Welcome to the huberman Lab podcast, where we discuss science and science based tools for everyday life. I'm Andrew huberman. And I'm a professor of neurobiology and Ophthalmology at Stanford school of
medicine. Today we are discussing nicotine. Nicotine is one of the most commonly consumed substances on the
entire planet.
There are literally billions
of people that ingest nicotine on a daily basis.
Most of those people consume
nicotine via smokin and in
They're smoking tobacco,
tobacco contains nicotine and it contains a bunch of other things as well,
which we will talk
about and the burning of tobacco liberates nikitina mates
accessible to the various cells and tissues of the body. But of
course, there are other sources of
nicotine as well. Some people consume nicotine through dip, that is placing Tobacco on the inside of the lip. We're in the cheek. Some people consume nicotine via snuff, which is literally the shoving of tobacco leaves up the nostrils and allowing the
The tobacco to access the nervous system and other areas of the body by permeating into the mucosal membranes. As is the lining, the soft lining of the nasal passages
and of course, there are nicotine, patches nicotine gum. There's nicotine in pill form, their toothpicks dipped in nicotine at cetera. Today, we are going to separate our discussion of nicotine from a discussion of
smoking and vaping and the other forms of delivery for
nicotine. We will be talking about smoking and vaping and other
routes of nicotine Administration. Both
Highlighting their detriments to health and believe it or not in certain cases,
keep in mind, very specific, certain
cases, the possible health benefits of delivering
nicotine through specific modalities. Turns out those modalities do not include smoking cigarettes, or vaping and we are going to
pay particular attention to vaping today because vaping use is on the
rise in particular in young people and vaping use.
You and the fact that most tobacco that's consumed through vaping includes
quite amount of nicotine has created a scenario where nicotine because of its ability to change certain chemicals in the brain can actually lead to addiction for a number of
other substances related to vaping and vaping Associated behaviors. If all of that seems like a lot to
get your arms and your mind around right
here at the outset. Don't worry I'll walk
you through this
regardless of whether or not you have a background in biology or not I promise that you'll come through
To the end of this episode with a deep understanding of how nicotine works in the brain and body, some of its benefits, some of its potential drawbacks and you will have clear Optics as to why smoking and vaping and other forms of nicotine delivery
have the effects that they do on your biology and
psychology. I'm pleased to announce that the human Lab podcast is now partnered with Momentis supplements. We partnered with Momentis for several important reasons. First of all, they ship internationally because
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before we go any further, I just want to highlight a key takeaway from a
previous episode which is
our episode on
focus and in fact was a toolkit for Focus. So
during the toolkit for Focus episode, we talked about a large number of Behavioral pharmacologic and other interventions that you can use to increase your level of
concentration.
And focus for whatever purpose cognitive Endeavors, learning languages
focusing in school on work, etc, or
physical Pursuits.
Now one of the key takeaways is that there are really two key protocols that I believe everyone should understand and know about and why they work because they are so effective and also because they dovetail nicely with some
of the information that we're going to talk about today, which will explain why nicotine is so effective in increasing Focus
And these two Protocols are as follows
data based on studies done in, when he Suzuki's
Lab at New York University. Of course, when he was a guest on this podcast, so you can check out that episode if you like, but
studies done in her laboratory point to the fact that a daily very
brief. In fact, only 13 minute meditation can
vastly increase, focus and focus ability. Not just immediately
after the meditation practice, but at all other times as well. So again, this is a meditation practice done.
Haley for just 13 minutes. It's a very simple meditation practice where one sits or lies down,
closes your eyes and directs your attention to a place, just between your two eyes and right above it. So, on your forehead, but just inside of that and please understand that your brain does not have sensory receptors, so unlike focusing on your fingertips and the sensations there, if you focus on your brain you can't actually sense anything in your brain except your thoughts. So the idea then is that you continually bring your focus
back to that location just about
An inch behind you. Your forehead over and over
again, and it's the refocusing of your
attention to that location after it
drifts that succeeds in increasing your focus
ability. Again, not just during the meditation and afterward but at other times as
well. So there's 13 minutes a day meditation is exceedingly, simple and exceedingly
effective, it should be
performed every day but if you miss a
day, just go back to doing it. Don't despair too much and you will see these positive effects. Say the data also increase effects on mood and other positive aspects of mental health and performance.
So that's the
First Tool in protocol, the second tool in protocol
relates to the general, what I call the arrow
model of focus was a model that I created in order to simplify the vast amounts of data on focus and concentration and how they are created by the various chemical systems within your brain. We're going to hear a lot about these chemical systems again today in the context of nicotine and they are as follows.
You can think about focus on any goal or any
Endeavor as an arrow. So just imagine an arrow which has an arrowhead and a shaft and we'll add a third component.
To it in a moment,
the head of the arrow. Meaning the direction of your focus is
largely set by acetyl choline, which is a chemical in the brain. The shaft of the arrow is set by a chemical called adrenaline also called epinephrine, those are the same thing in the brain. Typically it's referred to as
epinephrine and in the body. It's more commonly referred to
as adrenaline. But those are the same neurochemical
epinephrine /, adrenaline represents the shaft of the arrow and it's providing the energy for
To focus and then we can put
behind that Arrow. A little propeller or a motor if you like and the propeller or motor in the context of this. Neurochemistry model is dopamine which provides ongoing
motivation. It pushes that Arrow forward continually as you strive to focus on a particular thing.
This particular Arrow model that is your ability to
increase. Your focus can be
enhanced therefore by increasing acetylcholine
epinephrine and dopamine simultaneously.
And there are a lot of different ways.
Is to do that. But one of the more effective ways
to do that via supplement, protocols is so called Alpha, GPC Alpha GPC taken in 300 mg form,
10 to 30 minutes before
about of cognitive work
or about of physical work will increase your focus by way of increasing acetylcholine and to some extent
increasing epinephrine as well. The dopamine increase will have to be achieved either through
cognitive processing. That is
telling yourself you're doing a good job and moving forward because thoughts, really do impact your levels of
I mean or some other sort of pro dopamine or dopamine increasing
protocol also discussed in the toolkit for focus and our episode on dopamine for motivation and drive. So,
the key thing here to understand is that, the 13-minute a day meditation is a very effective way to increase
Focus capacity.
And then in the short term, if you want to provide a boost now, and again, to focus, 300 milligrams of
alpha, GPC can be very effective. There are various sources for that than we'll link to one of them in the show. No captions,
by no means. Am I saying that you need
to take?
Take Alpha GPC. A number of people will certainly opted,
not to, and a number of people might be saying, well I've heard that Alpha GPC can increase focus by way of increasing acetylcholine and norepinephrine or epinephrine. But it can also increase tmao, which is a kind of a
negative marker of cardiac health and cardiovascular
health for that reason. I and many others will take
600 milligrams of a garlic capsule which can offset that tmao, increase
it remains uncertain as to how much Alpha GPC one
needs to take before.
Seen tmao levels to a point where it's a concern that you would even need to take the
garlic capsule, but I just mention it in any
case because it's a pretty simple fix. Garlic, has other health
benefits to, of course. And for most people 300, mg of alpha GPC taken every once in a while. I certainly don't
encourage people to take Alpha GPC. Every time they want to focus. I always emphasize
behavioral tools first, then focusing on nutritional tools
and on occasion using supplement based tools to encourage increased levels of
Of focus. And then of course there are a various number of different prescription compounds that if you're working with a board certified physician, they could prescribe you, if you need additional tools for Focus things like Ritalin, Adderall, modafinil are modafinil Vyvanse, etc. For many people are going to be important and maybe even necessary for people with ADHD
Etc. But that's a category unto
itself and as I always say, I'm not a physician so I don't prescribe anything, I'm a professor. So I profess many things and today, I just wanted to pass
along
Redirect your attention to that episode on focus and highlight those two
tools. The 13-minute a day meditation and 300 mg Alpha, GPC for increasing Focus capacity and for
acutely, that is temporarily giving an additional boost
for about a focus. And of course, if you choose not to use those protocols, that's perfectly fine to. There's certainly, no obligation. They are simply available to you. Should you choose to try
them and if nothing else. You now have in mind, the neurochemistry of
acetylcholine.
Dean epinephrine, /,
adrenaline and dopamine. And that will really set the stage for understanding, just how effective and why
nicotine is so effective at increasing Focus motivation and even as you'll soon hear working memory and cognitive capacity. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is however, part of my desire and
effort to bring zero cost of consumer information about science and
science related tools to the general public in
keeping with that theme. I'd like to thank
the
Answers of today's
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checkout. Let's talk about
nicotine and how nicotine impacts
our brains, our bodies, Our mental performance, our mental health, our physical performance, and our physical health. And once again, I want to remind everybody that we really need to separate out a discussion about nicotine from the discussion about the delivery device for nicotine. In other words, when we're talking about nicotine, we are not necessarily talking,
About smoking. Although we might be, there are
things associated with smoking, and with vaping and other means of getting nicotine into our system that have their own
effects, both negative and in some cases, positive, indeed later, we will talk about how you can actually use nicotine to get over smoking addiction. This won't come as a surprise to many people. But what perhaps will come as a surprise,
is the fact that many people actually use nicotine like substances or nicotine itself in order to relieve.
