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• Nicotine is not the same thing as tobacco
• There are almost 70 carcinogens in the tobacco plant but nicotine is not one of them
• Nicotine has some potential cognitive benefits
• Nicotine replacement therapy alone only shows modest efficacy in helping smokers quit
• Peter Attia chews about 6-8mg of nicotine replacement gum daily and experiences cognitive benefits
• If you are interested in experimenting with nicotine gum, ease into it as it can cause some nausea at first

In this “Ask Me Anything” (AMA) episode, Peter and Bob dive deep into nicotine, a complicated and interesting molecule that has effects on both the brain and the body. They analyze the results of the studies that describe nicotine’s cognitive benefits and potential for inducing weight loss. They talk about a smoking cessation technique called nicotine replacement therapy and give a full breakdown of the various routes of administration, dosing, and safety. Finally, they explore the fascinating and counterintuitive observation that cigarette smokers are less likely to get a severe case of COVID-19.

If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #23 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

• How Peter first became interested in the potential benefits of nicotine [1:15];
  
• Untangling nicotine from tobacco [6:00];
  
• Nicotine replacement therapy (NRT) for quitting smoking: products, protocols, and a review of the literature [9:30];
  
• The cognitive benefits of nicotine: Overview of the literature [15:50];
  
• Where nicotine has the most positive impact on cognition [30:30];
  
• Possible mechanisms conferring the benefits of nicotine [37:00];
  
• How modafinil and other nootropics compare to nicotine [47:15];
  
• How nicotine may induce weight loss [54:00];
  
• Relationship between smoking and COVID-19: Analyzing the observation that smoking appears protective against COVID-19 [1:01:45];
  
• Breakdown of the various nicotine replacement therapies: route of administration, dosing, and safety [1:11:30];
  
• Concluding thoughts on nicotine: use cases, addictive properties, and more [1:19:45]; and
  
• More.

Learn more: https://peterattiamd.com/

Show notes page for this episode: https://peterattiamd.com/ama23 

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In this episode, we break the thermometer watch the mercury spill out as we discover temperature is far stranger than it seems. Five stories that run the gamut from snakes to stars. We start out underwater, with a snake that has evolved a devious trick for keeping warm. Then we hear the tale of a young man whose seemingly simple method of warming up might be the very thing making him cold. And Senior Correspondent Molly Webster blows the lid off the idea that 98.6 degrees Farenheight is a sound marker of health. 

This episode was reported by Lulu Miller and Molly Webster and was produced by Lulu Miller, Molly Webster, and Becca Bressler.

Support Radiolab by becoming a member today at Radiolab.org/donate.

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• Seven principles of persuasion
  • 1. Reciprocity
    • Always give first
    • People who receive something from you, are more likely to say ‘yes’ to your requests
  • 2. Liking
    • Before trying to influence someone, identify your similarities and bring them to the surface
  • 3. Social Proof
    • When people are uncertain, they look to their peers for answers
  • 4. Authority
    • People trust what experts say about a matter
  • 5. Scarcity
    • People want more of the things they can have less of
  • 6. Consistency
    • People want to be consistent with what they’ve already said or done in front of you
    • If you can get them to take a small step in your direction, they will want to be consistent with that in the future
  • 7. Unity (Shared Identity – Togetherness)
    • The idea that people share some identity with you can be extremely powerful
• Little changes that leverage these principles can have enormous effects
• When interacting with people for the first time, always expect the best from them
  • This allows you to be generous with them
  • Generosity acts on three different persuasion principles
• Ask for advice, not opinions
  • If you ask someone for an opinion, you get a critic
  • If instead, you ask for “advice”, they take a step towards you
    • In their mind, they become your partner

