Nicotine May Reduce Inflammation and Boost Cognition in HIV

A recent study published in Neuropsychopharmacology reveals that nicotine, commonly associated with smoking, might have unexpected cognitive and anti-inflammatory benefits for individuals living with HIV (PLWH). While smoking is widely known for its adverse health effects, the study suggests that nicotine could temporarily improve cognitive control and reduce neuroinflammation in HIV-positive individuals.

Advances in antiretroviral therapy (ART) have turned HIV into a manageable chronic condition. However, PLWH still face persistent challenges such as chronic brain inflammation and cognitive impairment, including difficulty focusing, memory lapses, and goal management. Interestingly, nicotine, the active compound in tobacco, has shown anti-inflammatory properties and the ability to enhance cognitive performance in both humans and animal models.

Nicotine Study:

In this study, researchers examined 59 participants, divided into four groups:

• HIV-negative non-smokers
• HIV-negative smokers
• HIV-positive non-smokers
• HIV-positive smokers

Participants underwent cognitive assessments using the 5-choice continuous performance test (5C-CPT) to measure accuracy and reaction time during visual tasks. Additionally, neuroinflammation was evaluated by analyzing translocator protein (TSPO) levels via brain scans.

The findings revealed that smoking significantly reduced brain inflammation and improved cognitive performance in PLWH smokers compared to their non-smoking counterparts. Specifically, smokers demonstrated better task accuracy and target detection rates, indicating enhanced cognitive control. However, smoking did not affect response inhibition, suggesting its benefits were limited to certain cognitive functions.

Interestingly, lower neuroinflammation levels correlated directly with improved cognitive performance, reinforcing the theory that reduced inflammation contributes to cognitive benefits in PLWH smokers.

Despite these findings, researchers caution against viewing smoking as a therapeutic option. The well-documented harms of smoking, including increased risks of cancer, cardiovascular disease, and respiratory issues, far outweigh any temporary cognitive benefits.

Instead, the study highlights nicotine’s potential as a therapeutic agent for managing HIV-related neuroinflammation and cognitive impairments. Future research could explore safer delivery methods for nicotine or related compounds, offering a targeted approach to improve cognitive health in PLWH without the health risks associated with smoking.

More Information: Brody, A. L., Mischel, A. K., Sanavi, A. Y., Wong, A., Bahn, J. H., Minassian, A., Morgan, E. E., Rana, B., Hoh, C. K., Vera, D. R., Kotta, K. K., Miranda, A. H., Pocuca, N., Walter, T. J., Guggino, N., Beverly-Aylwin, R., Meyer, J. H., Vasdev, N., & Young, J. W. (2025) Cigarette smoking is associated with reduced neuroinflammation and better cognitive control in people living with HIV. Neuropsychopharmacology. doi: 10.1038/s41386-024-02035-6. https://www.nature.com/articles/s41386-024-02035-6