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Br Med Bull 1996 Jan;52(1):58-73

   Beneficial effects of nicotine and cigarette smoking: the real, the  possible
and the spurious.

   Baron JA

   Department of Medicine, Dartmouth Medical School, Hanover, New    Hampshire,
USA.

   Cigarette smoking is an established risk factor for cancer and
cardiovascular    disease, and is the leading cause of avoidable disease in most
industrialized    countries. Less well-known are possible beneficial effects,
which are briefly    considered in this survey. Preliminary data suggest that
there may be inverse    associations of smoking with uterine fibroids and
endometriosis, and    protective effects on hypertensive disorders and vomiting
of pregnancy are    likely. Smoking has consistently been found to be inversely
related to the    risk of endometrial cancer, but cancers of the breast and
colon seem    unrelated to smoking. Inverse associations with venous thrombosis
and    fatality after myocardial infarction are probably not causal, but
indications    of benefits with regard to recurrent aphthous ulcers, ulcerative
colitis, and    control of body weight may well reflect a genuine benefit.
Evidence is    growing that cigarette smoking and nicotine may prevent or
ameliorate    Parkinson's disease, and could do so in Alzheimer's dementia. A
variety of    mechanisms for potentially beneficial effects of smoking have
been    proposed, but three predominate: the 'anti-estrogenic effect' of
smoking;    alterations in prostaglandin production; and stimulation of
nicotinic    cholinergic receptors in the central nervous system. Even
established inverse    associations cannot be used as a rationale for cigarette
smoking. These data    can be used, however, to clarify mechanisms of disease,
and point to    productive treatment or preventive options with more
narrowly-acting    interventions.

   PMID: 8746297, UI: 96362361
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Br J Nurs 1996 Oct 24-Nov  13;5(19):1195-202

  Does nicotine have beneficial effects in the treatment of certain diseases?

 Birtwistle J, Hall K

 University of Southampton, Department of Psychiatry, Royal South Hants
 Hospital.

 Although tobacco smoking has long been associated with diseases of the  lungs
and cardiovascular system, numerous studies have demonstrated a  negative
association between tobacco smoking and ulcerative colitis, and the
neurodegenerative diseases, Alzheimer's disease (AD) and Parkinson's  disease
(PD). The evidence suggests that nicotine--the main  pharmacologically active
ingredient of tobacco--appears to be responsible  for this effect. Pure nicotine
has no known carcinogenic properties and can  be administered in numerous ways
including transdermal patches and tablets. As a therapeutic agent, its
association with tobacco can be likened to  morphine and opium smoking. There is
ample clinical evidence to suggest  that nicotine could be beneficial in the
treatment of some patients with  diseases. Pharmacologically, nicotine acts on
cholinergic (nicotinic-specific)  receptors which are depleted in AD and PD.
Nicotinic receptors also interact  closely with several neurotransmitters
including dopamine, which is  implicated in both PD and Gilles de la Tourettes's
syndrome. There is no  doubt that tobacco smoking can be harmful and no-one
should be encouraged  to smoke. However, although nicotine has many harmful
side-effects, it may  have therapeutic value or at the very least be a useful
tool for future drug  development.

  PMID: 9006184, UI: 97158826





..........................................................................
                    Ray Strand
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                   48/47/45?
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...on the edge of the prairie abyss ......................