Nicotine and Tobacco Products in Sport and Exercise: A Scoping Review of Use Patterns, Exercise Performance, Physiological Responses, and Health Outcomes
DOI:
https://doi.org/10.12775/QS.2026.70.74558Keywords
nicotine; tobacco products; athletes; exercise performance; physiological responses; nicotine dependence; scoping reviewAbstract
Objective: To systematically map evidence on nicotine/tobacco use, exercise performance, psychophysiological responses, health outcomes, dependence, withdrawal, and anti‑doping governance in sport/exercise, and identify research gaps. Methods: JBI scoping review methodology and PRISMA‑ScR reporting. Searched PubMed, Web of Science, Scopus, and CNKI from inception to 1 July 2026. Results: Evidence grouped into six themes: use patterns and sport‑specific differences; acute performance; cognitive/psychophysiological responses; chronic cardiopulmonary outcomes; dependence/withdrawal; detection and governance. In‑competition nicotine exposure was not uncommon, with higher positivity in male and team‑sport athletes. Acute nicotine effects on performance were inconsistent—some endurance, repeated‑anaerobic, and skill tasks showed potential benefits, but most strength, overall anaerobic, and self‑paced time‑trial studies found no improvement. Nicotine consistently activated sympathetic activity, yet these changes did not reliably translate to competitive advantage. Conventional smoking correlated with poorer pulmonary function, lower VO₂max, and delayed post‑exercise heart rate recovery. Short‑term withdrawal temporarily impaired cognition/readiness, whereas long‑term cessation of combustible tobacco benefited cardiorespiratory fitness.Conclusions: Nicotine use in sport is not simply performance‑enhancing or purely hazardous,effects are jointly modified by product type, dose, route, dependence status, exercise task, and sport culture. Current evidence does not support nicotine as a consistent, safe, or effective ergogenic aid. Future research should prioritize women, adolescents, long‑term users; conduct sport‑specific trials with greater ecological validity; establish longitudinal athlete cohorts; monitor emerging nicotine products; and develop athlete‑centred dependence screening and withdrawal support.
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