An
addiction will talk about that and what that looks like and offer various protocols for you later in the
episode. I also want to mention here at the outset that I have a long-standing
interest in nicotine
fact, early in my scientific
career I did research on nicotine and its role in brain
development and I've had a long-standing interest in neural plasticity the brain's ability to change in response to experience and so experiments that have been done by close colleagues and friends of mine have really emphasized the fact that acetylcholine and in particular when
Acetylcholine activate so-called nicotinic
receptors something. You learn more about in a little bit
that can actually serve as a Gateway or a trigger for directed rewiring of the brain. So this is fascinating. We think of nicotine as something that we take. But actually we have receptors that is locations in the brain to, which nicotine binds and can exert its
effects. And
those receptors did not come about because of the existence of tobacco or the existence of vaping pens or because of the existence of
Anything in the outside world. The fact that there are nicotinic receptors in our brain and body tells you that acetylcholine and nicotine themselves have very important roles in normal
brain and body function.
So much, so that I often like to point to an anecdote of a very well-known Nobel prize-winning neuroscientist. I won't reveal who
they are. They're not a faculty member at Stanford but
many neuroscientists know of this person and many people in the outside world know of this person and they are
Also well known for their love
of nicotine. I once sat in this person's office and he will reveal it as a he
consumed no fewer than three pieces of nicotine
gum during that relatively short conversation of about 45 minutes and that was surprising to me. And I asked him why he was taking so much nicotine through nicotine gum
and he replied that for years. He had been a chronic smoker, which on the one hand had greatly impaired, his cardiovascular health, and
Is Fitness, no
surprise there and we'll talk a little bit more about what the underlying reasons are. But most everyone if not, everyone knows that smoking cigarettes or smoking in general, really a long Health, there's just simply no question about it. There are some more
or less unhealthy ways to smoke,
but the quite honest message is that smoking of any kind is going to disrupt lung endothelial function, lung function blood vessels and so forth. It's going to make it harder to breathe with Vigor. Take deep, breaths deliver, oxygen to tissues that
Era
that said, he also pointed out that the data on nicotine specifically are pointing to the fact that nicotine can be, can be protective against
certain forms of cognitive impairment. And that is why he continued to chew, nicotine containing gum, and
he swore by the focus enhancing and motivation. Enhancing
effects of nicotine containing gum. Now that is
not a call to arms for you to run out and start
shooting we're consuming. Nicotine containing
Painting products, we will talk about those products later in the episode some of their potential advantages, some of their potential disadvantages.
Now I share this anecdote because it nicely separates nicotine
from the delivery device through which nicotine arrives.
No, I haven't talked to this
individual in a few years
to see whether or not the nicotine is working to Stave
off any kind of Alzheimer's, or neurodegenerative or cognitive impairment, that would come with age. This gentleman is getting up in the
years and seems quite sharp
nonetheless. But then,
And was always exceedingly
sharp. The point is, nicotine is a substance
that can both promote cognitive function and under some conditions. If taken to inappropriate or I should say too extreme dosages can also impair cognitive function.
So today we really need to have a
nuanced conversation about nicotine.
One that includes some of the benefits, some of the drawbacks in particular for children, certainly for people that are pregnant for people that have addictive tendencies.
Aziz and for people that have depression and any
other kind of mood disorders,
what I will tell you soon as that nicotine can be very powerful as a mood modulator and many people who have
tried to quit nicotine, mainly through the form of
smoking will find that their mood can
drop substantially. So,
nicotine does a lot of things in the brain and body. And so, I'd like to begin by talking about what
exactly nicotine is, and how it impacts your brain and body.
So what is nicotine? And where is it found?
Obviously nicotine is found in the tobacco plant but
nicotine is also found in nightshades that is tomatoes eggplants and sweet peppers. Although the concentrations of nicotine in tomatoes eggplant and sweet peppers has
vastly lower than it is in the tobacco plant. You actually can also find nicotine in potatoes. Now, why is nicotine present in potatoes and tomatoes and in the tobacco plant at
all? Well, nicotine is a plant alkaloid will get into alkaloids.
A bit later. But it is thought that these alkaloids evolved in Plants as a way to prevent insects from eating them and without going into a lot of insect biology. The reason or the rationale
behind this explanation is that
nicotine is not only a
substance in tobacco that people use or in the various medications that people use. But it's also used as a pesticide because it can
dramatically disrupt the nervous system of
insects it can render them infertile,
which is not to say that it renders
Is infertile. Run a say again, it is not the case that nicotine renders humans and fertile, but it can make certain
insects and fertile, it can actually disrupt their motor function in their brain function. And the reasons that it has such different effects on
insects. In other words, it can kill them or prevent them from reproducing and therefore explains why plants probably evolved to have this plant alkaloid nicotine
in humans because of the differences in receptors for nicotine where they're located in the
types of
Of receptors, the effects of nicotine on humans is quite a bit different. And again, it does not cause infertility in humans, although I will
talk a little bit later about some double blind. Peer
reviewed studies conducted in
humans that indicate that for instance nicotine can reduce
penile girth. That is the girth of the
penis and can lead to certain forms of sexual dysfunction. And those changes are largely Downstream of
changes in blood flow and endothelial cell function and of Hela cells are the cells that make up blood vessels.
And other vascular type tissues within the brain and
body. So nicotine is found in these plants and what we can know for sure is that at some point in human evolution, somebody or some group of
people either and here I'm completely guessing. It's a just so story
but someone or some group must have inhaled the smoke from the
tobacco plant or
put the dried leaves of the
tobacco plant against some mucosal tissue. Any of the different mucosal Linings of.
Their body by which substances can pass through. That's right.
Any of the mucosal soft lining. Tissues of the body will allow certain
substances not all certain substances to pass in. That's why people can put tobacco in their mouth and a certain amount of nicotine makes it into the bloodstream for tobacco up their nose. Certain amount of nicotine gets into the bloodstream, I haven't heard of people putting tobacco and other orifices of their body continue mucosal tissue and I'm certainly not suggesting people do that, but you get the idea and how nicotine gets from these plants. These dried leaves into the
bloodstream
Burning tobacco leads to a heat induced change in the availability of nicotine in. This is why smoking
tobacco or vaping tobacco,
simply by heating. It up allows the nicotine to be liberated and go into the bloodstream, simply
by inhaling into the lungs. We will get back to smoking a
various kinds later. But right now let's just keep our attention on how nicotine is pulled from
these plants and into the human body.
Now whether by inhalation
or
They're not by placing in contact with the mucosal tissue of the mouth or other mucosal containing
orifice of the body. The nicotine, then gets into the bloodstream. And once it's in the bloodstream, it only exerts its effects because it binds to certain so-called
nicotinic receptors. Okay, so the
nicotinic receptors are of the acetylcholine nergic variety. I know this is a lot to think about and a lot to hear if you haven't heard about this, but it's actually quite simple. Anyone can understand this.
Acetylcholine is a molecule, a chemical that is that's released in the brain and body. And when it binds to receptors that is little parking spots on. Sells
it changes the way those cells behave, those cells can increase their
activity and release other chemicals
that can become electrically, active that can do any number of different things.
When we ingest nicotine, it gets into the bloodstream and eventually some of that will get into the brain and some of it gets into the body and in both of the brain and body there.
So called nicotinic, acetylcholine receptors. Now, the so-called
family and indeed they are a family. This is
how we refer to groups of receptors of related design and genetic background. Just like humans. You have a
family of these
acetylcholine receptors that are of the nicotinic variety. So,
you know, maybe on one Street in your neighborhood, you know, the Jones is on another Street, you know, the Chows and another shake well in your body, you have the nicotinic acetylcholine receptors and then you have the
so-called muscarinic acetylcholine receptors
today. It's really simple nicotine.
A binds
to the nicotinic, acetylcholine receptors. And there are a bunch of different ones on a bunch of different tissues and the differences in those receptors, dictate what sorts of effects the nicotine will have on those tissues. So let's talk
about what those effects are and let's do that by dividing, the effects of nicotine into effects on the brain. So everything from the neck
up and on the body, the
so-called central nervous system and the periphery. Although, I want to point out that your spinal cord is part of the central nervous system. So In fairness to the reality, your
In spinal cord are
all central nervous system. Everything else is considered the periphery. Now there are a
lot of different nicotinic, acetylcholine receptors, but for those of you that want to know you afficionados, or if your Ultra curious about this, the main effects of nicotine in the brain are mediated by nicotine binding to the so called Alpha 4 beta 2 receptor,
Alpha, 4, beta 2 receptor.
Even if you don't care about receptor subtypes, that's going to come up later when we discuss why.
Een suppresses appetite. In fact one of the major reasons why people don't want to quit smoking or they quit smoking or another form of ingesting nicotine. And then they
relapse, they go back
to smoking or ingesting nicotine in some other way is because indeed nicotine will increase metabolism and reduce hunger in large part by binding to this Alpha 4 beta
2 receptor in a particular area of the brain. We're going to return to that in a little bit. But if
you've ever heard that Nicotine kills the appetite, indeed
it does. It's
The behavior of smoking itself is not because you always have a cigarette in your mouth that you're not eating
more food. Although I suppose that might be a
minor effect. There are Direct effects of
nicotine on both
appetite, that is, it reduces appetite and Direct effects on
metabolism. That is it increases metabolism through its effects on some other areas of the brain and body will talk about in a
moment and within the brain, nicotine binds to this Alpha 4 beta 2 receptor in various locations in the brain. And there are three and maybe a fourth that will talk about neurochemical effects
of nicotine.
