Nicotine and tobacco use, whether it be through cigarette smoking or other devices, creates negative health conditions in pilots. The literature that was reviewed pertained to nicotine withdrawal symptoms and their negative impact on pilot performance. There have been studies conducted in order to explore how these symptoms impact pilot performance using cigarettes as the only nicotine device and does not specify the nicotine levels or the frequency of use. This thesis extends this work to examine the relationship between the nicotine withdrawal symptoms and the nicotine behaviors of pilots. It was hypothesized that the extent of withdrawal symptoms may differ by device and by nicotine levels and frequency of use, with higher levels and more frequent use being associated with more severe withdrawal symptoms. These behaviors included the device they use to take nicotine whether it be cigarettes, vaporizers, e-cigarettes, or smokeless tobacco. The behaviors also included exploration of how nicotine levels relate to withdrawal symptoms whether the nicotine level is as low as 3mg or high as 36mg. The last relationship that was explored was that between the withdrawal symptoms presented in pilots and how often they used nicotine, whether it be often as every day or less frequent as 1-2 times a year. It was found that there is no statistical relationship between nicotine withdrawal symptoms and the nicotine habits such as device used, nicotine level used, and frequency of use.

The field of study that this topic is derived from constitutes both federal aviation regulation as well as medical and biological sciences. The compelling idea of this thesis is an in depth investigation of the Federal Aviation Administration's (FAA) regulation and data collection throughout time regarding pilots with Insulin Treated Diabetes Mellitus (ITDM). When in comparison to the continuous evolution of diabetic research and endocrinology in all parts of the world, the regulations regarding this group of pilots seems displaced. This paper explores a chronological order of FAA research and regulations that were conducted on diabetic pilots stemming from 1959 - present. The findings seem to convey that the field of aviation is laden with inconsistencies and misplaced conclusions regarding regulation of insulin-treated diabetic pilots. This paper reflects on the impact of these regulations on this group of pilots from both a biological and medical standpoint as well as from an aviation point of view. In light of advanced medical knowledge, the paper explores what regulations regarding ITDM are in other countries and how FAA regulation should be refined and altered to realign with present day medical knowledge in the United States. This research was conducted to compare the sequential endocrinologic knowledge conducted and the subsequent regulatory actions.