A striking disparity defines current nicotine research: 100+ controlled trials have investigated nicotine’s cognitive effects, yet precisely zero have examined safety and efficacy in healthy individuals using nicotine daily for mental performance. Analysis of published literature reveals that 65% of studies focused on smokers or ex-smokers, 25% examined patients with cognitive impairment, and only 10% involved single-dose exposure in healthy participants. Notably absent: any investigation of the population increasingly self-administering nicotine patches and gums for cognitive enhancement. This research distribution reflects historical clinical interests in addiction treatment and neurodegenerative disease management, but leaves contemporary off-label users without an evidence base. As nicotine products marketed for cognitive enhancement gain popularity, this data gap represents a significant public health vulnerability requiring urgent attention from the research community.
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