New(ish) study demonstrates power of nicotine addiction

[Oliver]

I missed this in April's copy of Scientific American, but chanced upon it today - I normally read and reread SciAm and New Scientist but I've been busy. Here is the article from the Journal of Family Practice that inspired the article.

Anyway, it is a very interesting study indeed.

To summarize for those who don't have the inclination to read such a large article:

1. Symptoms of withdrawal can occur within the first weeks of smoking - leading scientists to devise new models of how it affects the brain - previously it has been believed that the initial use of cigarettes was a psychological one, with physical addiction kicking in later.
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2. The new theory says the brain quickly adapts to nicotine exposure, and when it is no longer present withdrawal symptoms occur since the adaptation is still in place.
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3. The period of time between nicotine exposure and symptoms of withdrawal depends on the frequency of nicotine exposure. Therefore, self-described "social-smokers" who smoke only a few cigarettes a week are able to do so because the latency-withdrawal period is larger than daily smokers.
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4. Nicotine withdrawal does occur in those who smoke fewer than 5 cigarettes per day - contrary to previous assumptions that dictated that those who smoke less than the required amount to keep a constant level of blood-nicotine levels could not be addicted.
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5. This leads to an interesting paradox in which smokers without nicotine in their system (ie, after 12 hours) may not suffer any withdrawal symptoms until after that point. The traditional model assumes that withdrawal is dictated only by the lack of nicotine in the system.

   In rats, the first dose of nicotine increases noradrenaline synthesis in the hippocampus for at least 30 days after the nicotine is gone. (23) Given this information, it is quite plausible, then, that a few puffs from a cigarette could suppress withdrawal for many days, and perhaps even several weeks

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6. In this new model, a novice smoker is likely to smoke again at some point regardless of the amount already smoked. If he does not, he will likely experience withdrawal and the urge to smoke. Over time, the latency to withdrawal period will shorten as he preemptively smokes to avoid symptoms. The circle is thus completed and addiction sets in.
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7. The brain is permanently restructured by nicotine, dependent on the intake and duration of usage. It never returns to its pre-exposed state, although those who do quit end up with a brain dissimilar to both smokers and those who have never smoked.[/*:m:373h5twz]

I have to say that this mirrors my early experience of smoking far better than other studies on nicotine addiction that I have read over the years.

Another intersting point raised in the Journal article, is that of those who experience the FIRE response (First Inhalation Relaxation Experience - experienced by roughly a quarter of young people) from a cigarette, 91% subsequently lost autonomy over their control of smoking. Pretty remarkable, huh?

 

[TropicalBob]

7. The brain is permanently restructured by nicotine, dependent on the intake and duration of usage. It never returns to its pre-exposed state, although those who do quit end up with a brain dissimilar to both smokers and those who have never smoked.

Thanks for passing this along. It does shed some new light on my personal addiction but does not explain to me how my two cousins now in their late 80s could have smoked for 50 years and each claims to have quit without a problem. One did FOUR packs a day. An in-law also just up and quit one day while shaving. Claims no withdrawal problems. Me? I still think of a cigarette daily and will have been without one for a year as of next month.

I began at age 16, because peers and idols smoked. It's not a joke when I tell people I started at a pack a day. I loved cigarettes almost from the first one. I quickly leveled off at one carton a week.

I guess over the next 50 years, my brain was permanently rewired to handle a large quantity of nicotine, which is why I keep using snus, Stonewall tobacco bits, pipe and e-cigarette. Until I read the studies you cite, I thought my biggest problem with quitting would be the habit part. A smoker is who I am! Always have been, it seems. Now I know the truth when some tell me they always want a cigarette, even 10 or 20 years after they quit. That will be me, until I die.

I wish I were more like my cousins, but I'm not. Thank goodness for safer alternatives -- like e-smoking and snus.

 

[dnakr]

My hubby is the same way. He can put down a cigarette right now and never want one again. He has no withdrawal problems whatsoever. He says he smokes because he likes it, not because he has to.

I on the other hand went 6 weeks on the patch and within 2 hours of taking it off, I was smoking a cigarette. During the time of using the patch, all I thought about was a cigarette.

It's now been 5 1/2 months since I began e-smoking and my desire for a cigarette is not there. I hope I will never that desire again. This has truly been a life changing event for me.

