Majdi · Acta neurologica Scandinavica 2021 · systematic review and meta-analysis · n=978 participants across 31 publications

Effects of transdermal nicotine delivery on cognitive outcomes: A meta-analysis.

Cited 18 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of placebo-controlled clinical trials

PubMed 33899218 · doi:10.1111/ane.13436 · record verified 2026-08-29

What was done

Systematic review and meta-analysis of clinical trials comparing transdermal nicotine patches with placebo in healthy non-smoking adults. Main outcomes were overall cognitive function, attention, and memory, evaluated using standard meta-analytic pooling methods to determine standardized mean differences (SMD).

What was found

Across 31 publications involving 978 subjects: - Overall cognitive function significantly improved with nicotine patches (SMD 0.233, 95% CI 0.111 to 0.355, p < 0.001; I2 = 50.17%, p < 0.001). - Attention significantly improved (SMD 0.231, 95% CI 0.106 to 0.356, p < 0.001; I2 = 34.07%, p = 0.042). - Memory enhancement was not statistically significant (SMD 0.270, 95% CI -0.293 to 0.833, p = 0.347; I2 = 77.98%, p < 0.001).

Why it matters

This review demonstrates that transdermal nicotine produces modest, statistically significant improvements in attention and overall cognition in healthy non-smokers, but does not reliably enhance memory.

Limits

Individual trials had small sample sizes (averaging approximately 31 participants per study). High heterogeneity was present in the memory analysis (I2 = 77.98%). Findings apply only to healthy non-smokers, and the abstract does not report dosing regimens, treatment duration, adverse effects, or long-term safety.

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