Nicotine Is a Great Fucking Drug, Part 1: 50,000,000 Schizophrenics Can't Be Wrong

 

This post is in response to a remarkable New York Times article called, “A Lesser Warning? Maybe,” about the efforts of Swedish Match (SM) to get the U.S. Food & Drug Administration (FDA) to approve a warning label for SM’s snus tobacco product that states it is less harmful than cigarettes, a move toward social harm reduction I am thoroughly in favor of.

I started smoking cigarettes in high school, sneaking them when I could. Of course my mom knew, because I stank like cigarettes, but she merely chose to look wounded and remain silent. Better cigarettes than something else, she might’ve thought, though, of course, I was doing a couple of something elses, too.

For my part, I knew that cigarettes were made for me, and that as soon as I left home for college, I would become a full-time smoker, which I did, in short order.

Did I know cigarettes were harmful, even deadly? Of course I did. Even if I hadn’t been aware of all the warnings and evidence that smoking was harmful, almost every pack-a-day smoker soon learns that cigarettes can make you feel like shit, even as you crave them.

Eventually, after many episodes of quitting—some many years long—and then relapsing to cigarettes again, my body quit for me. No matter how much I cut back, every cigarette made me feel terrible, and I started getting recurrent bouts of bronchitis. At that point, quitting smoking was easy.

In fact, every time I quit smoking it was easy, because every time I had reached a point where I hated it.

So why did I keep going back? For the same reason that a few years ago I used a couple of newly available forms of smokeless tobacco and am now a confirmed e-cigarette user: because nicotine is a great fucking drug. Even though I hated cigarettes, I never fell out of love with nicotine.

To me, this is a simple and obvious reality that can’t be ignored in the battle against tobacco related diseases. Once Europeans started obtaining tobacco from the New World, they had a hit trading commodity on their hands. According to Charles C. Mann in his book 1493: Uncovering the New World Columbus Created, tobacco was enthusiastically adopted by societies and cultures all over the world in less than a century.

And here’s the thing: not a single culture or society that has adopted tobacco has dis-adopted it. Why?

It’s the nicotine, stupid.

By the time Europeans learned about it, tobacco had spent centuries evolving to maximize its survival. And it did that by exploiting a chemical it contained: nicotine. Nicotine fits in certain human brain receptors like a key in a lock. For some people, putting this key in those locks makes our brains very happy, and we get addicted.

Ooh, addiction. Isn’t that bad? The answer is, it depends. The clue as to why is in this quote in the NYT’s story (emphasis mine): “Mitchell Zeller, who heads the Center for Tobacco Products—the F.D.A. agency that will rule on the Swedish Match application — has said that what kills smokers is combustion, not nicotine.”

Yeah, nicotine is addictive, but, at the doses consumed by tobacco users, it is not a health threat (like alcohol and caffeine, it is utterly toxic at certain doses). Furthermore, nicotine confers benefits to its users, which is the sole reason people consume it, no matter what form they consume it in, or what they claim are the reasons for their tobacco use.

Those people who say they don’t smoke cigarettes or cigars for the nicotine, but simply for the enjoyment of smoking? I believe that those people believe it. But I also believe they have been totally deluded by their subconscious.

Because the idea that anyone would consume tobacco for any other reason than to get nicotine into their bloodstream is bullshit.

As with alcoholic beverages and caffeinated drinks, two other psychoactive-containing substances that humans consume, nicotine has to work hard to convince our brains to continue using the product that contains it. Does anyone love their first taste of beer? Coffee? Does anyone find their first cigarette entirely pleasant? I’m sure some contrarians would say yes, but if there truly are such people, I’d assert they are rare exceptions. To some degree, alcoholic beverages, caffeinated drinks and tobacco products are noxious to first-time users. So why do we get hooked?

For most of us, I believe what happens is that our brains hoodwink us into becoming habitual users of these products that contain the substances they want more of. After a while, beer and coffee start to taste good, or at least their consumption seems to confer some aesthetic pleasure.

Why? Because our brain tricks us into associating the pleasure we get from alcohol and caffeine with the consumption of whatever product it is that delivers those substances to our brain receptors. Same with cigarettes and nicotine.

Back to the benefits of nicotine. Does it make me feel more relaxed? Check. Does it make me feel more alert? Check. To what extent does it do these? Very hard to quantify. The effect is ephemeral in the extreme. I just know that I’m happier when I have nicotine available when I want it—and I sometimes go for hours at a time without taking a puff of my e-cig, or even thinking about it—and that I never stop missing it when it’s not available.

When I started experimenting with less harmful ways of consuming tobacco, I was way, way past any physical addiction. I’d been off the smokes for years. But I still experienced moments where I “wanted a cigarette.”

That seemed totally counterintuitive. I had reached the point where smoking even one cigarette literally made me sick. There was never even a question that I would go back to smoking. No way. So what made me think I still wanted “a cigarette?”

The locks in my brain that were crying out to be opened by the nicotine key. And my subconscious brain knew that cigarettes delivered that key.

That’s when my conscious brain realized that my problem was not nicotine, my problem was how I was getting it.

As to the sub-title of this post, it refers to the fact that there are approximately 51 million schizophrenics in the world, and they are far more likely to be addicted to nicotine than the general population, and, on average, they consume vastly more nicotine than nicotine users who aren’t schizophrenic. Here’s what Schizophrenia.com, a non-profit online information clearinghouse, has to say (emphases mine):

Research during the past decade has revealed that nicotine is an especially addictive substance for people with schizophrenia and bipolar disorder. Approximately 85% of people who have schizophrenia are also heavy cigarette smokers (and 60% to 70% of people with bipolar disorder) and they smoke two to three times as much as an average smoker.

“In patients with schizophrenia, cigarette smoking is probably the single most important risk factor for developing pulmonary disease, including asthma… and lung cancer,” stated Clinical Psychiatry journal (April, 2005). Experts estimate that smoking kills 200,000 mentally ill people per year.

Research now suggests that people with brain disorders smoke at a high rate partly because nicotine reduces some of the cognitive dysfunction that is a common symptom. In fact researchers are now working to identify and develop nicotine-like drugs they hope will provide even more relief but without the addiction and negative health impacts of cigarette smoking.

Schizophrenics are drawn to nicotine because it makes them feel better. Clearly, the problem here is not the nicotine—it’s the mode of delivery. That’s what I’ll write about in the next installment, whenever I write the next installment.