 

[Oliver]

Indeed there is not any explanation in this study for those who seem able to quit without problem, although there is a hint towards a large variety of experience amongst nicotine users. The FIRE response interested me, particularly because I had sort of expected that most people got this reaction from nicotine. A quarter seems quite low, and would suggest a genetic predisposition. It is feasible, don't you think, that the other 75% react to nicotine in a variety of different ways.

The other interesting thing to bear in mind is that previous studies have found that long term smokers who do not experience the FIRE response are actually less likely to have quit one year after their quit date. Go figure.

 

[CaSHMeRe]

great article ...

i would love to see research as to why, most addicts find cold turkey easier then nicotine therapy replacement when it comes to quiting ... (atleast from what I've seen in real life and not tv ads)

I tried patches, gum, nasal inhalers, etc.... I smoked MORE when I was on those things then when I was just smoking regularly ... I quit cold turkey and after 2-3 days and a hiccup about a week later, never had issues :?

i now miss the oral fixation/ritual part of smoking and feel i have beat the nic addiction itself ...

 

[Oliver]

Perhaps the withdrawal-latency period is quite flexible either way? In other words, going long periods of time without nicotine might force the period to lengthen in the same way as it contracts as more nicotine is consumed.

If that were the case, would this go some way to undermining NRT as an effective method for quitting? If the user is never without nicotine, perhaps the latency-withdrawal period will not lengthen.

I have been chatting with a friend this afternoon who has quit for some years. Recently he has smoked on occasions and has quickly found himself having to force himself not to buy his own tobacco, days after smoking. Anecdotal, of course, but interesting nonetheless.

I bet everyone here has also known a smoker that has quit for years but says they occasionally get strong cravings out of the blue. I always thought there was a psychological mechanism that would explain this, but perhaps this is a manifestation of the latency-withdrawal, the latency period becoming more unpredictable over time?

SJ

 

[quirky]

One area I would like studied is how smoking affects pregnant women.
When I was pregnant with my son I had no trouble quiting. It was the only time I found it easy.
But, when he was about 6 months old, my milk began to dry up. As soon as it started drying up I began to crave cigarettes.
One might be tempted to think that this was just psychological - but I am inclined to think that there is some hormone released around pregnancy that precludes a simple psychological explanation.
I realize a lot of women are not able to quit - but this alone would only suggest the diffenences in brain physiology rather than prove any psychosomatic reaction taking place. (do you know how many times I had to use spell check with this post?)

 

[TropicalBob]

Quirky, what can a guy know? But I've always thought our bodies communicate needs to us. Never more strongly than during pregnancy, when so much rides on future mom's proper nutrition and care. Even those food cravings some pregnant women experience have a nutritional need at their bases. Your body told you, properly, not to take nicotine into your bloodstream, where it would be shared with your unborn. As that little brain developed, it would develop nicotine receptors just as reported in SJ's article. Those receptors never go away. And you would have given birth to a baby wanting a nic hit .. a baby almost certainly destined to become a future smoker if the new theories prove correct.

 

[UncleMidriff]

Interesting read.

My story:

Even at a very young age, with no smokers in my house, I enjoyed the smell of cigarette smoke. When my friends would catch a whiff of it and snort and wrinkle their noses, I'd take a good long sniff and enjoy the smell.

I began smoking on a road trip with one of my friends about 5 ears ago. The first tobacco I tried was a Black and Mild. I had no idea what I was doing ( didn't know how to inhale properly), and wasn't impressed. When I explained my disappointment to another friend, she told me the "proper" way to smoke; inhale deeply, hold it for a bit, and then exhale through the nose. I did that, and nearly fell out of my chair. The nic hit was extremely powerful, and extremely great.

After that, I'd only buy pack of cigarettes whenever I was stressed out. And even then, I'd smoke one or two cigarettes and throw the rest out, because I didn't want to get addicted. That progressed slowly, until I was smoking about 3 or 4 cigarettes each weekday, more on weekends. Around this time, my wife started giving me a hard time about smoking every time she smelled smoke on me.

Thus, several times over the last year or two, I've "quit" smoking for weeks at a time or longer. This last time, I made it 7 months without any nicotine.

