Historical and Current Ethnographic Use of Tobacco in Brazil: Implications for the Medicinal Use of Nicotine in Parkinson's Disease

Global epidemiology data show that disability and death due to Parkinson's disease (PD) are increasing faster than any other neurological disorder. In 2019, over 8.5 million individuals were diagnosed with PD globally, representing a doubling of cases over the past 25 years. Data of ethnic variation prevalence in US indicate more common occurrence of PD in White people than other ethnicities, although data for "Native Americans," is not available. Ethnic comparisons in Brazil also indicate more common prevalence of PD in White people, while no such cases have been reported in the indigenous people. In Brazil, this may be related to income concentration and better living conditions for white people, which results in greater longevity, the most important risk factor for Parkinson's disease. On the other hand, whether this is due to extensive use of tobacco by this ethnic group remains to be seen as numerous epidemiological data indicates an inverse relationship between smoking and PD. Although smoking can result in premature death, nicotine, the addictive component, has not only potent neuroprotective properties but also other therapeutic potentials. Indeed, tobacco has been historically used by indigenous and African-South American people for the treatment of a variety of diseases. Nonetheless, important controlled clinical trials on the effectiveness of nicotine in such diseases are lacking. In this article, we review the use of tobacco by indigenous and Afro-descendants in Brazil as a prelude to the pharmacological use of nicotine in modern medicine. Specifically, we discuss how this knowledge can contribute to a potential novel therapy for PD.