The French government is temporarily restricting sales of nicotine replacement therapy (NRT) products following new research that suggests nicotine patches could be a useful treatment for COVID-19 patients.

The decree lays down that until 11th May pharmacies will only be able to supply “the number of boxes required for a treatment lasting one month” in order to avoid possible product shortages.

The government has also suspended online sales of all nicotine-replacement treatments, including patches and nicotine gum.

This decision comes after a group of French researchers revealed in a study due to be published in the journal Comptes Rendus Biologie de l’Académie des Sciences the possible useful role of nicotine patches for coronavirus patients who smoke.

“Nicotine may be suggested as a potential preventive agent against COVID-19 infection. Both the epidemiological/clinical evidence and the in silico [computer simulation] findings may suggest that COVID-19 infection is an nAChR [nicotinic acetylcholine receptor] disease that could be prevented and may be controlled by nicotine,” the study suggests.

 

‘A path to be explored’

 

The research paper by Jean-Pierre Changeux, emeritus professor of neuroscience at the Pasteur Institute in Paris, comes amid growing scientific interest in the relationship between nicotine and COVID-19.

Other work in the field includes a recent study from Paris-based immunologist Makoto Miyara which suggests that active smokers could somehow be protected against the coronavirus infection.

A French Ministry of Health spokesperson acknowledged to TobaccoIntelligence that “nicotine substitutes have been identified as a path to be explored” and that health authorities support all research aimed at the prevention or treatment of COVID-19 “as long as they are respectful of the regulatory and ethical framework”.

“We must remain vigilant on the messages sent to citizens because nothing has been confirmed at this stage as to the interest of nicotine substitutes,” they added.

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    The researchers have opened the door to begin studies with infected patients to examine the possible preventive and therapeutic implications of nicotine in the illness.

     

    Patient and staff trial

     

    “In order to prevent the infection and the retro-propagation of the virus through the CNS, we plan a therapeutic assay against COVID-19 with nicotine (and other nicotinic agents) patches or other delivery methods (like sniffing/chewing) in hospitalised patients and in the general population,” Changeux’s report says.

    According to some sources, researchers have already asked the French authorities to approve a clinical study to be carried out in both patients and staff at the Pitié-Salpêtrière Hospital in Paris, one of Europe’s largest hospitals.

    Although the hospital would not confirm further details, it said: “Given the health emergency, it seems advisable to rapidly assess the therapeutic impact of nicotinic receptor modulating agents, direct and/or indirect, addictive or non-addictive on SARS-CoV-2 infection.”

    TobaccoIntelligence understands that all clinical study proposals in France must be submitted to the National Institute of Health and Medical Researach (Institut national de la santé et de la recherche médicale, Inserm). At time of publication, the Inserm has not confirmed whether it has received any submission for a clinical trial using nicotine patches.

     

    What This Means: The big task for researchers now is to find real evidence in humans to determine whether nicotine replacement therapies might be a possible and useful solution for smokers infected with COVID-19.

    Although the French health authorities have welcomed the preliminary scientific development, they are treating it with caution until further evidence is known. Although the possible link between the coronavirus and nicotine has not been officially confirmed, the restriction on the sale of NRT products is a precautionary move to avoid public stockpiling of these potentially useful products leading to shortages.

    David Palacios TobaccoIntelligence staff

    Photo: Wikimedia Commons

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    David Palacios Rubio

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