Dr Ardis and nicotine: what he has said

1. Nicotine and COVID-19

The idea that nicotine might matter in COVID-19 did not start with Dr Ardis. It comes from a 2020 paper, "A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications", published in Comptes Rendus Biologies. The first author, Jean-Pierre Changeux, is listed with the Department of Neuroscience at the Institut Pasteur and the Collège de France. The paper states the central idea directly: "we hypothesize that the nicotinic acetylcholine receptor (nAChR) plays a key role" in the disease. It also says the hypothesis "might be further challenged by additional clinical studies."

The paper's starting point was observation: some early hospital data showed fewer current smokers among COVID-19 patients than in the general population. One such study, published in Frontiers in Medicine by Miyara and colleagues, looked at 340 inpatients and 139 outpatients with confirmed COVID-19 at one hospital in Paris. They compared the rate of daily smoking in those patients with the French general population, adjusted for age and sex. The standardised incidence ratio was 0.24 for both groups, with confidence intervals of 0.12 to 0.48 for outpatients and 0.14 to 0.40 for inpatients.

The authors are careful about what that number means. They write that their work "could not be representative of the general population," that "we cannot conclude whether daily smoking is associated with SARS-CoV-2 infection," and that "our findings remain observational." Observational data show a pattern in who got sick. They cannot show that smoking, or nicotine, caused a difference. Smokers and non-smokers also differ in age, work and many other habits, and the authors note that smoking rates vary by social and ethnic group in ways their data could not adjust for.

The trial that tested the idea directly is NICOVID-REA. Researchers ran it in 18 intensive care units in France and published it in Intensive Care Medicine in June 2022. Adults with severe COVID-19 who were receiving invasive mechanical ventilation for up to 72 hours were randomised to a daily 14 mg nicotine patch or a placebo patch. Of 220 patients randomised, 218 were analysed. Day-28 deaths were 30 of 106 (28%) in the nicotine group and 31 of 112 (28%) in the placebo group. The difference was not statistically significant. The authors wrote: "There is no indication to use nicotine in this situation."

That trial studied very sick patients on ventilators, on one dose, in one country. It did not test whether patches prevent infection, and it says nothing about healthy adults. A prevention trial, NICOVID-PREV, was also registered (NCT04583410). We found no published results from it, so this guide does not report any.

2. Eggplant and nicotine patches

Dr Ardis is reported to have said that eating eggplant could replace nicotine patches. The reviewers who checked that video excerpt, from Science.Feedback, note that eggplant and other nightshade plants do contain nicotine, but they argue that the amount is far too small to matter. That is the one part of the review we rely on here, as the source for what was reported.

Whether the sum works depends on how much nicotine a vegetable holds per gram and how much of it is eaten. Published measurements vary from study to study, so this guide does not put a single number on it. A fair comparison between a meal and a patch needs both figures.

What you can check is the patch itself. Our patch holds 7 mg of nicotine, as stated on its label, and it is worn for a day. Benowitz's review of nicotine pharmacology describes the design directly: "Nicotine patches, on the other hand, deliver nicotine gradually." That slow, steady delivery is what a patch is built to do. It is not the same thing as eating a food, and comparing the two needs the food numbers this guide does not have.

3. Is nicotine addictive?

Dr Ardis is reported to have said that nicotine is not addictive. The research on this is extensive, and the most relevant review, Benowitz's pharmacology review, is direct on the point. It states: "Nicotine sustains tobacco addiction, a major cause of disability and premature death." It also says that "it is primarily the pharmacologic effects of nicotine that produce the addiction to tobacco." Dependence on nicotine is documented in people who use it.

The research also looks at how fast nicotine reaches the brain, and that is where forms differ. Benowitz writes that "the more rapid the rate of absorption and entry of a drug into the brain, the greater the rush," and that "the degree of positive reinforcement is related to the rapidity of absorption." Fast-delivery forms are the ones most linked with reinforcement. Patches are the other end of that range. The same review says they "deliver nicotine gradually," and that sustained patch levels provide "not much positive reinforcement."

So the honest picture has two parts. Nicotine can create dependence, and that is documented. Slow delivery, as in a patch, carries less reinforcement than fast delivery, as in smoking. That is a difference of degree, not a finding that a patch is free of addiction risk. Our separate guide, "Are nicotine patches addictive?", covers this in more detail.

4. Venoms and nicotine receptors

The other idea Dr Ardis raises is that viruses act like snake venom by binding to nicotine receptors. In a deep-dive episode streamed on Man in America on 17 December 2024, Dr Ardis appears as a featured guest. The transcript does not label speakers, so the line below is attributed to the episode rather than to one named speaker. The host introduces the snake-venom comparison as coming from his research. One line in the transcript reads: "this nicotine receptor called alpha seven nicotine receptors that most of the venoms of COVID-19 target."

The Changeux paper describes the receptor link as a hypothesis as well. It says that "this observation supports the hypothesis that SARS-CoV-2 virus itself is a nAChR blocker." Whether viruses bind these receptors, and what that would mean for patients, is still being studied. The trial above did not test that question.

The same episode also carries sponsor boxes with health claims about nicotine, including claims about long COVID and a 4 mg patch. Those boxes are not attributed to him, so this guide does not repeat them.

What the research has and has not shown

The COVID-19 idea rests on one 2020 hypothesis paper and on observational data from a single hospital. The observational data show a pattern, and the authors say it cannot show cause. The one controlled trial of nicotine patches, in severely ill COVID-19 patients on ventilators, found no difference in deaths. No published results exist from the prevention trial we could find.

On addiction, the research is clear that nicotine dependence is real and that fast delivery is more reinforcing than slow delivery. On eggplant, the answer depends on food measurements that vary between studies.

The short version

Dr Ardis has talked about nicotine and COVID-19, about eggplant as a substitute for patches, and about nicotine's addictive potential. Each idea has a source you can read. The COVID-19 idea came from a 2020 hypothesis paper. The observational data behind it cannot show cause. The controlled trial in severely ill patients found no difference in deaths. Nicotine is documented as addictive, and slow delivery carries less reinforcement than fast delivery. He has no connection to this store, and he does not endorse this patch.

These sources are about nicotine in general and about Dr Ardis's statements. None of them is a study of this patch.