Nicotine effects on exercise performance and physiological responses in nicotine‐naïve individuals: a systematic review

Abstract

The purpose of this systematic review was to evaluate the effects of smokeless forms of nicotine on physiological responses and exercise performance. Methodology and reporting were based on the PRISMA statement. The intervention was defined as any product containing nicotine that did not require smoking. Searches were conducted across two electronic databases with supplementary approaches utilized. Studies were selected following set inclusion and exclusion criteria and checked by two independent authors. A modified PEDro scale was utilized to rate study quality with studies averaging 9·3/13. Six studies assessed exercise performance with endurance-based parameters reported as significantly improved with nicotine in one study, while anaerobic parameters were unaffected or decreased compared to placebo except in one study which reported enhanced leg extensor torque but no effect on countermovement jump or Wingate anaerobic capacity. Sixteen of 28 studies investigating physiological responses reported that nicotine significantly increased heart rate compared to placebo or control. Blood pressure and blood flow were also reported as significantly increased in multiple studies. While there is strong evidence of nicotine-induced changes in physiological function that would benefit physical performance, beneficial effects have only been reported on leg extensor torque and endurance performance by one study each. Subsequently, there is need for more research with strong methodological quality to definitively evaluate nicotine's potential as an ergogenic aid.

Cardiopulmonary and Muscular Interactions: Potential Implications for Exercise (In)tolerance in Symptomatic Smokers Without Chronic Obstructive Pulmonary Disease

“…Diminished resistance to fatigue in smokers was demonstrated using effort-independent techniques, such as electrically evoked muscle contractions (Wüst et al, 2008c) and CO inhalation (Morse et al, 2008). Interestingly, however, nicotine may also have ergogenic effects through augmented release of adrenaline and enhanced performance of fast-twitch muscle fibers (Johnston et al, 2018). Thus, any potential increase in muscle fatigability in smokers might be compensated by the central excitatory actions of nicotine leading to preserved time to task failure compared to equally sedentary controls (Orlander et al, 1979; Larsson and Orlander, 1984).…”

“…The present review aims to succinctly summarize the recent advances in our knowledge on the effects of smoking on the muscle-lung-heart axis under the stress of exercise. Despite the fact that there is an acute-on-chronic effect of current smoking on these interactions, we will refrain from discussing the large body of clinical and experimental evidence showing the deleterious effects of acute tobacco smoking in nicotine-naive subjects (Johnston et al, 2018). Thus, we will focus on the chronic consequences of smoking on exercise intolerance from an integrative physiological perspective, giving special attention to the ancillary effects of aging, and physical inactivity.…”

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

“…Yet what is the evidence base that might support or oppose the use of nicotine in the athletic arena? There have been reviews published that have included sub-sections on nicotine and human performance [ 49 ], been focussed on the cardiovascular response to smokeless tobacco (ST [ 11 ]) and physiological exercise responses to tobacco smoking [ 29 ], focussed on nicotine-naïve individuals [ 33 ] or on attention and cognition as outcome measures [ 25 ]. No attempt has been made to review nicotine’s potential for influencing physical performance that would be of interest to the sporting community.…”

Phytochemicals for Improving Aspects of Cognitive Function and Psychological State Potentially Relevant to Sports Performance

“…Much of the human literature is therefore confounded by conducting research in smokers who had abstained from smoking, making the interpretation of any net effects of nicotine difficult to disentangle from alleviation of decrements due to being in a state of a withdrawal. However, whilst there is plentiful evidence of nicotine exerting cardiovascular effects potentially relevant to improved physical performance in nicotine-naïve consumers [ 228 ], this evidence is not matched by any persuasive evidence of actual performance improvements [ 228 , 229 ]. The story with regard to brain function in a non-sporting context is better.…”