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• Microneedling builds structural strength and resilience in the skin
• Microneedling can be done on the face or the scalp to stimulate hair growth
• Dermarolling is the home version of microneedling but does more harm than good because of the method used to break the skin barrier and trauma caused
• Elastin is actually more important than collagen in the elasticity and appearance of skin
• It’s best to know the underlying cause of hair loss – but C60 and GHK copper peptide are mechanistically sound methods to assist hair growth
• Vasodilation is an underlying component to many hair growth treatments: try sauna, hyperbaric chamber, infrared light, massage
• Hair transplantation is the best way to improve the look of hair and has come a long way
• Laser treatment is the best route to reduce the appearance of scars
• Collagen stimulating injection may help with stretch marks, depending on the depth
• If your diet is sound, you won’t need to supplement with collagen and keratin – it doesn’t work the way you hope it will

I get a ton of questions about hair growth, grey hair, male and female pattern baldness (alopecia), skin beauty treatments, scar and stretch mark fixes, beauty "biohacks," and beyond.

So I figured it was high time to get an expert on the show to unpack all of this. His name is Dr. Cameron Chesnut.

Dr. Chesnut and I have quite a history. We've known each other since way back in our Ironman triathlon competition days, grew up in the same general region of Northern Idaho/Eastern Washington, and have recently reconnected as brothers with similar interests in fitness, health, nutrition, spirituality, biohacking, beauty, and beyond.

Dr. Chesnut recently opened a brand spankin' new biohacking facility in Spokane, WA called "ÔPTIM," which is a fully comprehensive health optimization practice, combining a revolutionary blend of functional medicine and regenerative modalities in a way that offers you unparalleled wellness.

Recently at a dinner, Dr. Chesnut was enlightening me on common myths and tips regarding hair growth (based on my recent project of growing out my hair, and potentially, magically sprouting a beard), and also showing me all the other cool toys they have at Optim, such as hormone optimization, cryotherapy, laser, and other photobiomodulation treatments, platelet-rich plasma (PRP) treaments, hyperbaric oxygen, IV's stem cells, and beyond—so I figured we could geek out on a podcast.

So who is he, exactly?

Dr. Chesnut is recognized worldwide as a key opinion leader and innovator in both minimally invasive and non-surgical cosmetic procedures. He was fellowship-trained in cosmetic surgery, reconstructive plastic surgery, laser surgery, and Mohs micrographic surgery at UCLA, training in the most demanding cosmetic and surgical environments of Beverly Hills, Hollywood, and Los Angeles.

His fellowship at UCLA featured a rigorous, full integration of plastic surgery, facial plastic surgery, oculoplastic surgery, and dermatologic surgery. Through this one-of-a-kind integration, Dr. Chesnut is a well-rounded and cross-pollinated surgeon.

He has an unparalleled foundation in skin cancer treatment, plastic reconstruction, and cosmetic surgery, as well as laser and aesthetic dermatology. Dr. Chesnut is an international expert on both the art and science of facial aging, utilizing an approach that relies not just on surgery but addresses all aspects of aging.

He loves to utilize this knowledge and skill of cosmetic surgery to improve the results of his skin cancer patients during their plastic reconstructions.

A leader in the fields of dermatologic and cosmetic surgery, Dr. Chesnut is an internationally acclaimed, award-winning speaker and has been invited by his peers to present throughout the world on numerous cosmetic and reconstructive topics. He is a regular contributor to the surgical literature, continues to author numerous book chapters, and has been recognized for his research and innovation in cosmetic surgery, lasers, and noninvasive treatments.

A native of Coeur d’Alene, Idaho, Dr. Chesnut has returned home to the Inland Northwest. He graduated with Honors from the University of Washington School of Medicine as a member of the Alpha Omega Alpha Honor Society. He completed his dermatology residency at UCLA where he was selected as the Chief Resident and subsequently was selected for the integrated Procedural Dermatology Fellowship, also at UCLA.

Outside of surgery, Dr. Chesnut enjoys active time with his wife, Aubree, and his children Torin, Tatum, and Callum. He is an avid surfer, passionate skier, loves beach volleyball, tennis, and playing on the river.

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