Despite over a century of controlled research examining nicotine’s effects on cognitive function, a critical knowledge gap persists: not a single study has evaluated daily nicotine use in healthy individuals seeking mental enhancement. This oversight is increasingly problematic as nicotine patches and gums gain traction among students and professionals as off-label “smart drugs” for improved focus and concentration. Current research has focused almost exclusively on two populations—smokers attempting cessation and patients with cognitive impairment—leaving the fastest-growing user demographic entirely unstudied. Even the most comprehensive long-term investigation, a 2-year trial in mild cognitive impairment patients, failed to demonstrate significant cognitive benefits. This divergence between growing consumer demand and scientific evidence raises urgent questions about safety and efficacy in healthy populations pursuing cognitive enhancement through nicotine products.
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