Tobacco as a self-medication and ‘wellness'

American Thinker ^ | May 10, 2008 | Thomas Lifson

[neverdem]

Today's article on smoking restrictions and the "wellness" movement makes no mention of a politically incorrect truth: some people smoke because they find net positive benefits in it. Nicotine is not just an addictive drug, it is a powerful drug which affects the mind in ways that are often positive.

Now let me add that I do note advocate people taking up smoking. I have no financial interest in tobacco, have never owned a tobacco stock, and if tobacco companies have advertised on American Thinker, I have not noticed it. (I would not get rid of their ads if they did, either. Unless an ad is obscene or patently offensive, we do not screen it out.) My beloved mother died young of lung cancer after trying and failing at quitting cigarettes for a couple of decades. I do not have particularly tender feelings for the industry.

But I do not like bullying, and I loathe dishonesty in the public discussion of issues. And it appears that for some people, smoking is not just a pleasant experience, it is self medication. Eric at Classical Values writes: 

Most people who suffer from schizophrenia smoke. A lot.

This is one of those stereotypes that not only happens to be true, but there's a special reason why schizophrenics smoke:

Cigarette smoking may improve attention and short-term memory in persons with schizophrenia by stimulating nicotine receptors in the brain, according to a study by Yale School of Medicine researchers in the June issue of The Archives of General Psychiatry.

This explains not only why they smoke, but why they smoke so much more than people who don't have schizophrenia. They are engaged in self medication.

Persons with schizophrenia smoke two to three times more than smokers without mental illness, said the researchers. They found that when study subjects with schizophrenia stopped smoking, attention and short-term memory were more impaired, but, when they started smoking again, their cognitive function improved. No effects from stopping or resuming smoking were observed in smokers without mental illness.

Participants with and without schizophrenia were then asked to smoke while taking a drug called mecamylamine, which blocks nicotinic acetylcholine receptors in the brain, preventing the nicotine from acting on those receptors. Mecamylamine blocked the ability of smoking to improve cognitive deficits in schizophrenia, but not in persons without mental illness. The findings suggest that when people with schizophrenia smoke, they may in part be self-medicating with nicotine to remedy cognitive deficits.

Calls like this have been made for more studies, and new, nicotine-like drugs have been proposed, but never offered.

I have a silly moralistic question, based on what many people would call "fairness." Considering the evidence that as many as 88% of these unfortunate people are resorting to self-medication with a legal drug, and considering the medical evidence that it helps them, is it really fair to punish them with punitive taxes aimed at making cigarettes unaffordable?

A few months ago, I ventured into related territory, commenting  on the startling news that Christopher Hitchens had suddenly given up smoking.

Christopher Hitchens has always been a puzzle and delight to me. He brings equal passion to being appalled by Bill Clinton and Mother Teresa, an odd coupling, and is always eloquent and funny, even when dead wrong. A legendary drinker and smoker, he has always struck me as a man whose use of nicotine and alcohol, the traditional lubricants (and devils) of literary genius, was integral to the productive, free-wheeling state of mind he must maintain. Alcohol lowers assorted kinds of barriers, while nicotine sharpens certain faculties.

Both substances can be addictive and harmful, but some believe them almost necessary to the occupation. Which is not to say that observant Mormons can't be literary geniuses. Not everyone needs to drink and smoke to be a great wit. However there is a category of human beings who are funnier, more free-wheeling and in some ways faster, with a drink and a smoke, or (depending on the setting) chaw, dip, or a little snuff up the nose. These days there is even the Patch.

So it is with a certain shock that I learn from Edward Luce of the Financial Times that Hitch has given up smoking. In the course of a description of a long lunch at a restaurant specififcally chosen because outdoor tables allow smoking, Luce learns Hitch has stopped, quoting him:

"I've tried many different methods over the last few months -- everything, absolutely everything; therapy sessions, various classes and groups -- none of them worked at all," Hitchens continues, oblivious to what he has unleashed. "Then I woke up yesterday and said: ‘Enough.' By the way, don't let me stop you from smoking," he adds airily. "Doesn't bother me. I feel no temptation at all." And so the meal begins with a unilateral cigarette.

