Tobacco (Nicotiana tabacum)
Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
2,3,6-Trimethyl-1,4-naphthoquinone, 2-methylquinone, 2-naphthylamine, acrolein, albumen, aldehydes, anabasine, anatabine, anatalline, anethole, anthalin, areca nut, arghile, aromatic hydrocarbons, beta-naphthylamine, benzo[a]pyrene, betel quid, bidi, carbon monoxide, catechols, cembrene, chewing tobacco, choline, cigar, cigarette, collidine, fatty acids, furfurol, goza, gum, harman, hookah, hubble bubble, hydrocyanic acid, ketones, latakria, narghile, narkeela, nicotelline, Nicotiana fruticosa, Nicotiana latissima, Nicotiana multivulvis, Nicotiana persica, Nicotiana quadrivalis, Nicotiana repandu, Nicotiana rustica, nicotianin, nicotine, nicotinine, nitric oxide, nitrosamines, norharman, organic acids, orinoco, paraffins, paraphenols, Persian tobacco, phenolic compounds, phenols, pipe, polycyclic aromatic hydrocarbons (PAH), propionic acid, pyrene, pyridine, resin, shisha, smokeless tobacco, snuff, tabacine, tabacinine, tannins, toombak (Sudan), Turkish tobacco, water pipe, waxes.
Note: This summary does not review quitting smoking in detail. Information on quitting smoking may be accessed under a separate Natural Standard summary. Also, this summary does not review nicotine-only supplements in detail. Products containing only nicotine are not considered dietary supplements.
Nicotiana tabacum is the most commonly used tobacco plant for commercial tobacco products. The leaves of the tobacco plant are the source of all smoking and chewing tobacco products. Tobacco leaves contain around 2-8% nicotine.
Tobacco has been reportedly used for many conditions in traditional and folk medicine. Limited research suggests that tobacco may be used to treat Alzheimer's disease, schizophrenia, or nicotine cravings.
However, it is well-known that smoking tobacco represents a major public health concern. Nicotine is highly addictive and contains several compounds known to cause cancer. Nearly one-third of people who try a cigarette later become addicted to nicotine. An estimated 25-35% of all cancer-related deaths are due to nicotine.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Although this area has not been well studied in humans, limited research suggests that nicotine may promote memory recovery and protect against Alzheimer's disease. However, conclusive evidence in this area is currently lacking. More high-quality research is needed before any firm suggestions may be made, especially on the use of the Nicotiana tabacum plant.
Although this has not been well studied in humans, tobacco has been suggested as a risk factor for schizophrenia. Compared to healthy people, those with schizophrenia are more likely to smoke, according to some evidence. However, it has also been suggested that nicotine aids in the relief of psychotic symptoms. Conclusive evidence in this area is currently lacking. More high-quality research is needed, especially on the use of the Nicotiana tabacum plant.
Limited research suggests that various nicotine products may reduce cravings to smoke and help people quit smoking. Such products include nicotine chewing gums, lozenges, and the patch. More high-quality research in this area is needed, especially on the use of the Nicotiana tabacum plant.
According to early research findings, evidence is lacking to support the claim that either the nicotine content of cigarettes or the act of smoking itself helps reduce stress. More high-quality research in this area is needed, especially on the use of the Nicotiana tabacum plant.
Sexual arousal (dysfunction)
Some research suggests that smoking and nicotine use may be associated with adverse sexual function in both males and females. Cases of impotence and decreased sexual arousal have been seen. More high-quality research in this area is needed, especially on the use of the Nicotiana tabacum plant.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Anesthetic (loss of feeling), angiogenesis (new blood vessel growth), antibacterial, antiestrogen, antifungal, antioxidant, antiseptic (preventing infection), anti-spasm, antiviral, asthma, baldness, bronchitis, bruises, cathartic (cleansing), childbirth (labor induction), constipation (difficulty emptying the bowels), diuretic (increased urine flow), emetic (causing vomiting), enema (increasing fluids in the rectum or colon), exhaustion, expectorant (draining mucus from the lungs), eye problems, glaucoma (increased pressure within the eye), headache, hemorrhoids (swollen veins in the anus), hernia, hoarseness, indigestion, insect bites and stings (scorpion), insect repellent, insecticide, kidney disease, lice, lung conditions, motion sickness, mouth sores, narcotic, nausea, pain relief, paranoia, parasites and worms, pneumonia, rheumatism (joint pain and stiffness), seizures, sleep aid / sedation, skin diseases, skin inflammation, snakebites, sores, stimulation of secretion (saliva), stomach spasms, stomatitis (mouth inflammation), tetanus, ulcer, urinary retention, wounds.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
Tobacco has been taken by mouth as a tea or smoked as part of a cigarette. Nicotine-only products are available; however, they are not considered dietary supplements.