Nicotine after you. Ingest it
first things first, when you ingest nicotine by smoking nicotine containing tobacco, or if you place tobacco in contact with the mucosal lining of the nasal, passages of the mouth takes about 2 to 15 minutes for that nicotine to enter the bloodstream, smoking hits the bloodstream faster vaping even faster, I should mention for a variety of reasons and placing tobacco directly. In
contact with the mucosal lining is going.
The
slowest. Now, as I mentioned before, nicotine gets into the bloodstream and then because nicotine can pass through the
so-called blood brain barrier, the BBB, which is basically a
fence around the brain because it can pass through the blood-brain barrier. It's going to have very rapid effects on the brain. In these four major
categories of neurochemicals and neural circuits.
The first of those categories, this is a very important one. This is one that was brought up in the episode on, dopamine motivation and drive and I think not just all scientist but all
A human being should know that within their brain. They have what is
called the Miso limbic.
Reward pathway the mesolimbic reward pathway. If you just want to call it, the dopamine reward pathway is as the name suggests a set of connections between a brain area called the ventral tegmental area, you don't have to remember the names of these
things, of course, but if you want to, that's fine too,
the ventral tegmental area are VTA. Connects to another area called the nucleus accumbens now with. Here's what's very important, nicotine triggers. The release of dopamine from the nucleus accumbens. This is what gives nicotine.
Rewarding properties. It increases motivation. It tends to give a not so subtle, but very transient increase in feelings of well-being,
and alertness, and motivation. And
that's because of the increase in dopamine caused by nicotine
directly within the nucleus
accumbens
Nicotine also triggers the release of certain neural chemicals from the ventral tegmental area itself. And those impinge on nucleus accumbens and increase, dopamine levels further, this is what makes
the rewarding Properties or sometimes referred to as the reinforcing properties of nicotine. So powerful, this is why
so many billions of people ingest
nicotine in one form or another. It's also why nicotine is so hard to quit because there's a
potent increase in dopamine from multiple.
All
circuit Pathways within this means Olympic reward
circuitry. Now within the mesolimbic reward circuitry, there's an interesting feature there accelerators, that essentially, push out, more dopamine, get more dopamine released. And there are breaks of the so-called gabaergic. Variety gab has an inhibitory neurotransmitter. You don't need to know too much about to just understand that nicotine. Both increases dopamine, but also decreases the activity of Gaba. And so this is like pushing on the accelerator for
Dopamine but also removing the brake. So there's a two-pronged effect of nicotine on reinforcement reward. Dopamine related Pathways the feel good motivation
Pathways, and that
is an increase in dopamine and
a decrease in Gaba. And again, that's all mediated through this means Olympic reward pathway involving the ventral tegmental area and the nucleus accumbens.
So if you can conceptualize even just five percent of what I just told you or even if you can just remember nicotine increases dopamine and that's why
Feel so good. It makes you want more of it. You will have everything you need to know, in mind, in order to
understand both the why nicotine is so highly used and indeed abused why it's so hard to quit and that will point to Avenues as to
how to quit or reduce intake. And it also points to how nicotine can actually be used in an
antidepressant way, should you choose? And we will talk about what the various criteria are for choosing that. But
just understand nicotine increase.
Is motivation it decreases. Negative feelings of mood, it increases
positive, feelings of mood and motivation.
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Well sites in the brain and the two major sites are the nucleus by Solace. So these are a collection of neurons in the front and base of your brain and from some brain stem areas. And there are a bunch of different ones back there in your brain
stem, which is indeed in the back
that release acetylcholine that include the locus coeruleus, as kind of a minor site that pedunculopontine. Nucleus, they're a bunch of these of different areas. The parabolic geminal nucleus, there are a bunch of these things back there. We don't have to go into all the names but just
Understand that there are little pockets of neurons, nerve cells located in the front and the back and some extent in the middle of your brain, but really in the front and the back of your brain that can serve two major roles, here they are, acetylcholine release from nucleus, basalis leads to a sort of spotlighting or highlighting a particular, neural circuits in the brain. What do I mean by this? Well, let's say you're working on a puzzle. Let's say it's a cognitive puzzle. Maybe that you're doing a word puzzle or nowadays. I've heard of this Wordle thing. I'm on Twitter and people always posting their Wordle
I have no idea what it is, but I'm guessing it's
some sort of puzzle. I'm guessing it's like a crossword
puzzle. And here if I'm wrong, I don't know. Educate me. Tell me what Wordle is somebody? Put it in the comments and tell me if I should play it or not, here's the deal.
When acetylcholine is released from nucleus basalis, the neurons are there in the base of the brain. But they extend axons which are like little wires elsewhere in the brain. And when acetylcholine is released, it tends to be released at particular locations in the brain that are associated with whatever activity we happen to be doing. So if I'm doing Wordle
here, I'm talking about as if I've ever done it, doing a
crossword puzzle or Wordle. Well, the neurons that were involved in. Trying to figure out the solution to that word or crossword puzzle are active and then acetylcholine is released from the little wires. The
Endings of these cells in nucleus per Salas and all of a sudden those neural circuits get a boost they become more active and believe it or not our ability to perform that crossword puzzle or at least focus on that word alone or crossword puzzle gets enhanced. It literally increases our attention for that and not anything else is enhance. So it literally like a neurochemical attentional spotlight, nicotine increases
acetylcholine and
thereby, focus and concentration, and mental performance. Not
Not by changing the neural circuits that are activated per se but rather by making more, acetylcholine available at those release sites. So it's as if the spot lighter got more intense, the highlighter is more intense than it
would be otherwise and should also mention because of the so-called pharmacokinetics the time course, in which nicotine has its effects, which are pretty
short-lived, talk about those in a moment. This enhancement in cognitive performance and attention. It's going to be very transient probably.
The order of about thirty, maybe forty five minutes the half-life of nicotine depending on how it's ingested and whether or not you have food in the gut and what else is in the bloodstream etcetera? It's gonna be anywhere from one to two hours,
but typically, the effects of nicotine will come on in about 2 to 15 minutes as I mentioned before and then will last anywhere from about 30 to
45 minutes. This is why in the old days and still to some extent answer areas of the world but less. So in the United States and
certainly in Europe as well, we don't see quite as many people
smoking, cigarettes for reasons. We can discuss
Later. But
you would see these chain smokers, who are trying to maintain
constant levels of nicotine in their brain and blood stream. Now,
perhaps, they didn't know that nicotine has this wanted to our
Half-Life, but they could sense, no doubt the cognitive and the physical effects of nicotine, including this cognitive enhancement effect in highlighting of neural circuits effect. And they would notice, they would smoke a cigarette. And then for the next 5 to 45 minutes, have heightened focus and then it would start to drop off some. They smoke another cigarette. So in other words,
Trying to maintain a constant level of
nicotine, for whatever activities, they needed to perform obviously chain-smoking because of the
terrible effects
of smoking, I'll talk about those terrible effects of, I'm sure you've heard of them before cancer. Depletion of just about every organ in body tissue to the point that it can actually be measured how many years of your life, you're peeling off in terms of lifespan
and health span by smoking. Well, the terrible effects of smoking are
indisputable but the positive effects of nicotine.
18 on the circuitry part of the reason why people would chain smoke in the first place rather than get one, big peak of concentration and focus. And then just let it disappear after 45
minutes. Okay? So what we have is a scenario where dopamine is going up in the knees Olympic pathway
that's why smoking or ingesting nicotine. And any other weight feels good and makes us feel
motivated. And then the increase in acetylcholine, especially, from nucleus per solace in the front of the brain. Is the reason why it can increase our
ability to focus on particular types of
A particular mental work that we're doing or maybe even particular physical work, although I should mention any time i'm pairing, the words nicotine and physical work, it's obvious that because of the ways that smoking a lung function. Those two things really run counter to one another. In other words, if you are thinking about ingesting nicotine, through smoking or vaping in order to improve physical performance, that's a terrible idea to logic isn't there? And the health detriments are certainly
there. The third Noah chemical pathway that strongly activated when nicotine is brought.
It into the central nervous system into the brain.
Is epinephrine or particular norepinephrine which is related to epinephrine. Now, earlier I said epinephrine is the same as adrenaline, that still true norepinephrine is closely related to epinephrine. And for today's discussion we're going to use them interchangeably. Although I realized, as I say that the medical students and some biology students are probably going to have a
minor seizure when I lump norepinephrine and epinephrine. I don't do that to be too much of a lumper, you know, in science, we talk about lumpers and Splitters Lumbers. Are people that like to
over simplify a little bit Splitters? Are
people that really like to
detail you
See a lot of Splitters on social media from time to time. They'll say wait, you know, you didn't mention the alpha to Beta 6 receptor, subunit. Okay,
look. I get it. And I am all for
having Splitters in the room but for sake of today's discussion and for ease of digestibility of some of this just want to point out that norepinephrine epinephrine and adrenaline, I'm going to treat as a common pool of similar. In fact, very similar molecules that
all have the same net effect at least in the context of this discussion and that's the increased
levels of alertness energy.
Arousal. And the way that nicotine accomplishes, those increases in alertness, and arousal and energy within the
brain by triggering, the release of norepinephrine from a little cluster of neurons in the back of the brain called, Locus coeruleus tiny cluster of neurons that offers
up or I should say has because they're always there
from birth, has these little wires these axons that extend many many places in the brain not every place but virtually every place and can sprinkler the brain with norepinephrine essentially serve as a wake-up signal elevating.
