Disease × agent evidence record

Nicotine for COPD: evidence, trials and status

Nicotine has both completed registered trials and synthesis-level publications linked to COPD. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit.

8 registered trials 1 recruiting 15 publications Evidence tier A · Strong Score 73.5
Research Tracker › Pairs › COPD › Nicotine
Research map, not treatment advice. This page aggregates registry and literature records. It does not evaluate efficacy, dosing or safety for any individual. Discuss any treatment decision with a qualified clinician.

Summary

Nicotine has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. ClinicalTrials.gov lists 8 registered trials linking Nicotine to COPD: 1 is currently recruiting; 7 have completed. The most advanced is Phase 3 (NCT02148445). The largest enrolment is 1500 participants (NCT05919511). Registration activity spans 2014 to 2023. The literature layer holds 15 publications for this pair: 5 Cochrane reviews, 3 meta-analyses, 2 systematic reviews and 5 clinical trial publications. Publication years run from 2004 to 2026. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.

The RepurpOS disease-intelligence file for Chronic Obstructive Pulmonary Disease ranks 505 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: Effectively zero — airflow obstruction is irreversible by definition in COPD; FEV1 decline continues at 30-60 mL/year on standard care.

Open in Repurposing ExplorerCOPD hubCOPD biomarkers & interventionsChEMBLOpen Targets

Evidence table

Evidence tierA · Strong
Evidence score73.5 (trials 23.5, literature 30.0, tier 15, approved bonus 5.0)
Registered trials8 total: 1 recruiting, 0 active / not yet recruiting, 7 completed, 0 other
Linked publications15 (5 Cochrane reviews, 5 clinical trial publications, 3 meta-analyses, 2 systematic reviews)
Agent typeDrug (Small molecule)
Development stage (any indication)Approved
Mechanism / classNot recorded
Data sourcesOpen Targets, ChEMBL
Linked via biomarker / targetADCY5
How the evidence score is calculated
  • Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
  • Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
  • The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
  • Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
  • The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.

Registered clinical trials

NCT IDTitleStatusPhaseEnrolment
NCT02148445Smoking Cessation Versus Long-term Nicotine Replacement Among High-risk Smokers
2014
completedPhase 3398
NCT05610514Pulmonary and Cardiac Effects of E-Cigarette Use in Pulmonary Patients Who Smoke Cigarettes
2022
completedPhase 221
NCT05374629Study on the Effect of Smoking Cessation in COPD Patients After Shared Decision Making Intervention
2020
completedNot applicable88
NCT04043728Addressing Psychological Risk Factors Underlying Smoking Persistence in COPD Patients: The Fresh Start Study
2019
completedNot applicable18
NCT02612389Meditative Movement for COPD Symptoms in Non-Smoking Flight Attendants
2015
completedNot applicable220
NCT02892396Influence of Electronic Cigarettes in the Evaluation of the Inflammatory Response in Patients With a Diagnosis of COPD
2016
completedNot applicable10
NCT04223362PICk-UP: PersonalIsed CommUnity-based Physical Activities for Patients With Chronic Obstructive Pulmonary Disease
2020
completedNot applicable61
NCT05919511Observational Study for Patients at Risk for Chronic Graft-Versus-Host Disease
2023
recruitingNot applicable1,500

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Published literature

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Mechanism and notes

No mechanism of action is recorded for this pair in the source databases.

OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL, in this case via the biomarker or target ADCY5. The tier describes how well the drug-disease link is documented, not how well the drug works.

Frequently asked questions

Is Nicotine approved for COPD?

Nicotine has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.

Is Nicotine in clinical trials for COPD?

ClinicalTrials.gov lists 8 registered trials linking Nicotine to COPD: 1 is currently recruiting; 7 have completed. The most advanced is Phase 3 (NCT02148445). The largest enrolment is 1500 participants (NCT05919511). Registration activity spans 2014 to 2023.

What does the evidence show for Nicotine in COPD?

Nicotine has both completed registered trials and synthesis-level publications linked to COPD. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL, in this case via the biomarker or target ADCY5. The tier describes how well the drug-disease link is documented, not how well the drug works.

Cite this page

Open Source Medicine Foundation. Nicotine for COPD: evidence, trials and status. OSMF Research Tracker. Updated 2026-07-05. https://research.opensourcemed.info/pairs/chronic-obstructive-pulmonary-disease/nicotine.html

Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.

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This is a research map, not treatment advice. Evidence tiers and scores summarise what has been studied, not whether a treatment works or is safe for you.