Children (under 18 years old)
There is no proven safe or effective dose for tobacco in children.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid in people with a known allergy or sensitivity to tobacco or any of its components (e.g., cocoa, menthol, licorice, colophony, and formaldehyde).
In general, allergic reactions to natural tobacco leaves are rare. However, some research suggests that secondhand tobacco smoke may increase allergic responses. Tobacco smoke should therefore also be avoided in people with any known allergy.
Limited evidence suggests that exposure to tobacco smoke may increase the likelihood of developing a food allergy, asthma, or allergic diseases.
Allergic contact dermatitis (allergic skin inflammation), lip coloring, lip scaling, skin redness, and tissue swelling have been seen following exposure to various components of cigarette filters, paper, and tobacco.
Side Effects and Warnings
Nicotine exposure, whether by direct tobacco use or secondhand smoke, has been related to increased risk of bone fractures (decreased bone mineral density); brain and blood vessel conditions (blocked blood flow, ruptured blood vessels); cancer (lung, skin, mouth); heart and blood vessel conditions (artery damage and degradation, clogged arteries, coronary artery disease, heart attack, heart disease, high blood pressure, irregular heartbeat); fertility problems (compromised semen quality, decreased arousal, erectile dysfunction, impaired conception, infertility, reduced testicle size); kidney disease; lung conditions (asthma, bronchitis, chronic obstructive pulmonary disease (COPD), emphysema, tuberculosis); neurological problems (autism, schizophrenia); oral and dental problems (bad breath, excess saliva, mouth and throat irritation, mouth sores, sensitive teeth, stained teeth and tongue, tartar, tooth and gum disease, tooth decay, tooth loss); skin conditions (acne, eczema, irritation, premature aging, psoriasis); and stomach side effects (acid reflux, ulcer disease, heartburn). Reported side effects may also include depression, dizziness, drowsiness, ear ringing, excess mucus secretion, expanded lung bronchi, fetal illness, fungal infection, hair loss, headache, heightened alcohol effects (clumsiness, confusion), insomnia, irritability, light-headedness, loss of taste and smell, nausea, painful menstruation, poor wound healing, sleep problems, stroke, suicidal behavior, uncontrolled urine, violent sneezing, vomiting, and early death.
For quitting smoking, nicotine products approved by the US Food and Drug Administration (FDA) are possibly safe when used as directed by a healthcare professional.
Avoid casual use for personal enjoyment or social purposes. Tobacco products are highly addictive and contain compounds known to promote cancer.
Avoid exposure to secondhand smoke. Children are especially vulnerable to secondhand smoke-related adverse effects such as increased risk of allergic diseases, asthma, autism, blood vessel dysfunction, bronchitis, colds, ear and other infections, food allergies, lung problems, pneumonia, and sudden infant death syndrome (SIDS).
Avoid with known allergy or sensitivity to tobacco or any of its components (e.g., cocoa, menthol, licorice, colophony, and formaldehyde).
Avoid use in pregnant or lactating women, and in those wishing to conceive.
Avoid use when combined with alcohol, betel quid, high-dose beta-carotene supplements, or marijuana, due to possible interactions.
Avoid use in people with any existing allergies, bone loss problems, breathing conditions, dental problems, heart conditions, kidney problems, neurologic disorders, skin conditions, stomach disorders, or urinary problems.
Pregnancy and Breastfeeding
Avoid tobacco use and exposure to secondhand smoke during pregnancy. Some research has suggested that tobacco exposure may increase the risk of complications during pregnancy and delivery, and harmfully affect both babies and young children. Increased risk of asthma, early delivery, low birthweight, learning and behavior deficits, random abortion, ruptured membranes, nonuterine pregnancy, and maternal and newborn death have been reported.