Of course, I do want the best for Mr. Hitchens, and hope to enjoy his wit for as long as possible. I should hope Hitch would do what is best for his health. And a big part of me is very happy that he has made this important choice and seems set on succeeding.

But I can't help wondering if altering his blood chemistry will affect Hitch's thinking and productivity. After all, there is a delicate balance between the stimulative and depressive elements of the two drugs. Will Hitch lose his edge? A friend of mine is currently about a month into kicking the habit, and she is as sharp as ever (which is saying a lot), though not much of a drinker.

Judging by the many comments Hitch made in his conversation (Luce wondered how he could eat at all, given how much talking he did), so far, so good for him, too. Hitch covers a lot of ground, from what triggered his exit from the left to the Clintons and his ethnic identity as a new American. This is a great read.

Don't mistake my intentions. I would never urge anyone to start smoking in a way likely to lead to addiction. My own use of tobacco is limited to an occasional cigar, which relaxes and yet sharpens my mind. I don't think I have smoked one for nearly two weeks, which should show that I am not addicted. But I want to acknowledge the truth that there are benefits to limjited tobacco use. As with alcohol.

Posted at 01:21 PM | Email | Permalink

[muggs]

In June it will be 3 years since I smoked a cigarette. I miss them every damn day and really believe they did make my mind sharper. Some days are more of a struggle than others.

[The Ghost of Rudy McRomney]

Good One. I like it (lights cigar). ;^) Waiting for the ‘convenient conservative’ contingent of rabid smoker-haters to arrive.....6...5...4...3...(raycpa,moonman,Ditter,the usual suspects)

[PowderMonkey]

Very interesting. I smoked a pack a day for 35 years until my heart attack last July. I quit immediately, cold turkey with no withdrawal symptoms, “nic fits”, cravings, nothing. Quiting was easy. Haven't had a smoke since. Weight gain, however, was “impressive.” And,I've now got the attention span of a gerbil. A chimp has more focus to tasks. As for short-term memory...fuggetaboudit. The change was so stark that my wife complained to my Doctor: “He's turned into a head of lettuce! He's just not ‘there’ anymore!”

[nightlight7]

Nicotine is just one medicinal component of tobacco smoke. For example, there are unknown components in the tobacco smoke which inhibit MAO B enzyme, the enzyme which breaks down dopamine and which normally increases as we age. As result of this effect of tobacco smoke (which is not due to nicotine) smokers in their fifties have MAO B levels of non-smokers in their twenties (see this thread which also debunks often parroted myths of antismoking pseudo-science). There are numerous other little publicized but scientifically well established beneficial effects of tobacco smoking.

[aruanan]

And,I've now got the attention span of a gerbil. A chimp has more focus to tasks. As for short-term memory...fuggetaboudit. The change was so stark that my wife complained to my Doctor: “He's turned into a head of lettuce! He's just not ‘there’ anymore!”

Well, you went from supplements of a neurotransmitter to cessation. Have you tried therapeutic doses of nicotine from nicotine gum to see what difference that makes?

[neverdem]

The change was so stark that my wife complained to my Doctor: “He's turned into a head of lettuce! He's just not ‘there’ anymore!”

Exercise on the Brain

You Name It, and Exercise Helps It

I'm sorry to read about your MI.

[neverdem]

Thanks for the links.

[nightlight7]

Very interesting. I smoked a pack a day for 35 years until my heart attack last July. I quit immediately, ...

Mistake. Smoking doesn't cause heart attacks. In randmized intervention trials, where researchers pick a random subset of smokers and convince them to quit, then follow them for years or decades, comparing them to control group (smokers left alone), the quit group gets more heart attacks and more lung cancers. That's why only a handful such trials were done (in early years of antismoking swindle) and you don't hear much about them. Similarly, in animal experiments, the smoking animals live longer and have better health. The antismoking racket has stopped doing the real science on smoking since the results too often come out the "wrong way" showing that the correlations between smoking and disease are of the same kind as those between taking aspirin and headaches.

In short, smoking is good for you.