During the entire 7 months, I never experienced a single withdrawal symptom other than just wishing I didn't have to refrain from smoking. No headaches, no (extra ) irritability, no nothing. I wanted to smoke because I really enjoyed everything about the experience, but I never felt ill. I always assumed that this was because of the relatively low amount I smoked, but I guess this study might cast some doubt on that assumption.

For comparison's sake, I was on low dose of Xanax for about 2 months for panic attacks. That bull.... got ahold of me and didn't want to let go. I had absolutely zero desire to take it, but if I didn't, I felt absolutely horrid. It took over 4 months for me to wean myself off of that stupid ..... So, It's not like I'm somehow generally resistant to physical addiction.

 

[Mamba]

To play devil's advocate I think Difranza's article reeks of anti-smoking propaganda. Most of the research is from subjective questionnaires given to high school students, surveys given to adults and DSM IV criteria for addiction. There is only one example of a brain study which supposedly shows an instant increase (within 24 hours) in nicotine brain receptors. One must also note that this study was on adolescent rats (the cited article title of "Short-term adolescent nicotine exposure..." is misleading) and Difranza doesn't mention this fact in his article. So rat brains may be 'remodeled' but apparently no connection to actual nicotine addiction in humans was shown in the cited study.

I'm not sure what to think of Dr. Yael Abreu-Villaca (the author of the brain study) anyway. (S)he has studies (which I'm not sure have been replicated) supposedly linking prenatal nicotine exposure to the increased likelihood that the offspring will become smokers as teenagers. This is also a rat study. Do the results apply to human populations at all? For complex behaviors like addictions I don't put much stock in rat studies.

Joseph R. Difranza is obviously trying to push the idea that "it only takes one cigarette to get hooked". He is blatantly ignoring sociocultural factors and he tries very hard to make it seem like his argument is scientific even though his 'evidence' is mostly subjective or based on animal studies. I wonder if the same people given the same questionnaires concerning sugar consumption wouldn't have similar answers. Here's a sarcastic analogy:

"Within minutes of consuming sugar drastic biological changes occur in the body to respond to the massive glucose assault. Just one candy bar can lead to a life-long addiction. And just that one candy bar can come back to haunt you years down the road. Your body remembers that sugar rush and feeling of well-being and the increased glucose 'remodels' the brain and leads to permanent changes in neurochemistry. Blah, blah, blah..."

Well, I obviously don't really buy this line of reasoning. Even if some of it turns out to have a biological basis then it would apparently only seem to apply to a percentage of the population as many people claim they have quit nicotine with no withdrawal symptoms. I don't know if there is any way to tell from someone's first reaction to nicotine either. I had a profound response to nicotine the first time I ingested it and I have quit for up to five years at a time with no withdrawal or cravings whatsoever. My experience is only anecdotal, but so is just about everything in Difranza's article.

 

[jamie]

Thanks for some perspective and context Mamba.

 

[Lady Python]

I agree with Mamba on this one (two snakes together).

One has to delve a little deeper into these studies. Who funded the study? No doubt one of the big pharmas is involved there somewhere. The vast majority of these studies are backed by big pharma simply because they want people to buy their products at over-inflated prices.

Then there's WHO (World Health Organisation). They want tobacco products banned worldwide. Who's pulling their strings? That's right, the big pharmas!

Ironically, there are studies which have completely rubbished the anti-smoker's studies.

The leading anti-smoker, Stanton Glantz who portrays himself as a doctor. The man is a complete fraud. A liar and a cheat:

Hes a quack doctor- a mechanical engineer who is a professor in medicine- obtained this by doing a thesis on the mechanics of the heart.

Yet, he has free rein to spout his hatred and rhetoric - backed of course, by the pharmaceuticals

Here in the UK we've had a blanket ban on smoking in public places for a year now, thanks to our corrupt government renaging on their manifesto pledge that a smoking ban would only be in establishments that served food and pubs that didn't serve food would be exempt as would private clubs. The result has been that many pubs and clubs have closed down through lack of trade and many people have lost their livelihoods. Many of us have lost their social lives. I have been in a pub once since the smoking ban - and that was for a funeral wake. Both hubby (a non-smoker) and myself left after the statutory tea and sandwiches. At Christmas we went to the work's night out. Given that 98% of us there are smokers, all of us left within 30 minutes of the end of the meal (which was garbage anyway). None of us enjoyed ourselves. We went home quite upset as did everyone else. Before the ban, we would all have enjoyed ourselves but having to go out into the freezing cold, push our way through the other people who were there (there were other people not involved with our firm having their parties too) really put a downer on things. Even our rabid anti-smoker had the good grace to look sheepish.

