1 Nicotine can activate primary a erent nociceptors, one result of which is to increase neurogenic plasma extravasation. In this study we have demonstrated a novel proin¯ammatory e ect of subnanomolar nicotine, mediated by peripheral action at sensory neurons. This action is normally masked by adrenal medulla-derived d-opioid receptor agonists. 2 While neurogenic plasma extravasation in the knee joint of the rat was not increased by intraarticular perfusion of nicotine (10 78 M), perfusion of nicotine, at concentrations as low as 10 710 M, combined with naloxone to block opioid receptors (or naltrindole to block d-opioid receptors) was able to enhance bradykinin-induced plasma extravasation. This pro-in¯ammatory e ect of intraarticular nicotine was mimicked by subcutaneous nicotine which was abolished by intra-articularlyadministered hexamethonium, a nicotinic receptor antagonist. 3 Following denervation of the adrenal medulla, intra-articular nicotine, alone at 10 78 M, enhanced plasma extravasation, which was no longer enhanced by naloxone. 4 Destruction of primary a erents by neonatal treatment with capsaicin or blockade of sensory neurotransmitter by neurokinin-1 receptor antagonist RP-87,580 abolished the pro-in¯ammatory e ect of nicotine.5 The e ect of nicotine we describe in promoting in¯ammation is exerted at extremely low concentrations and therefore could have relevance to smokers, patients receiving medicinal nicotine as therapy and even second-hand smokers. Since receptor mechanisms on peripheral terminals of nociceptors may also be present on central terminals, actions of the endogenous nicotinic agonist acetylcholine, at central terminals of primary a erents or at other sites in the central nervous system, may be similarly modulated by opioids.