Levels of energy and when that combines with the acetylcholine from nucleus, but Solace,
which causes attentional spotlighting increases in concentration and focus
and with the feel-good properties of
dopamine in the motivating, properties of dopamine and released from the mesolimbic
reward pathway. Now, you can start to get a picture of
why nicotine is such a powerful molecule. It's making people feel motivated and good, it's making people feel
focused, and it makes people feel alert.
It
when they would otherwise feel a little bit sleepy. So this is a really powerful compound. In fact,
going back to our earlier discussion about focus and some tools for focus
and I encourage you if you're interested to, please check out the episode on Focus. There are a number of different tools and protocols there to increase Focus. But here
we're talking about one molecule nicotine found in plants like tomatoes and
potatoes in the tobacco plant and
it can be
synthesized in a laboratory and ingested through a patch or a gum or
even a pill or a toothpick dipped in nicotine. One molecule
that can trigger activation of all the circuits for focus and
motivation. In one Fell Swoop, that is remarkable. That is absolutely
remarkable. And here, we haven't even touched on some of the psychological components of Focus, right? Whether or not we're
interested in something whether or not, we're excited about it or not. This
is a very, very powerful system so powerful, in fact that I think we can really Place nicotine right up
there.
The top right next to caffeine as the molecule that has fundamentally changed. Human evolution, human consciousness and Human Experience. Even if you're somebody who's never
ingested nicotine, this absolutely has to be true because you have these nicotinic receptors,
which is to say that a seagull calling, that's
naturally released without any external trigger within your brain and body. Or, I should say, without any trigger from nicotine in particular, is binding these nicotinic acetylcholine receptors and is
Eating these effects in your brain and body is just absolutely
staggering. Now, earlier I mentioned the appetite suppressing and indeed metabolism, increasing effects of nicotine. And while that's a fairly Niche component of what nicotine does, I mean, it's an important one, but it's not the major reason why most people consume nicotine, like, to take a moment and talk about that now, because we are in the brain. And we're talking about the effects of
nicotine in the brain. And so it seems to me the appropriate time to talk about this.
Now, we can have this conversation about nicotine and appetite and
metabolism and of
Very simple and straightforward way.
If you'd like to learn more about the biology of metabolism and appetite, and how those things are
mediated by neural components. So not just stuff like your liver Etc. We have episodes on that but really the neural components of hunger and appetite encourage you to check out our episode on hunger and
appetite. But in that episode we had a discussion and it's one that I'll just Briefly summarize. Now that you have a collection of neurons that sits right above the roof of your mouth or so called the hypothalamus.
Boo means below and Thalamus is Right Above It
hypothalamus. So the small collection of neurons in the hypothalamus, do a number of different things
related to sex Behavior, aggression
mediating, the temperature, your body etcetera, but also appetite and
suppressing appetite and
within the hypothalamus, there's a compact collection of these little neurons which are referred to as the Palm c p om C neurons. And the name comes from the fact that they express certain peptides we won't get into that now, but the pom C neurons have a very
profound impact on whether or not you feel hungry or whether or
not, you do not feel hungry, whether or not your appetite is
suppressed, it turns out that when nicotine gets into the bloodstream and then into the brain, some of that nicotine binds to nicotinic Alpha 4 beta, 2 containing nicotinic
receptors again these subunits are receptors but basically the nickname bind some of
those parking spots parks there and as a consequence these Palm CP o MC neurons increase their electrical activity and appetite is suppressed. And
Because the pom C neurons have outputs to various
areas of the brain and body controlling
everything from how full we feel to whether or not, our blood sugar goes up or down, which can impact our hunger and believe it or not, whether or not we have a tendency to want to move the job our mouth in order to chew food. Yes, believe it or not, the neural circuitry associated with appetite and suppression of appetite. Actually dictates whether or not you prefer to or I should say, are more biased or less biased
to
Moving your mouth. That is chewing.
Which makes perfect sense. When you hear it, right? One way to
suppress appetite is to, so the jaw, shut Neroli, or at least, make it less likely to open your mouth and put food in. It
actually, that reminds me of a story. I'll just interrupt myself to tell a brief story that there's a famous Nobel, Laureate, who won the Nobel Prize for something totally
distant from appetite. But
once turned to a friend of mine at a meeting and said, you know, I discovered the biological mechanism
for
losing weight.
And my friend said, well, of course, it's a, you know, ingest fewer calories than you burn right. Calories in, calories out, fundamental rule of thermodynamics. And basically, the fundamental rule of weight loss weight gain or weight maintenance and he said, no, it's actually the gene that controls whether or not you open your mouth now, he was making it a very nerdy joke. So if you didn't register that as a joke, that's about as funny as Neuroscience or biology jokes get there, a couple
funnier ones, but that one's kind of considered on the funnier side. So this is
why we're not considered
comedians.
But the point of the matter is that whether or not you crave or desire or impulsively want to put things in your mouth and chew it will actually dictate how many calories that you eat and so I find it remarkable and indeed important to know that these pom C neurons are actually inhibiting the opening and the movement of the mouth for chewing. So when we smoke or when we ingest nicotine in any other way, you activate these pom C neurons you suppress appetite but in
part you do that, by actually
limiting the impulse to
chew incredible at least to me now,
Now, in addition to limiting, appetite by changing one's desire to ingest food, and chew it,
and
actual craving of food, by regulation of blood sugar Etc
there, do seem to be some quite Direct effects of nicotine
on metabolism,
and the effects on metabolism aren't enormous. These are increases in metabolism that are about two percent up to about 5%, but I want to emphasize that those are transient
increases in metabolism.
Nonetheless, people that
Smoking often, find that their appetite goes up. They sometimes
gain weight, they sometimes, do not depending on whether or not they offset that increase in appetite with increased physical exercise, or would decrease food, intake,
and other ways, but there does seem to be this direct effect of ingesting nicotine on metabolism, which I find is interesting because if you look in the literature, one of the
reasons why people are
reluctant to quit
ingesting nicotine. If for instance, they want to quit using the deliver your device to nicotine. That's causing such problems for their
With
like smoking or vaping or whether or not, they find themselves, quote-unquote addicted to or have the habit
of ingesting nicotine
in part that's likely due to be the
dopamine effects, right. Because dopamine is highly reinforcing and rewarding, it feels good. So people want to do
more of it but it's also that for many people and hear the data really point to the fact that a lot of the younger female smokers or younger female Vapors,
or when I say that of course, I mean younger.
That Vape
are doing that because they like the
appetite suppressing effects, which of course, opens up an entire conversation about the sociology of you. Nobody imagery, Etc, a topic for a future podcast.
Okay? So nicotine has certain effects on the brain, by virtue of
the fact that nicotine binds these nicotinic,
acetylcholine receptors. And those receptors are found on some but not
all neural circuits within the brain and we talked about some of them already Musa. Limbic the pom C neurons Etc. Now when we ingest nicotine it,
Goes from the
bloodstream to all the tissues and organs of the body.
How does it do that? An amazing. It can pass to everything the brain. The
body it does that because nicotine is fat soluble. And now, in any time people hear the word fat, they tend to think about body fat subcutaneous fat. Or maybe they think about dietary fat, what I mean by
fat soluble in the context of nicotine being fat soluble?
Is that the cells of your body have an outer
layer so called outer membrane.
And it's
Made up of lipid of fat, very particular types of lipids. In
fact,
nicotine has this remarkable ability to move through that fatty tissue, not all
molecules have that ability, but nicotine
does so it can move relatively freely through the brain and body, and relatively freely from
outside of cells, extracellular space, to Interstellar space
so I can get into cells. It can do that with the brain. We talk about those effects and it can do that within the body. Now any time, we're talking about the body,
We could be talking about any number of things but today I'm going to refer to the periphery and the body in more or less the same way, but keep in mind in the back of your
head, pun intended,
you have your brain, your eyes and the spinal cord, and those three things, make up your central nervous system, the peripheral nervous system and the periphery, which is the rest of your body, the contain your organs, and so forth outside of the nervous system. It's like your liver and your stomach, Etc. That's what we're going to talk about now because nicotine has profound effects.
On the organs of the body that are separate from, but that occur in parallel, at the same time as the effects of nicotine on the brain. So let's talk about what some of those effects are, when nicotine makes it into the bloodstream again within 2 to 15 minutes of ingesting. It, depending on the delivery device, your heart rate will increase, blood pressure will increase, and the contract ability of the
heart tissue will actually increase.
So what that essentially speaks to is an increase in so-called
Sympathetic tone. And when I say that, I don't mean an increase in sympathy for others of the emotional sort. What I mean is an increase in the sympathetic activity of the sympathetic arm of the autonomic nervous system, which is a real mouthful and mindful of ideas. But all you need to know is that it's a generalized system that increases levels of alertness and physical Readiness. So it
makes you ready for action, makes you ready for thought
it's balanced by a whole other system called the parasympathetic nervous system, which is basically
The so-called rest and digest system which is a system in neurons and organs, Etc, that put your body in your brain into a state of not being able to think, clearly to digest and to fall asleep, okay? So, nicotine increases heart rate blood pressure and contract ability of the
heart, so it's going to cause
more blood flow in theory. Although it also tends to constrict blood vessels in many locations in the body, this explains the decrease in penile girth effect of nicotine in particular, nicotine ingested by
by smoking or vaping. That's right smoking and vaping reduces penis size and also will have damaging effects on the blood lining and ethelia tissue. So over time, it actually is impairing blood's ability to
get to the penis
chronically as well as to other organs in the body. But when people ingest nicotine acutely, and let's say, they do that by Nicorette patch or by toothpick dipped in nicotine. It will have some of these same effects, but when not
Smoking tobacco, when bringing nicotine into the bloodstream through other mechanisms, many, if not, all
of the disruption of the endothelial cell function can be bypassed, but the
effects on penile girth, the effects on reducing blood flow to various tissues is still present during the effects of nicotine. Which is I mentioned last about one to
two hours. The half-life is about one to two hours, depending on a number of factors, not interesting for today's discussion.