Before the ban, when we went shopping we always went to a cafe for a cup of coffee. We don't do that anymore. I have been in a cafe once since the smoking ban started and that was because I bumped into a friend I'd lost touch with and we were both so gobsmacked that we HAD to have a coffee. Suffice to say, I didn't stay long (she's a non-smoker) and made my excuses.

What's happened to me has been repeated up and down the country. Pubs are closing down by the score each week, as are clubs. Just last week it was said that in less than two years time there will be no working men's clubs left as they are struggling to survive. The smoking ban has been the worst thing inflicted on people. The annoying part is that our government did not have a mandate from the people of this country to implement this ban, but the likes of ASH, funded by the big pharmaceuticals are relentless in the persecution of smokers. Deborah Arnott, head of ASH stated that the SHS - secondhand smoke was "...a confidence trick..."

That is on record, so the hysteria against smokers perpetrated by Glantz, Arnott and their ilk are based on junk science, manipulated statistics and out and out lies.

The consequences are far-reaching.

This week here in the UK, a company advertised for staff. In big letters it said:

NON-SMOKERS ONLY NEED APPLY

Smokers are the only group of people discriminated against LEGALLY in this country. If the same advert had said black/white/whatever religion etc. etc. their feet would not have touched the ground on the way to the cells Now it would seem smokers are to be excluded from jobs and probably those already in jobs will find themselves suddenly "made redundant".

And what for? So that the big pharmas can make lots of £££ $$$s selling their equally addictive and useless, expensive products and our government (and probably yours too, wherever you live) can exercise control over our lives

However, there is a change. A subtle change, but it's there. Where a year ago all the newspapers were trumpeting how wonderful the smoking ban was, how all the non-smokers who wouldn't go to pubs and clubs because they hated the smoke for one reason or another would go to the pubs in droves after the ban - well, it didn't happen. These same newspapers are now starting to sing a different tune - that the smoking ban isn't such a good idea after all as people are losing their livelihoods etc. and that the anti-smoker's arguments are based on junk science.

We told them that to start with, but they wouldn't listen.

The government is hated by the vast majority of people in this country. In May we had local elections. The Labour party got well and truly hammered. One of the main reasons why they got hammered was the smoking ban. That came from one of their own activists.

When you oppress and dictate to a people, sooner or later the people will rebel. That is what we're starting to see in this country.

People should be free to make their own minds up about something. No government should have the right to dictate what people do in their private lives or in their own properties and the sooner people start standing up to these nanny-state bullies the better.

I got my e-cig so I can "smoke" where I want. Basically, I got it to stick two fingers up at our dictatorship...sorry I mean government. The fact that I really like it and it's saving me money but depriving the government of about £4 I would have spent in cigarettes makes it very worthwhile.

Wherever you live I urge you to join

Freedom To Choose

The antis will go out of their way to ban e-cigs too - just because they don't like the idea of anyone "smoking".

Don't let another injustice happen.

Sorry for the rant but it is something I feel very strongly about (reaching for her e-cig)...

 

[Ruby]

Lady Python that's a good post. I feel much the same. I found it interesting that you don't go to pubs etc anymore - me too. I can't be bothered with standing outside in the cold weather feeling like a leper. Same goes for restaurants.
I hope many pubs start to look at allowing vaping - it's time both the public and businesses that rely on social interaction stand up and forcefully refuse to be bashed around again. Now is the time - before the nanny state starts to suppress this too.


I had to spend an afternoon at a local hotel - usually this would be my idea of partial hell. I asked permission to vape (brainwashed creature that I am!) & was allowed to do so no probs. I think businesses could welcome this...we just have to make them aware of it.

 

[e-pipeman]

Yesterday I popped into a pub in Congleton for a pint, and asked the barman whether it was "ok to use electronics", showing him my supermini. He said that it was fine and so I had a wonderful relaxed time, sitting in an English pub "smoking" - a pleasure that I believed had been denied to me forever by the Smoking Ban. Nobody objected or seemed disturbed in any way. The more we "smoke" in such circumstances (asking permission first seems both polite and fair) the more e-cigarette use will become an accepted part of everyday life.