Dr. Peter Attia
speaker
5,258 appearances
36 recordings
6 series
first heard Jan 2024
last heard Jun 2025
Dr. Peter Attia’s voice in public audio — every appearance, attributed to the second.
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Appearances
Hey everyone, welcome to a sneak peek, Ask Me Anything, or AMA episode of The Drive Podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe.
So without further delay, here's today's sneak peek of the Ask Me Anything episode. Welcome to Ask Me Anything AMA episode number 70. For today's AMA, we're discussing a topic that has been gaining significant attention in both the scientific community and among the public, and that is nicotine.
This is a topic that we get a lot of questions about, not only from our audience, but also from my patients. In this episode, we discuss the distinction between nicotine and tobacco, understanding why nicotine itself is not the primary driver of the major health risks associated with smoking.
We discuss the risks of nicotine use, including addiction, sleep disturbances, cardiovascular effects, and its impact on mood and anxiety. We talk about the various delivery methods of nicotine, from traditional cigarettes, which I think everybody would agree are bad, to pouches, gums, and synthetic options, ranking them from least to most harmful.
the role of nicotine in physical performance, cognitive enhancement, fertility, and its interaction with other stimulants such as caffeine. We touch on the guidance for those interested in minimizing the risks while still using nicotine. And we end this podcast by looking at smoking cessation and considerations for those trying to quit smoking, which often involves using nicotine replacements.
If you're a subscriber and you want to watch the full video of this podcast, you can find it on the show notes page. And if you're not a subscriber, you can watch the sneak peek of this video on our YouTube page. So without further delay, I hope you enjoy AMA number 70.
You know, I'm actually drinking it in a glass.
Nick, I have made several changes following the AMA on microplastics. I believe that they are all in the spirit of 80-20. So I'm really low on the sigmoidal curve of cost and energy with one exception. And yeah, I think I'm just taking what I think are the relatively easy steps to hopefully mitigate 80% of my exposure.
And I'm going to spend no more time worrying about the last 20%, which A, I have no idea if it matters. And even if it does, I don't think I could live my life and be concerned with it.
I am looking forward to the day when someone else hosts an AMA for me.
One of the things that we appreciated, meaning the team and I as we were preparing for this, was trying to appreciate how much of the research on nicotine is based on tobacco and its first application through, obviously, cigarettes.
But then also the idea of using tobacco to extract nicotine for non-smoke, but tobacco derived nicotine versus synthetic nicotine, which is honestly what a lot of people are thinking about in that context. And so I think that's important to understand that it is not always easy to tease out the impact of nicotine.
And I'll foreshadow one example that we're going to talk about, which is infertility. You would think we would have legions of data that would explain the effect of nicotine on fertility, both for males and females. It turns out that if you want to talk about it through the lens of smoking, that's true.
But if you want to talk about it through the lens of vaping or nicotine pouches, that's not true. And so I think that's one of the issues that I think makes this difficult to talk about with complete clarity. So anyway, I guess that's the first thing I would say. I think the second thing I would say is, and you alluded to this four years ago, we did an AMA on nicotine.
Don't worry, those of you that listened to that, there's very little overlap. I spent way more time talking about how nicotine worked, mechanisms of action. Today, we're probably going to, I think, answer a lot more of the practical questions that people have. And I will also say that four years later, there's frankly more research on some of the benefits of nicotine.
And to be sure, we're going to talk about both the risks and benefits of nicotine today. So anyway, I would say that's probably a good place to start.
Yeah, this is something I think I, maybe I didn't do a good job of this four years ago, or maybe I did. And at the end of the day, people just don't appreciate nuance. But I remember being very surprised at how, A, people thought that the takeaway from the podcast four years ago was we should all be using nicotine. And B, people were like, how can you advocate for this as a doctor?
So my hope is to untangle all of that for people. Nicotine is one of many compounds found within the leaves of the tobacco plant. As such, it is in tobacco-based products. But the major health concerns that are associated with tobacco, which are primarily cancer and cardiovascular disease, for reasons we can talk about another time and we're not going to talk about today...
are not caused by nicotine per se, but instead they are caused by several other components of tobacco itself and tobacco smoke, such as everything from toxic metals, formaldehyde, things called polycyclic aromatic hydrocarbons. These are actually the things that are causing the harm. Now, There are byproducts of nicotine that are produced in processing tobacco, and they can be carcinogenic.
So that means, and this is a very important point, I want to make sure if you're trying to pay attention to the key points, this is one of them. This means that any tobacco-derived nicotine product may contain carcinogens. This was actually something I did not appreciate prior. I thought that you could extract nicotine from tobacco and be completely free and clear of carcinogens.
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