So when nicotine gets into the bloodstream, it's making us.
More alert. It's preparing our body for Readiness. The heart is pumping harder.
Epinephrine that is adrenaline is released from the adrenal glands which ride atop our kidneys. So everything is pointed toward creating more Readiness to move more Readiness to think. And again this is happening in parallel with all the
effects of neurochemistry that are happening with the brain that we talked about a few minutes ago. And what's interesting about nicotine is that, while it causes this
global increase in Readiness and alertness and attention, and mood etcetera. It also has the effect of somewhat relaxing.
Muscle. Now that might seem counterintuitive to those of you out there that already
know what I'm about to tell the rest of you didn't know it. Previously
that your muscles are able to contract because of the effects of acetylcholine released from neurons in your spinal cord that spit out acetylcholine on to the muscle and bind to what nicotinic acetylcholine receptors put into plain English. Nicotinic receptors are also the ways in which
It's your muscles can get activated, so therefore why would it be that increasing nicotine would cause relaxation of the muscles and it has to do with some of the neural circuits that are Upstream of the muscles and asked to do a little bit of how the autonomic nervous system is arranged in terms of which receptors go where a topic and kind of rabbit hole of conversation far too deep for right now at
least in the context of this already somewhat detailed discussion of the effects of nicotine. But
if we were to zoom out and just think about the effects of nicotine, we now have a very
Our picture.
Reward pathways are turned on. Attention is turned on. Alertness is turned on. You
feel better than you felt a few minutes ago. Your blood pressure is up, your heart rate is up your preparedness for thinking is elevated as well and yet your body is somewhat
relaxed.
That's a very interesting State of Mind and Body interesting because it's somewhat ideal for cognitive work. If you're going to sit down and work,
A book where you going to sit down and try and figure out a hard math problem or you're going to write a letter that's been really challenging you for you to ride or maybe that you're really excited to write. But that you've been you know slow to get out the door for whatever
reason. Here, I'm talking about my own habits of procrastination. Well, that state of
being very alert, but your body being relaxed is almost, if not, the optimal state for getting mental work done. Because if you're feeling agitated in your body and you want to physically move, your body is very hard
to do cognitive work, at least the sorts of cognitive work that involve.
Typing or writing or these sorts of things. It's also the exact opposite of the optimal state
for physical performance, which is one
of yes also alertness. Yes, also motivation and elevated mood that's all wonderful stuff to have in mind. Literally when you are exercising, you're competing in sport or something of that
sort. But under those conditions, you really also want to have a fast Reaction Time, a low latency for muscle Activation, so that you can make coordinated muscle movements
in the ways that you need.
Which is of course, what's required of physical Endeavors.
Now, tells us a few things. First of all, it tells us that nicotine is going to be generally, a bad
idea for a pre-workout tool or for enhancing physical performance. However, it's apt to be an in fact, is an excellent tool for enhancing cognitive
ability and of course that triggers my mind to return to
the anecdote, about my Nobel prize-winning colleague, who ingest nicotine by way of nicotine containing
Dumb in order to increase levels of cognitive Focus. Certainly, not for going out and playing sport. In fact, despite the fact that he is a very, very tall, he often points to himself in a in an appropriately, funny way that, you know, he despite being on the basketball team of his high school, you know, probably the worst player that ever existed and they only position him there because of his height and I guess his head was designed to prevent balls from entering the
basket in any event. Nicotine does seem to be very good at
enhancing cognitive functioning
In the short term
which is not to say that it isn't without
its side effects which we will talk about. And again, those are side effects that are independent of smoking or vaping or other forms of ingesting
nicotine, for instance, dipping or chewing. Tobacco is known to cause a 50-fold. Yes, 50. 50 fold, increase
in mouth. Cancers things like leukoplakia and just generally is
terrible for your health. I'm sorry to break
it to you, but if you're dipping or you're using snuff or
things of that sort, you know, sir.
Only I'm not going to tell people what to do. I'm that's not
my role in life but you are dramatically,
increasing the probability of an oral cancer or of a mucosal lining cancer of some sort. So it's not just that smoking and vaping are bad for your health. These other forms of delivery from nicotine can be bad for your health as well.
Now, whether or not ingesting nicotine by way of nicotine containing gum or patch, or toothpick or other method is dangerous. For other reasons, is a discussion that's important right now. It appears that provided
The dosages are kept reasonable. We'll talk about what reasonable
means a little later and the frequency is kept relatively
low. So not relying on these things constantly. There, may in fact be
some benefit to ingesting nicotine from time to time
provided, that you are not
still developing your brain. Now, in reality, neuroplasticity goes on throughout the lifetime. Your life is actually one long developmental or it's not like development occurs in then stops
but certainly for people before puberty during puberty and
For the next 15 to 20 years after puberty. Avoiding, nicotine is probably a good idea. Now, of course,
development is your entire life is not like development starts and then ends, but
certainly for people that are 25 years, old, or younger ingesting nicotine, as a
way to enhance cognitive function is probably not the best idea. And certainly please for those of you that
are 15 years old, or younger ingesting nicotine in any form, unless it's
prescribed by your doctor for a very specific clinical reason
to
To me seems
just like a terrible idea based on all the data that I've read. And the reason for that is it's going to create a scenario of nicotine dependence, in order to achieve heightened levels of mood and alertness Etc, and that's bad. And what we're effectively talking about is an addiction for nicotine directly, not necessarily the delivery device method, like smoking or vaping, although it could pull that in as an addictive or habit-forming behavior as well, but you want to let your neural circuits. Develop to the point where again, unless there's a clinical need for a prescribed drug from a licensed physician, or
Etcetera that you're
not relying on chemical enhancement of the circuits for people who are 25 years or older. And again that's not strict, cut off but roughly 25 years or older. But for those of you that are thinking about using nicotine to enhance cognitive function as
adults and your brain development is slowing down, right? Never ceases but is slowing down or has slowed down to the point where we would say developmental plasticity is
largely over in your now.
Now, operating in
the, in the context of adult neuroplasticity.
Well, in that case, there may be instances in which increasing
acetylcholine dopamine, Etc. By way of nicotine ingestion, might be a good idea, but certainly not by smoking vaping, or by direct contact of tobacco to the mucosal lining tissue of the mouth or nose. So called dipping or snuffing
for the last 20 minutes or so. We've been talking about the
biology of nicotine specifically how it impacts the brain, how it impacts the body. Why it feels so good. Why
Enhanced focus and
we've largely set aside smoking vaping dipping tobacco and snuffing and the negative effects that
those all have on mental and physical health.
Working down from the top of the head to the bottom of the feet. We can say that smoking vaping dipping and snuffing negatively impact every organ and tissue system and
cell of the body by virtue of the
fact that they all damage. The endothelial cells, again, the endothelial cells are the cells that make
Make up the vasculature, which delivers blood and other nutrients
to all the cells and organs and tissues of the body. And those
endothelial cells are strongly, a negatively impacted by all of the
practices that I just described
the way that that happens. Varies a little bit from each one to the next. For instance, it has been estimated that cigarettes contain anywhere from 4,000 to
7,000 toxins. The word toxins is a real Buzz word. These days, you hear about
detoxes and toxins but
More specifically. We know that it contains carcinogens, these are cancer-promoting compounds for instance, we know that the tar in cigarettes even low tar, cigarettes as well as the ammonia within cigarettes, as well as the
formaldehyde contained within cigarettes, as
well as the carbon dioxide that's generated from smoking. Those cigarettes are all carcinogens, carbon dioxide also has the negative effect of depleting, the amount of oxygen. That's delivered to any and all of our tissues by way of the impact of carbon dioxide.
I'd binding hemoglobin in preventing hemoglobin from delivering
oxygen to the tissues of the body. So while there may be four thousand or 4,500 or 7,000
toxins depending on which cigarette which papers they happen to be rolled in whether or not they're filtered or non-filtered, the type of tobacco etc etc. There are a tremendous number of toxins and there are some very potent carcinogens within that
long list of toxins again ammonia tar formaldehyde and carbon dioxide being the most potent of those carcinogens.