Avoid use while breastfeeding. Nicotine has been found in human breast milk. Smoking may lower breast milk production and quality. Smoking may result in the early weaning and slow growth of babies.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Tobacco may interact with blood pressure-lowering agents. Caution is advised in people taking any drugs that affect blood pressure.
Tobacco may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
Tobacco may also interact with agents that affect nicotine receptors, agents that block cannabinoid receptors, alcohol, Alzheimer's disease agents, antianxiety agents, anticancer agents, antidepressants, antihistamines, antipsychotics, blood vessel-widening agents, marijuana, nicotine replacement therapies, opiates, and silver acetate.
Interactions with Herbs and Dietary Supplements
Tobacco may interact with blood pressure-lowering agents. Caution is advised in people taking herbs or supplements that affect blood pressure.
Tobacco may increase the amount of drowsiness caused by some herbs or supplements.
Tobacco may also interact with acupuncture therapy, agents that affect nicotine receptors, Alzheimer's disease agents, antianxiety agents, anticancer agents, antidepressants, antihistamines, antioxidants, antipsychotics, beta-carotene, blood vessel-widening agents, cocoa, curcumin, epigallocatechin gallate (EGCG, a chemical found in tea), flavonoid-rich foods (e.g., berries, citrus fruits, red wine), folic acid, fruits and vegetables, grape seed extract, green tea, lobelia, marijuana, meditation therapy, menthol, Mint Snuff™, mucus-clearing agents, mustard family vegetables (e.g., broccoli, brussels sprouts, cabbage), Nicobrevin®, oat extract, probiotic supplements (healthy bacteria), spirulina, St. John's wort, vitamin A, and vitamin E.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
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Boyle RG, Enstad C, Asche SE, et al. A randomized controlled trial of telephone counseling with smokeless tobacco users: the ChewFree Minnesota study. Nicotine Tob Res 2008;10(9):1433-1440. View Abstract
Christian P, West KP Jr, Katz J, et al. Cigarette smoking during pregnancy in rural Nepal. Risk factors and effects of beta-carotene and vitamin A supplementation. Eur J Clin Nutr 2004;58(2):204-211. View Abstract
Fiore MC, Smith SS, Jorenby DE, et al. The effectiveness of the nicotine patch for smoking cessation. A meta-analysis. JAMA 1994;271(24):1940-1947. View Abstract
Glick ZR, Saedi N, Ehrlich A. Allergic contact dermatitis from cigarettes. Dermatitis 2009;20(1):6-13. View Abstract
Harte CB, Meston CM. Acute effects of nicotine on physiological and subjective sexual arousal in nonsmoking men: a randomized, double-blind, placebo-controlled trial. J Sex Med 2008;5(1):110-121. View Abstract
Harte CB, Meston C. M. The inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: results from a randomized, double-blind, placebo-controlled, cross-over trial. J Sex Med 2008;5(5):1184-1197. View Abstract
Hatch JP, Bierner SM, Fisher JG. The effects of smoking and cigarette nicotine content on smokers' preparation and performance of a psychosocially stressful task. J Behav Med 1983;6(2):207-216. View Abstract
Houtsmuller EJ, Henningfield JE, Stitzer ML. Subjective effects of the nicotine lozenge: assessment of abuse liability. Psychopharmacology (Berl) 2003;167(1):20-27. View Abstract
Johnson N. Tobacco use and oral cancer: a global perspective. J Dent Educ 2001;65(4):328-339. View Abstract
Lopez-Arrieta JM, Rodriguez JL, Sanz F. Efficacy and safety of nicotine on Alzheimer's disease patients. Cochrane Database Syst Rev 2001;(2):CD001749. View Abstract
Punnoose S, Belgamwar MR. Nicotine for schizophrenia. Cochrane Database Syst Rev 2006;(1):CD004838. View Abstract
Severson HH. What have we learned from 20 years of research on smokeless tobacco cessation? Am J Med Sci 2003;326(4):206-211. View Abstract
Stead LF, Perera R, Bullen C, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2008;(1):CD000146. View Abstract
Yach D, Hawkes C, Epping-Jordan JE, et al. The World Health Organization's framework convention on tobacco control: implications for global epidemics of food-related deaths and disease. J Public Health Policy 2003;24(3-4):274-290. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017