Jan, aged 60, quit smoking 20 years ago. But she was recently reading in various magazines that nicotine was good for the memory, and might help prevent forgetful "senior moments." She began to wonder if she should take up smoking again.

The answer to that question is a resounding "no!" The U.S. Surgeon General, expressing the consensus of medical opinion, has said, "Smoking cigarettes is the chief, single avoidable cause of death in our society and the most important public health issue of our time." Nicotine is only one of the thousands of chemicals found in cigarettes, cigars and pipe tobacco (including the poisons arsenic and cyanide), but it is the one that is most addictive in spite of its known hazards. Smoking destroys the fine hairs (cilia) that line the respiratory tract and prevent hazardous materials from advancing down the airway. Over time, the cells supporting the cilia become distorted and possibly malignant. Men and women who smoke increase the risk of diabetes, stroke, heart attack, sleep problems (insomnia, snoring), early wrinkling of the skin and delayed wound healing. Younger female smokers have more reproductive problems such as miscarriages and low birth weight babies. Moreover, exposing others to second hand smoke doubles their incidence of lung cancer. In veterinary medicine, nicotine is used as an insecticide and to rid animals of worms and other parasites. So why are so many of us such devoted smokers? We have been aware of its feel-good properties for centuries. It was named after Jean Nicot, the French ambassador to Portugal who sent tobacco seeds to Paris in 1550. By 1828 the compound was purified, and it was synthesized by 1904. Nicotine works by stimulating the release of the neurotransmitter dopamine and blocks nerve endings from collecting it and removing it from circulation. It also mimics the effects of acetylcholine, a neurochemical which plays a role in memory and learning. The net effect is pleasurable and calming, and nicotine may indeed sharpen one's mental skills. Recent research has shown that nicotine not only increases attention and focus, calms nerves and improves memory, but may also offer some protection from Alzheimer's and Parkinson's diseases and reduce symptoms of schizophrenia and attention deficit hyperactivity disorder. It may also repair learning and memory deficits due to hypothyroidism. But all this comes at a cost. Based on animal studies, the brains of teenagers who smoke may not fully develop. Also, while low doses of nicotine improve learning, high doses have been found to retard learning. And not to be ignored--overdosing on nicotine can cause lethal respiratory arrest. Other symptoms of toxicity include weakness, fainting, coma, abdominal cramps or vomiting, elevated heart rate and blood pressure--followed by a fall in both--confusion, agitation, and depression. The challenge facing researchers today is to develop a nicotine delivery system with the right dosage, without the side effects of smoking. Nicotine patches applied to the skin are one possibility, as are products containing cotinine, the primary metabolite of nicotine. Nicotine patches have not been approved for long term use. Reading labels on vitamin supplements can be very confusing, as many have nicotinic acid or nicotinamide as an ingredient. The names are no coincidence. Oxidized nicotine yields niacin, also known as nicotinic acid, and nicotinamide (also known as niacinamide) is a derivative. Niacin and niacinamide are part of the set of B vitamins. Smoking is a source of nicotine, but will not supply needed niacin. Niacin deficiency is known as pellagra, with symptoms of skin problems such as blistering and oozing, nausea and loss of appetite, and nervous disorders which may progress to delirium and dementia. Niacin is widely found in plant and animal food sources, especially in lean meat. The minimal daily requirement is 10-20 milligrams. In some mammals, including humans, bacteria convert the amino acid tryptophan to nicotinic acid. If dietary tryptophan is plentiful, other niacin sources may not be essential. If your goal is rest and sleep, you need not rely on cigarettes. Go straight to natural sources of tryptophan, which is a precursor of the sleep-inducing serotonin and melatonin. These include dairy products, soy products, eggs, whole grains, rice and lentils. Calcium helps the brain produce the sleep-inducing melatonin. When your mother recommended a cup of warm milk on a sleepless night, she knew what she was talking about. Junk food--pure carbohydrates--will set off the chain reaction of high blood sugar, rapidly falling blood sugar, and release of stress hormones sure to keep you awake. Surprisingly, chocolate is not especially high in the stimulant caffeine, and a chocolate chip cookie with your evening glass of milk may help induce sleep. In short, look forward to the health advantages of nicotine derivatives that do not involve the poisons found in tobacco. Find smoke-free ways to relax!

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