Now the fact that there are carcinogens in cigarettes sometimes lead
cigarette smokers in particular the cigarette smokers that have the hardest time quitting or that enjoy their cigarettes. The
most from saying, well listen, everything is a carcinogen or everything kills you. Well, certainly that's not a true statement and while there are other carcinogens in the environment. So
environmental hazards, like solvents. And if you even if you work in a laboratory, for instance, we use in the laboratory DNA, intercalating dies. These are literally dies that allow us to see the DNA structure of cells, and
See the proteins they make and see the rnas they make and
it's very important to wear gloves when you work with those
things. Because as the name suggests a intercalate, they actually get in between the strands of DNA and separate them. They are mutagens. They mutate DNA, they are often carcinogens as well. So we have them in our laboratory, but we take certain precautions to not have them negatively impact our health safety, protocols. And so on, we hear that there are carcinogens in car exhaust and bus exhaust, and then all sorts of things like pesticides and that's all
true. So in the
Probability is one would say, well, if there are all these other carcinogens in the environment,
why would you compound their carcinogenic effect by smoking or vaping? We're dipping her snuffing but that usually doesn't get people to quit smoking or doing those things because of the powerful reinforcing effects of nicotine itself. So, again, nicotine is the reinforcing element by way of triggering. That, dopamine reinforcement pathway. The mesolimbic reward pathway. And, of
course, there are all the other additional
effects of increased Focus such
Such as increased ability to pay attention
to work or to others that lead to other
Awards. And so, then it becomes a situation of compounding reward. So it's not really about the cigarette, it's about the nicotine, it's not really about the nicotine,
it's about the dopamine that the nicotine evokes and that's not really about the dopamine that the nicotine evokes
directly per
se, but also about all the positive
effects that that increase dopamine results in. So
we can easily Circle back to the negative effects of smoking, vaping dipping, and snuffing and say the endothelial cells are
The endothelial cells are involved in delivery of blood and other nutrients. Every tissue of the body and smoking vaping dipping. It's nothing contain carcinogens which are cancer promoting and because the epidemiological studies are out there, we can actually arrive at some very clear numbers as to how much life one will lose from
ingesting nicotine by way of those for delivery devices or I should say any one of those four delivery devices, although I should also mention that many people who are vaping are also smoking cigarettes.
It is becoming increasingly common. A lot of people are using vaping in one context and cigarettes, and another dipping in one context vaping in another. But
even for those that only smoker only Vapor only Dipper, only
snuff the negative effects are dramatic and calculable. So it is thought that for every pack
of cigarettes consumed per day,
so you could average that out. If you're a to add a cigarette smoker or more OPAC, add a cigarette smoker. A 2 pack a day
for every pack of cigarettes.
Smoke per day. We can reliably estimate a
14-year reduction in lifespan. So cigarettes are literally peeling years off your life now
because of the way that the brain works and the way that human beings anticipate, the future
and can be grounded both in the present and the future, or the present and the past, that's just how the mind works, right? That's why we can think about the future but also realize where we
are in time and space today because of that many people will say,
well,
I enjoy cigarettes or I enjoy vaping and so, at least while I'm here, I'm enjoying it. And
that's because the dopamine system is not very good at understanding opportunity cost, that is what we would be doing in
those 14 years and what we would be enjoying and the enrichment that we would get if we were to live into those 14 years.
So at some level, the smoker, The Vapor is being
rational when they say, yeah, but I enjoy this. And so the years lost I can't really register that because it's hard to register what you don't have and what you've never had right on.
Other hand, we can also point to the statistic that there is this 50 fold increase in mouth cancers from dipping.
And there are nasal cancers as well that are greatly increased by
snuffing and from smoking. And now we know Based on data from vaping that the endothelial cell damage and the Direct
effects of damage to the lungs from
Tarzan. Even if people are vaping which tends to have lower tars than do cigarettes, even for people, that are vaping
A greatly increased probability of stroke of peripheral vascular disease. So, this is peripheral pain because remember, you know, blood is delivering not just blood, but other nutrients and it's clearing things
out from tissues. So, there's an accumulation of literally toxins and debris, that cells generate all the time, which is healthy. But then, the normally is cleared Away by the endothelial cells and by other cell types of the immune system, that's all increased in people that engage in these nicotine delivery device,
Yours.
Rates of heart attack rates of stroke rates of cognitive decline are all increased and you might say cognitive decline. I thought that nicotine increases
the likelihood that we can maintain healthy neuronal function and cognitive capacity. It might even increase cognitive capacity in a potent way in the short term and indeed it does. However,
cigarette smoking in vaping are now known to
dramatically decrease cognitive function. Because one of the key
things about the brain, is that it is the most
metabolically.
Organ. Which means it consumes a lot of glucose or even if you're ketogenic, you need ketones,
you need nutrients, getting to the neurons and other cell types of the
brain and nervous system in order for it to function properly. And when you
disrupt the
vasculature through this endothelial cell dysfunction, you got things
like interstitial, which just means in the spaces between dysfunction, so it's not just beating up the endothelial cells themselves, but the spaces between the cells as being disrupted, there's a lot of debris that accumulates there. And as a consequence, the brain just simply will not
function as well. So,
Start getting short term
memory lapses. You start getting working, memory lapses, working memory, is the stored memory. If someone tells you, they're seven digit for phone number
typically, nowadays people just share their
info by the seven digit phone number or a sequence of numbers or an address and your inability to remember that. So, you're walking back to the kitchen sink and you
can't remember what you were trying to. Remember, just a
short moment ago, that's working memory, working memory, suffers, long term, memory, projective or intergrade,
memories into the future. How can you memory? How can remember things in the future that haven't occurred yet? Well,
Is more of a memory for future plans or ideas and planning for things that are to come.
So what we can very reliably say, is that currently more than 1 billion billion more than 1 billion, people consume tobacco in order to get their nicotine because
that's really the reinforcing element within tobacco,
more than 1 billion, people consume tobacco in the
form of cigarettes every day.
A growing number of people more than half a billion people now
are starting to vape. The estimates range from 200 million to 500 million and there's a lot of debate about this because
a lot of people are hybrid smokers and Vapors. Meaning they do one or both Depending on time of day and location as I mentioned before.
But now you start to see how you can get to the number that
billions of people are consuming tobacco, because of course, you also have your people that are dipping in your people that are snuffing and as
Mentioned before you have people that are engaging in multiple of these behaviors. So
billions of people on planet Earth, anywhere from 18 to a quarter of human beings. Incredible right? Anywhere from 18 to a quarter of human beings are consuming tobacco in one form or another in order to get their nicotine one way or another. And as a consequence are peeling ears, off their life dramatically, increasing the probability of cancer stroke, heart attack.
Tack peripheral neuropathies, brain
dysfunction, meaning, cognitive dysfunction memory impairment, sexual dysfunction. There are a number of Studies have looked at increases in cortisol and while minor, those increases do exist decreases in
growth hormone and while minor, those decreases exist, but
Even setting aside the negative impact. On endocrine, on hormone
factors. It's
very very clear that smoking vaping dipping and snuffing
are among the worst things that we can
do for our health, right? They are among the leading
causes of preventable death and debilitating life conditions.
Which may lead you to the question as to why in the world would people do this?
Well, it turns out most of them don't want to in the best surveys. That one can find
of if you could quit smoking, if you could quit vaping, would you
what you find is that at least for cigarette smokers, 70%, 70 want to
quit, they would love to quit and yet they find that to be exceedingly difficult and the reason they find
To be exceedingly difficult is because of
all the brain, neurochemistry that we talked about before. The reason I spent close to 20 minutes talking about dopamine in the knees Olympic pathway, acetylcholine in the nucleus plus, Alice and epinephrine, and the relaxation of muscles in the periphery, and the increase in Readiness and the body. And brain is that all of those combined to make a nicotine, one of the most powerful and potent cognitive enhancers, and to some extent physical enhancer. Although, as I mentioned before the total number of
Physical exercise or physical sport promoting effects of nicotine is very, very small. If not is 0. There are certain conditions under
which one might imagine using nicotine specifically for
cognitive enhancement where performance of complex motor skills which sort of
outweigh the negative effects on the neuromuscular system. Our ability to generate coordinated movements. There's actually an excellent study looking at the effects of nicotine, not by smoking delivery but by
Different delivery
mechanism in which they looked at
performance of hitters in baseball. The sperm was kind of an interesting one, even though these were fairly skilled baseball players, what they have them do is hit a ball off a tee, you know, in as I recall growing up and admittedly, I didn't play much baseball but you start off on t-ball and then you would go I think it was two pitching machine, then they would use actual pictures to throw the ball. But in
this case, it was a couple of different baseball
related tasks that have people hit the ball off a tee in but they had to direct.
Act that hit toward a ball. Atop another T so it's fairly precise targeting that's required in order to knock that ball off the other T. So, this is an activity that involves not just motor output, but coordinated motor output, and not just coordinated motor output, but directed coordinated output.
That requires
some as we would take top-down processing. This isn't the kind of thing that can be done reflexively. This is the kind of thing where the for brain. The prefrontal cortex in particular has to be heavily involved, in order to suppress certain actions and then create other
And so, the basic takeaway of the study is that nicotine delivered by way of nicotine gum, not by
smoking dipping or snuffing
was able to increase, cognitive performance and motor output. So a rare circumstance, where a specific set of Demands that involve both cognitive engagement and physical engagement, showed a slight, but significant Improvement. But again, in most cases nicotine is just simply
not going to improve physical output if it's delivered through.
A smoke cigarette through vaping through dipping or through snuffing. So if
all these behaviors are terrible for
essentially every aspect of our health, frankly?
I mean, when you look at the literature, it's terrible for pregnant women, it's terrible for kids, it's terrible for older people. It's terrible for younger people and you really cannot find a scenario in which smoking vaping dipping, or snuffing are good for us. And yet people like
the effects on the brain and they feel quite addicted to them, even if they say they're not, most of those people would be unwilling to
Of up their practice of nicotine delivery for more than a few hours. In fact, if you look at the
effects of withdrawal, and we are
going to talk about what withdrawal of nicotine. Looks
like you find is that as soon as
four hours after the last ingestion of nicotine by way of cigarette or vaping or dipping or
it's nothing what people start to experience this. Imagi Tatian craving for nicotine of course and while craving is kind of a vague concept, it's actually a very
specific biological.
