. Meta-analysis of the acute effects of nicotine and smoking on human performance. Psychopharmacology. 2010;210(4):453–469. doi: 10.1007/s00213-010-1848-1.
    1. Hendricks PS, Ditre JW, Drobes DJ, Brandon TH. The early time course of smoking withdrawal effects. Psychopharmacology. 2006;187(3):385–396. doi: 10.1007/s00213-006-0429-9.
    1. Henninger S, Fischer R, Cornuz J, Studer J, Gmel G. Physical activity and snus: is there a link? Int J Environ Res Public Health. 2015;12:7185–7198. doi: 10.3390/ijerph120707185.
    1. Hirsch GL, Sue DY, Wasserman K, Robinson TE, Hansen JE. Immediate effects of cigarette smoking on cardiorespiratory responses to exercise. J Appl Physiol. 1985;58(6):1975–1981.
    1. Hoyt GL. Cigarette smoking: nicotine, carbon monoxide, and the physiological effects on exercise responses. Sport Sci Rev. 2013;22(1–2):5–24.
    1. Hukkanen J, Gourlay SG, Kenkare S, Benowitz NL. Influence of menstrual cycle on cytochrome P450 2A6 activity and cardiovascular effects of nicotine. Clin Pharmacol Ther. 2005;77(3):159–169. doi: 10.1016/j.clpt.2004.10.012.
    1. Hukkanen J, Jacob P, 3rd, Benowitz NL. Metabolism and disposition kinetics of nicotine. Pharmacol Rev. 2005;57(1):79–115. doi: 10.1124/pr.57.1.3.
    1. Jamner LD, Girdler SS, Shapiro D, Jarvik ME. Pain inhibition, nicotine, and gender. Exp Clin Psychopharmacol. 1998;6(1):96–106. doi: 10.1037/1064-1297.6.1.96.
    1. Johnston R, Doma K, Crowe M. Nicotine effects on exercise performance and physiological responses in nicotine-naïve individuals: a systematic review. Clin Physiol Funct Imaging. 2017
    1. Kaijser L, Berglund B. Effect of nicotine on coronary blood-flow in man. Clin Physiol. 1985;5:541–552. doi: 10.1111/j.1475-097X.1985.tb00767.x.
    1. Landers DM, Crews DJ, Boutcher SH, Skinner JS, Gustafsen S. The effects of smokeless tobacco on performance and psychophysiological response. Med Sci Sports Exerc. 1992;24(8):895–903. doi: 10.1249/00005768-199208000-00011.
    1. Lee WE. The action of tobacco smoke, with special reference to arterial pressure and degeneration. Q J Exp Physiol. 1908;1(4):335–358. doi: 10.1113/expphysiol.1908.sp000024.
    1. Lester MJ, Jacobson BH, Edwards SW. Effect of ingestion of smokeless tobacco on motor distal latency of the median nerve. Percept Mot Skills. 1988;67(1):283–290. doi: 10.2466/pms.1988.67.1.283.
    1. Marclay F, Saugy M. Determination of nicotine and nicotine metabolites in urine by hydrophilic interaction chromatography-tandem mass spectrometry: Potential use of smokeless tobacco products by ice hockey players. J Chromatogr A. 2010;1217(48):7528–7538. doi: 10.1016/j.chroma.2010.10.005.
    1. Marclay F, Grata E, Perrenoud L, Saugy M. A one-year monitoring of nicotine use in sport: frontier between potential performance enhancement and addiction issues. Forensic Sci Int. 2011;213(1–3):73–84. doi: 10.1016/j.forsciint.2011.05.026.
    1. Marsot A, Simon N. Nicotine and cotinine levels with electronic cigarette: a review. Int J Toxicol. 2016;35(2):179–185. doi: 10.1177/1091581815618935.
    1. Martinsen M, Sundgot-Borgen J. Adolescent elite athletes’ cigarette smoking, use of snus, and alcohol. Scand J Med Sci Sports. 2014;24(2):439–446. doi: 10.1111/j.1600-0838.2012.01505.x.
    1. Mattila VM, Raisamo S, Pihlajamäki H, Mäntysaari M, Rimpelä A. Sports activity and the use of cigarettes and snus among young males in Finland in 1999–2010. BMC Public Health. 2012;12:230. doi: 10.1186/1471-2458-12-230.
    1. Mayer B. How much nicotine kills a human? Tracing back the generally accepted lethal dose to dubious self-experiments in the nineteenth century. Arch Toxicol. 2014;88(1):5–7. doi: 10.1007/s00204-013-1127-0.
