At present, the use of nicotine is not prohibited by the World Anti-Doping Agency.

Nicotine is available over-the-counter and use is widespread amongst professional team/strength sports (e.g. American football, ice hockey, wrestling, bobsleigh, gymnastics, rugby, skiing) whereby active consumption of nicotine and nicotine-containing substances in-competition occurs in approximately 25–50% of such athletes.

Nicotine’s mode of action includes both psychostimulatory and sympathomimetic effects.

Of the 16 performance investigations presented in the ten studies reported herein involving nicotine or a nicotine-containing substance to date, the majority (12) have demonstrated no significant effect. However, the current evidence base is limited both in the quantity and quality of studies performed.

This literature review outlines important considerations for a more complete interpretation of results, and proposes future avenues of investigation that should determine the true magnitude of whether nicotine enhances performance, increases the health risk to an athlete and alters the spirit of sport.