In ISM. It's the drop in dopamine that starting to occur so much so that there's a drop in dopamine below Baseline. That is the increase in
dopamine. That would normally be experienced
from smoking vaping. Dipping
course nothing. Is now not happening. And in fact, the levels of dopamine are dropping below where they would have been
even without performing that behavior. So that's
what craving is and withdrawal, is an increased sense of that craving as well
as a lot of negative stuff like stomach aches, or
Nausea or irritability and often collections of all of those. So because these nicotine delivery approaches are so terrible for our health and also, because
as many as 70 percent of people who smoke
would like to quit. But either feel, they can't because they've tried and failed repeatedly often, or because it's just too scary. Meaning, the reinforcing properties are too strong and therefore they can't imagine living without them or the withdrawal effects are too strong, and they can't imagine living with those.
Well then is there
hope for quitting smoking vaping snuffing or dipping and the short answer. Fortunately is yes, there are excellent ways to
do that and some of them are single event treatments
and we're going to talk about those
shortly. But before we do that, I want to highlight one very brief point, which is that nicotine is not the
cause of cancer. Nicotine is not the carcinogen, it's
the other things in tobacco or associated,
With the nicotine delivery device that are causing cancer and I should mention the other negative impacts on our health in particular, by way of disrupted, endothelial blood vessel function. Now, that leads us to this issue of vaping because as many of you know and probably are thinking, as I've been delivering this information. People don't Vape tobacco
the way that vaping pens are designed, is that it includes some liquid, it involves heat, and it does
Does not involve the burning
off of tobacco. In fact, there's a constant updating of the engineering of these vape pens so that they can be very low heat. And some cases, they use even non heating
approaches to vaporize
the nicotine and allow it to enter the bloodstream very quickly.
I must say in a lot of ways. Vaping resembles,
crack cocaine. The reason why vaping and crack cocaine are. So similar is the speed of Entry of
Teen into the bloodstream, this isn't an episode about cocaine,
but I just want to very briefly touch on some of the delivery routes for cocaine because they
parallel a lot of the delivery routes for nicotine and we can learn a lot about drug. Pharmacokinetics and dopamine, if we look at the parallels between cocaine and nicotine, I'll preface this by saying
cocaine is a terrible drug. It is actually a schedule 2 drug in the United States which means that it has a very, very limited.
Stood yet, still
present medical application, many mainly as an anesthetic and certain laboratory and Hospital conditions.
But aside from that,
it's very clear. That cocaine is one of the most debilitating drugs that humans can use because of the way that it impacts the dopamine system and it
basically creates a loop whereby. The only thing that can really trigger dopamine
release is cocaine and as I've said before, the way that I Define addiction, as it's a progressive, narrowing of the things that bring people pleasure,
Cocaine certainly falls into the category of addictive drugs, strongly addictive drugs. And in fact, it has the additionally pernicious feature that after using cocaine for some period of time, the amount of dopamine that's released becomes progressively lower and lower and lower so that people can never get back to a state in which dopamine release is ever as great. As it was the first time they did cocaine or prior to doing cocaine now, with a
long period of no cocaine use whatsoever.
And protecting the dopamine system in a number of different ways. People
can often not always, but often recover their dopamine system, if not completely the near completely. So by all means, if you have a problem with cocaine, quit find a way to quit, get treatment, get over that one way or another. We have an episode with an expert guest dr. Anna Lemke. Who's a physician and the chief of the Stanford School of Medicine, dual diagnosis addiction, Clinic World expert in dopamine.
In an addictive substances and addictions of all kinds. Can find that episode at huberman lab.com, it's filled with information about how to get over different types of addictions, including cocaine addiction. Also check out her absolutely phenomenal, and indeed important book dopamine nation which touches on some of this as well and in the show. No captions for the episode where dr. Lemke was my guess. You can also find some additional resources related to that.
So cocaine is terrible that needs to be acknowledged. It
should be avoided and you should find a way to quit it. If you are currently using
With that said the delivery mechanism for cocaine strongly parallels. The delivery mechanisms for nicotine, that is people will snort cocaine,
which is a lot like snuffing or dipping. That is when people
snort cocaine. They're bringing cocaine into
proximity or into contact really with the mucosal lining of the nasal passages which then allows the psychoactive substances to permeate into the bloodstream.
Very seldom. Do people eat it?
Although that does happen from time to time. People will inject it.
The so-called mainlining which is a very rapid entry into the bloodstream because it's direct application to the bloodstream by way of injection.
And then there's crack cocaine which is essentially like a
vaporizing of the cocaine from a from a so-called cocaine
rock that somewhat resembles vaping of
nicotine. So while the vape pen, involves a liquid, that sold a cartridge that contains nicotine and often other flavors as
well.
Flavorings. I should say
both crack
cocaine and vaping
cause very rapid increases in the relative substances that are psychoactive in the case of cocaine, that would be cocaine and the increase in dopamine in the brain and body. I should mention.
And in the case of vaping, there's a very
rapid increase in blood concentrations of nicotine, much faster than occur with cigarette smoking or other modes of nicotine delivery.
So that speed of onset, turns out to be a critical parameter because
The speed of onset of nicotine is
going to also determine the speed of release of dopamine in the
nucleus accumbens and ventral tegmental area that means Olympic reward pathway and with the
mesolimbic reward pathway. It's not just about the peak meaning that
maximal amount of dopamine that's released but it's the
time course how steep the curve is how quickly that dopamine increases that's going to determine how reinforcing how
habit-forming and indeed how addictive a particular substance is so
One of the major important differences between vaping and cigarette.
Smoking is that the onset of dopamine release from vaping is faster and even a
subtle increase in the rate at which dopamine increases in the mesolimbic reward pathway can make a given amount of nicotine much more habit
forming and addictive. This probably explains the fact that
many, many more people in particular. Young people aged 25 and younger are vaping at phenomenal rates now.
People are starting to
Vape in just about every see this in restaurants. You see it on the street, indeed, you even see it in the classroom, you know, this is actually become sort of sport of sorts. The certainly not something I encourage. In fact, when I learned about this from a college student, new college
student, is telling me that many college students are actually
bringing vape pens into the classroom. I think this is also happening in high schools and even junior high
schools. This is a really concerning practice here. I'm not trying to come
across as the, you know, the anti vaping Crusade.
Sir,
but I must say given the negative effects
on one's Health in the long term,
but also given these exceedingly powerful
reward properties of nicotine, entering the bloodstream
quickly and dopamine being released very quickly from the me's Olympic reward
pathway. What we're
seeing out there, makes total sense. Young
people's brains are essentially getting wired to the
expectation that dopamine is going to be
increased dramatically and quickly
under their control, except it's under their control.
Only in a very narrow set of circumstances, recall, the definition of addiction, a progressive,
narrowing of the things that bring you pleasure, we
can change that statement to also say a progressive, narrowing and specific kinetics that is specific time course
of the things that bring you pleasure. Now that's a bit of a nerdier statement than a progressive narrowing of the things that bring you pleasure but
we're going to see in the
next few years, I believe is an
entire generation of young people for which a
A large percentage of them are going to be seeking out a pattern or
feeling because to the person taking out they're not looking at their dopamine levels rising in their blood. They're
experiencing this as an increase in focus and increase in the alertness and increase in mood and well-being. That is very rapid. Very dramatic and that simply cannot be recreated by any other substance. And that's a very concerning scenario concerning because that means Olympic reward pathway is the only
pathway the
Only pathway by which you can achieve the rewarding properties of any kind of endeavor,
not just
vaping. Of course it is the way in which people achieve satisfaction from reaching a
relationship goal or an athletic goal or an educational goal, any kind of goal or sense of satisfaction, and so, it comes as no surprise. That
vaping a strongly associated with
increased levels of depression, especially when vaping use drops
off. Why would that be if people are getting so much more dopamine, so much more
Quickly from vaping. Should they be feeling
better? That brings us back to the critical and I should say defining feature of the dopamine reward
pathway for motivation and well-being,
which is that initially a given substance will. Cause
let's say an 8 out of 10 Again, arbitrary units, but Ada out of 10 increase in dopamine. But with repeated use what ends up happening
is that even at similar or
higher levels of injection. So, not just one in Elation a minute, but maybe to Innovations a minute or inhalation.
Every 30 seconds. Now it's level four
out of ten activation of dopamine and then three and then two and eventually it drops below Baseline. Now, the whole system can be recovered by abstinence from nicotine consumption,
but the dopamine system is applied to everything.
All sense of well-being, all sense of motivation. So,
During the period in which one is abstaining from nicotine and vaping in particular,
people do not feel good, they feel miserable. That's why it's called withdrawal. Its
associated with a bunch of
Illogical and physiological symptoms that all lead back to trying to get to the same levels of dopamine
release in the same patterns that were experienced when one initially started vaping. I'm not trying to paint a dark picture here. But, frankly, the picture is very dark. I'm very
concerned about a practice
of ingesting. Something that powerfully modulates, the dopamine system with the sorts of kinetics, that one sees from ingestion of crack cocaine. In young people, that has all these other negative health effects
that in the short-term,
Very powerfully, rewarding increased Focus well-being
etcetera but that over a very brief period of
time, leads to a state, in which, the entire dopamine reward system is impaired and can become
permanently impaired, unless one intervenes in a very deliberate way.