    1. Moore M. Smokeless tobacco is ‘burning’ youth athletes. Phys Sportmed. 1981;9:21. doi: 10.1080/00913847.1981.11711091.
    1. Morente-Sánchez J, Zandonai T, Mateo-March M, Sanabria D, Sánchez-Muñoz C, Chiamulera C, Zabala Díaz M. Acute effect of Snus on physical performance and perceived cognitive load on amateur footballers. Scand J Med Sci Sports. 2015;25(4):e423–e431. doi: 10.1111/sms.12321.
    1. Mündel T, Jones DA. Effect of transdermal nicotine administration on exercise endurance. Exp Physiol. 2006;91(4):705–713. doi: 10.1113/expphysiol.2006.033373.
    1. Mündel T, Machal M, Cochrane DJ, Barnes MJ. A randomised, placebo-controlled, crossover study investigating the effects of nicotine gum on strength, power and anaerobic performance in nicotine-naïve, active males. Sports Med Open. 2017;3(1):5. doi: 10.1186/s40798-016-0074-8.
    1. Parrott AC, Garnham NJ, Wesnes K, Pincock C. Cigarette smoking and abstinence: comparative effects upon cognitive task performance and mood state over 24 hours. Hum Psychopharmacol. 1996;11:391–400. doi: 10.1002/(SICI)1099-1077(199609)11:5<391::AID-HUP780>;2-Z.
    1. Pesta DH, Angadi SS, Burtscher M, Roberts CK. The effects of caffeine, nicotine, ethanol, and tetrahydrocannabinol on exercise performance. Nutr Metab. 2013;10(1):71. doi: 10.1186/1743-7075-10-71.
    1. Perkins KA, Grobe JE, Fonte C, Goettler J, Caggiula AR, Reynolds WA, Stiller RL, Scierka A, Jacob RG. Chronic and acute tolerance to subjective, behavioral and cardiovascular effects of nicotine in humans. J Pharmacol Exp Ther. 1994;270(2):628–638.
    1. Poltavski DV, Petros TV, Holm JE. Lower but not higher doses of transdermal nicotine facilitate cognitive performance in smokers on gender non-preferred tasks. Pharmacol Biochem Behav. 2012;102(3):423–433. doi: 10.1016/j.pbb.2012.06.003.
    1. Pontieri FE, Tanda G, Orzi F, DiChiara G. Effects of nicotine on the nucleus accumbens and the similarity to other addictive drugs. Nature. 1996;382:255–257. doi: 10.1038/382255a0.
    1. Pyšný L, Petru D, Pysna J, Cihlar D. The acute effect of nicotine on anaerobic exercise performance. J Phys Educ Sport. 2015;15(1):103–107.
    1. Roth GJ, McDonald JB, Sheard C. The effect of smoking cigarettes and of intravenous injections of nicotine on the electrocardiogram, basal metabolic rate, cutaneous temperature, blood pressure and pulse rate of normal persons. J Am Med Assoc. 1944;125:761–767. doi: 10.1001/jama.1944.02850290001001.
    1. Rottenstein H, Pierce G, Russ E, Felder D, Montgomery H. Influence of nicotine on the blood flow of resting skeletal muscle and of the digits in normal subjects. Ann N Y Acad Sci. 1960;90:102–113. doi: 10.1111/j.1749-6632.1960.tb32622.x.
    1. Severson HH, Klein K, Lichtensein E, Kaufman N, Orleans CT. Smokeless tobacco use amongst professional baseball players: survey results, 1998 to 2003. Tob Control. 2005;14:31–36. doi: 10.1136/tc.2004.007781.
    1. Silvette H, Hoff EC, Larson PS, Haag HB. The actions of nicotine on central nervous system functions. Pharmacol Rev. 1962;14:137–173.
    1. Van Duser BL, Raven PB. The effects of oral smokeless tobacco on the cardiorespiratory response to exercise. Med Sci Sports Exerc. 1992;24:389–395.
    1. World Anti-Doping Agency. The 2012 monitoring program, Montreal. . 2012. Accessed 19 Oct 2016.
    1. World Health Organization. Who report on the global tobacco epidemic. . 2013. Accessed 20 Oct 2016.
    1. Wüst RC, Morse CI, de Haan A, Rittweger J, Jones DA, Degens H. Skeletal muscle properties and fatigue resistance in relation to smoking history. Eur J Appl Physiol. 2008;104(1):103–110. doi: 10.1007/s00421-008-0792-9.
    1. Zandonai T, Tam E, Bruseghini P, Pizzolato F, Franceschi L, et al. The effects of oral smokeless tobacco administration on endurance performance. J Sport Health Sci. 2016

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