[RandallFlagg]

ping

[Paul Heinzman]

Congratulations on your upcoming milestone. I wish I had your determination.

[muggs]

you can do it, I can’t tell you it will be easy but it is worth it. I was smoking 3 packs a day.

[aruanan]

For example, there are unknown components in the tobacco smoke which inhibit MAO B enzyme, the enzyme which breaks down dopamine

There are compounds in broccoli that appear to do the same thing. On another note, I just attended a post-doc's presentation about certain mutations that can lead to the failure to break down dopamine, leading to endogenous dopamine toxicity, so it looks as though you can get screwed either way.

[LifeOrGoods?]

1 major problem here, Capitan. You have no right to think for yourself or make any decisions on your own in our current PC, feminized, sodomized society. That truth doubles for a Christian White Male(CWM). More taxes for you slave!!

[LifeOrGoods?]

Coffee and Cigs anyone?::lights one up as he pours a cup of Sumantra blend...

[LifeOrGoods?]

endogenous dopamine toxicity

What the hell is that and why does it sound so damn scary?

[nightlight7]

...certain mutations that can lead to the failure to break down dopamine, leading to endogenous dopamine toxicity...

There is also "water toxicity" i.e. you can die if you drink too much of it. In the case of MAO B inhibition and other dopaminergic effects of tobacco smoke, the ancient 'gift of gods' seems to have been well tuned over the millenia of cultivation and life-long use by billions of test subjects, to maintain the optimum youthful levels of MAO B and dopamine (also of acetylcholine, glutathione, catalase, SOD, pregnenolone, DHEA, testosterone,... see the links given earlier). Tobacco smoke is the closest thing to youth elixir humans have ever known.

[aruanan]

What the hell is that and why does it sound so damn scary?

Well, like most things in life, too much or too little of something often carries bad consequences. Apparently there are proteins that are responsible for dopamine degradation after dopamine uptake. If you have a mutation that either prevents the formation of this protein (more likely than not this would be embryonically lethal) or that impairs the protein's function, then there will be an abnormally high level of dopamine. It's bad to have too little or too much of a neurotransmitter around.

Another example of something like this is cholinesterase. After the nerve impulse is transmitted, you want the acetylcholine broken down. If it's not broken down, then the nerve impulse continues to be triggered which could lead to unresolved trembling and twitching. In C. elegans, there are mutations in a subunit of the acetycholine receptor so that the receptors get continuously triggered leading to degeneration and the necrotic death of the neuron. In a genetic screen of these mutants it was noticed that there were some that appeared to be resistant. A further screen discovered that these mutants also had a mutation in another protein. Further investigation revealed that this protein was required for the maturation and expression of the acetylcholine receptor. If its role was inhibited by the mutation, then the defective subunit of the acetycholine receptor would never make it to the neuron cell surface. Apparently there is enough redundancy between acetylcholine receptors and other neurotransmitter-triggered receptors that the lack of the ACh receptor isn't lethal. My lab was working on finding out just what that protein (RIC-3, for Resistance to Inhibitors of Cholinesterase) did to get the acetylcholine receptor subunits from the endoplasmic reticulum, through assembly and transport, to cell-surface expression.

[PowderMonkey]

Smoking doesn't cause heart attacks? It sure as Hell doesn't help. Tell you what, the first time you feel the searing pain of a coronary artery in full lock-down light one up, take a full drag, and see what happens.

“The results of all were uniform, forthright and unequivocal: giving up smoking, even when fortified by improved diet and exercise, produced no increase in life expectancy. Nor was there any change in the death rate for heart disease or for cancer.”

Increased life expectancy is not my goal. Improved quality of life is. I don't want to live to be 100. I just want to live my final years without spewing tar with every cough. I want to be able to run up a flight of stairs, or “dance” for more than 10 minutes, and not be short-winded. I want to leave the house and not worry about remembering to bring smokes and matches. I want to taste a Big Mac and fries, the way they tasted when I was a kid. That's just a few of the good things that happen when you quit smoking.

[FreeManWhoCan]

What a very intersting post and articles. Thanks. Who smokes what here? I like Lucky Strike.