Nicotine, Smokeless Tobacco & Tourette Syndrome

A man with Tourette Syndrome, a nerve disorder developing in childhood and involving muscle tics (repetitive involuntary movement) and voice problems (here), recently posted online his experience with smokeless tobacco.  Diagnosed at age six, he was treated unsuccessfully with numerous drugs.  At ten, he experimented with dipping and discovered that it controlled his symptoms.  His doctor “was not happy that i was dipping but he under stood [sic] and told me the reason for that [alleviation of symptoms] was the nicotine…”  The doctor prescribed nicotine lozenges, which worked.  Later, the man resumed dipping.

Youth initiation of tobacco use is wrong, but this individual’s experience is worth noting.  Tourette is a challenging and frustrating disorder for which medicines are not always effective.

A search of the medical and scientific literature reveals that nicotine has been used with mixed results to treat the symptoms of Tourette, mainly as a supplement to other medicines (here, here, here, here, here, and here ).  Researchers have primarily tested nicotine gum and patches, which deliver very low, non-addictive doses.  These medicines have been shown to be less than ideal quit-smoking aids (here); perhaps their low nicotine levels limited their effectiveness with Tourette as well.  Moist snuff, in contrast, delivers a higher dose of nicotine for several hours, which may account for the symptom relief in the case described above.   

There is growing evidence that tobacco and nicotine may play a role in preventing and/or managing nerve disorders such as Parkinson’s disease, multiple sclerosis and Alzheimer’s disease (here).  Unfortunately, nicotine and smoke-free tobacco have been so demonized by prohibitionists that researchers are reluctant to fully investigate the benefits of these products.