Objective-To determine if nicotine's effects are influenced by caffeine in nonsmoking, moderate-caffeine consuming individuals (N=20).Methods-The first 3 sessions included one of 3 randomly ordered, double-blind caffeine doses (0, 75, or 150 mg, oral [po]) and 2 single-blind nicotine gum doses (2 and 4 mg) in ascending order. The fourth session (single blind) repeated the 0 mg caffeine condition.Results-Nicotine increased heart rate and subjective ratings indicative of aversive effects, and decreased reaction times. These effects were independent of caffeine dose and reliable across sessions.
Conclusions-In nonsmokers, nicotine effects are not influenced by moderate caffeine doses.Keywords nicotine; caffeine; interaction; subjective effect; cognition Nicotine and caffeine are mild psychomotor stimulants and the most widely used drugs in the United States. 1,2 Interestingly, 80-97% of nicotine users also use caffeine: 3 smokers drink more coffee than nonsmokers and self-administer more nicotine when using caffeine. 4,5 This frequent co-administration may reflect the influence of pharmacokinetics 6,7 and/or environment. 8 Also, the effects of the nicotine-caffeine combination may differ from those of either drug alone. 1,9 Individually, nicotine and caffeine increase heart rate, 10 produce stimulation and arousal, 11,12 and improve attention. 13,14 Some of these effects may be enhanced when the drugs are combined. For example, oral caffeine, but not placebo, increased the subjective and reinforcing effects of intravenous (IV) nicotine (eg, higher ratings of "stimulated" and monetary crossover point, or amount of money willing to be paid to receive drug; [N = 9] 9 ; see also [N = 12] 1 ). Also, 2 mg nicotine gum increased accuracy on a digit-recall task when administered with active, but not placebo, caffeine [N = 6]. 15 Importantly, results from these studies may be influenced by the fact that all participants were regular nicotine users. When regular nicotine users are included in studies examining nicotine effects, results can be influenced by tolerance and dependence. For instance, recent
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript nicotine exposure may result in a marked reduction of drug effect (ie, tolerance), 16 whereas dependence can produce withdrawal signs and symptoms after a period of drug abstinence. 17 Drug-induced suppression of these signs and symptoms 18 can be mistaken for a direct effect of the drug. One way to understand the direct effects of drugs is to include individuals who are not tolerant to or dependent on them. 19,20 Accordingly, there are several reports of the combined effects of nicotine and caffeine in nonnicotine users (N = 10). 21,22 However, these small-sample studies may have been underpowered. Thus, their failure to report an enhanced effect of the nicotine/caffeine combination, relative to either drug alone, may reflect a Type II error. Although including individuals with no history of caffeine use would also be valuable, this goal is vi...