Metabolism and biochemical effects of nicotine for primary care providers

Med Clin North Am. 2004 Nov;88(6):1399-413, ix. doi: 10.1016/j.mcna.2004.06.004.


Nicotine is a colorless and volatile liquid alkaloid naturally occurring in the leaves and stems of Nicotiana tabacum and Nicotiana rustica. Nicotine, the primary component of tobacco, is responsible for both tobacco product addiction (with chronic exposure) and the odor associated with tobacco. In addition to cigarettes, nicotine is found in chewing gum, transdermal patches, nasal spray, and sublingual tablets. Following its inhalation and absorption, nicotine and its metabolic products exert diverse physiologic and pharmacologic effects. This article covers the absorption and metabolism of nicotine, nicotine toxicity, pharmacologic effects of nicotine, nicotine-drug interactions, and the use of nicotine for the treatment of disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Aryl Hydrocarbon Hydroxylases / genetics
  • Brain / drug effects
  • Cardiovascular System / drug effects
  • Cognition Disorders / drug therapy
  • Colitis, Ulcerative / drug therapy
  • Cytochrome P-450 CYP2A6
  • Humans
  • Mixed Function Oxygenases / genetics
  • Nicotine / metabolism*
  • Nicotine / pharmacology*
  • Nicotine / therapeutic use
  • Nicotinic Agonists / metabolism*
  • Nicotinic Agonists / pharmacology*
  • Nicotinic Agonists / therapeutic use
  • Polymorphism, Genetic


  • Nicotinic Agonists
  • Nicotine
  • Mixed Function Oxygenases
  • Aryl Hydrocarbon Hydroxylases
  • Cytochrome P-450 CYP2A6