So people are directly controlling the rate of dopamine in the frequency of dopamine
release by the duration and frequency of inhalations off the vape pen. And that's
an incredible thing. Because what it does
Does is it sets up the mesolimbic reward pathway for an expectation? That dopamine will be delivered on that schedule. So that's one of the things that makes vaping in particular so hard to
quit. Vaping is actually harder to quit than cigarette smoking for most people,
does that mean that cigarette
smoking is fairly
easy to quit for most people know, 70% of people who smoke cigarettes
report that they would like to quit if they thought they could the success rate.
Of quitting smoking when people try to go just cold turkey. Just quit with no assistance whatsoever. They might tell their family and friends. Hey, I'm quitting that's it is exceedingly low. It's
5% so 5% of the people that say that's it. I'm not smoking again
despite cancer diagnosis. I'm not smoking again despite the fear of the negative health effects. I'm not gonna ever smoke again, despite the financial cost, the health cost, I mean we could list off the huge number of things that it does there - but you already know.
Oh, these are you've heard them makes your skin worse it. As I mentioned it, it lowers libido. It disrupts hormones, it
disrupts, vascular function, brain function, does it all these terrible things? And yet, most people who try and quit, simply can't and of the 5% that succeed in quitting a full sixty
five percent of them relapse within a year. So that's a very depressing
picture but it's not to say that people cannot quit. In fact, they can, there are a couple of methods that have been shown to help people. Quit some are
Averell and some are pharmacologic. I just want to touch on the
behavioral ones first because it turns out that there's a quite
powerful method for quitting nicotine ingestion
by way of cigarette smoking, which also carries over to vaping. This is beautiful work that's been done by my colleague. In fact, close collaborator, although I was not involved in the research that I'm about to describe at Stanford in his name is, dr. David
Spiegel.
He is our associate chair of Psychiatry he's been a guest on the huberman Lab podcast, and he is a world.
Expert. If not the world expert
in the clinical
applications of hypnosis.
Now, when I say hypnosis a lot of people think stage hypnosis, which is the hypnotist trying
to get people to do certain things and say, certain
things not necessarily against their
will because they actually have to agree. But the hypnotist is dictating what the person thinks says and
does clinical hypnosis
is vastly different from that
clinical. Hypnosis is where the person, the patient actually directs, their own brain changes toward a specific
emotional.
Behavioral goal work from dr. David Spiegel is
laboratory done in 1993, but that now has been repeated many. Many times as
carried over into some more modern studies and I'll provide
links to those studies in the show notes captions so that you can access
them. Those Studies have shown that using a specific form of hypnosis. People can achieve complete and total cessation of cigarette smoking and there's no reason to believe this doesn't also carry over to vaping through one.
One
single hypnosis session and the success rates are
incredibly high when one considers that. Normally, it would be only a
five percent success rate,
the success rate, with this particular, hypnosis developed at Stanford School of Medicine by dr. David Spiegel, is 23 percent of people who do this, hypnosis one-time
succeed in quitting smoking. Now in the old days, which actually wasn't that long ago before the Advent of smartphones. And before the internet, took off to the extent that it has now.
This was done by having someone come into the clinic and dr. Spiegel
himself, or one of his colleagues would take somebody through the hypnosis
nowadays. You can access this hypnosis. There's a wonderful app that was developed by dr. David Spiegel and others. It's called a reverie are EV
ER, I have talked about this a few times on the podcast
before because they're hypnosis scripts within the app for enhancing sleep for
improving ability of fall asleep. If you wake up in the middle of the
night for focus and a number of other
behavioral and emotional changes.
There's also a function in the reverie app for
smoking cessation, which
exactly parallels. The sort of in laboratory. And in clinic, approaches
that dr. Spiegel would use where you just show up at his clinic or in his laboratory. And since that's not possible for the large number of people out there.
If you or somebody else is trying to quit smoking or vaping or dipping or snuffing for that matter. I strongly encourage you to check out the reverie
app you can find it easily by going to reverie.
Cam it's available in various formats. Some of it is available free, some of his behind a pay wall but given the tremendously negative impact of smoking, vaping dipping, and snuffing the hypnosis for smoking cessation. That reverie has seems at least to me as
a very powerful and worthwhile resource so please check that out. If you're somebody who's trying to quit ingesting nicotine by any of the four methods that I just described.
Now, of course, there are other methods that people have used to successfully.
Quit smoking.
Or vaping or other forms of nicotine delivery. And there's
actually an excellent review on this topic. So, before diving into a few of the specifics about some of the
pharmacology of using nicotine itself to quit smoking, or nicotine itself to quit vaping, or the use of various things, even ssris, antidepressants to
quit smoking or vaping. Just want to point you to a review article that if you'd like to get a
complete survey of all the options
that are available. There's an excellent review on this. It was published just a couple of years ago in
Winning the title of the article is pharmacologic approach to smoking cessation and updated review for daily clinical practice. And even though this is mainly focused on smoking cessation, it carries over quite nicely to vaping and it details a number of Statistics. You
know, the fact that every year, or seven hundred thousand or more people died because of smoking-related diseases. So there again, you have the the negative health effects that
younger people are smoking that women are smoking more
nowadays and that even though you see less smoking typically in the US and Canada and even in northern Europe, some
places
There's still many, many people are smoking who would like to quit, but that 75% of people at least
according to this review. Earlier I said, 70%, but estimates are as
high as 75% of people who try to quit smoking
relapse within the first week. The first week, they just go right back to it. That's how powerfully reinforcing the nicotine is. Remember, it's the nicotine in the cigarette. That's powerfully reinforcing
but it's also the oral habit. The motor habit,
you know, there is this thing about density of sensory receptors in the
lips people like bringing things
Their lips, food cigarettes,
their lips in some
cases, Etc, there is a reinforcement pathway
related to that, for sort of obvious,
adaptive reasons. And as a consequence, there is a reinforcement both from the behavior and from the dopamine released from the nicotine itself. And as I mentioned earlier, from the positive
reinforcement that comes from increased Focus. So the money that you make through work or your attentional ability or the fact that you're alert and people feel you present all of that fun.
His back into positive reinforcement, behavioral reinforcement, and in what we would call addiction.
So this review covers all of that and then steps beautifully through, nicotine replacement therapy and various
compounds. Several of which I'm going to talk about
now, which have been shown to increase that number that we talked about earlier of only five
percent of people who try to quit with no other support pharmacologic or hypnosis or otherwise just say that's it. I'm not going to smoke again or I'm not going to vape again, only 5% of people.
Succeed in doing that. And even among those
many end up, relapsing later, there are a couple pharmacologic approaches one of the main ones that's received. A lot of attention. In recent years, is Brew prone. Sometimes referred to
by its commercial name. Wellbutrin now, you Pride Peron
is a compound that increases the release of dopamine and to a lesser extent epinephrine and some other neurochemicals as well. It's used for the
treatment of depression and for smoking cessation.
Now, I want to point out again. I'm not a psychiatrist.
Trousseau. I'm not telling you to take proprietor own AK Wellbutrin, but I'm gonna give you a little bit of
the Contour of what's typically done in terms of you Piper own Administration
to help people get relief from some of the withdrawal, symptoms of trying to quit smoking or vaping or other forms of nicotine ingestion.
Typically be prone is taken in 300 mg per day. Dosage is divided into two dosages of 150 milligrams, each or sometimes there is a slow release formula, the dosages will vary from person to person.
I want to really emphasize that there is an
increased seizure risk with be prone. It only occurs in a small fraction of the population. But nonetheless is a real
concern for those members of the population. So for those of you with seizure risk, whether you know, it or not, that's going to be a valid concern in terms of potential side effects.
The other thing about Brew proper own is that it has to be used with caution in patients that have liver disease or renal
disease that can impact the amount that anyone can take many. Sometimes people have to take a much lower dose.
If they have renal disease or liver
disease and sometimes they can't take it at all. Sometimes,
if people are taking
benzodiazepines for whatever reason or other sedatives, there are contraindications there, so you proper own, isn't a kind of one
size, fits all or Magic Bullet for quitting
smoking nonetheless for people that can take it safely. And again, this is a prescription drug a board-certified
psychiatrist or other physician is going to have to prescribe it for you if it's appropriate for you
and it moves that number of five percent success rate to about
what one sees with the
Clinical hypnosis to about 20% of people with successfully overcome their nicotine, or I should say they're smoking or vaping addiction. Now, it's important to ask why this would work, right? I mean, it's not as if B Prime her own is increasing,
nicotine per se, what it's doing is its tapping on
that means Olympic reward pathway increasing
dopamine or at least allowing dopamine levels to
say substantially elevated enough that people don't experience some of the drop and do.
I mean that leads to the withdrawal symptoms, the lessening of mood etcetera and
it's no coincidence. If you
prone, is also an antidepressant, it's a common antidepressant for people that experienced negative side effects with the so called ssris is selective serotonin reuptake Inhibitors that, prevent them from taking those things like less and libido or appetite or in some cases increased appetite
or any number of other side
effects. That some people not all, but some people experience with ssris, they'll be prescribed, Wellbutrin view, proper own is the generic name. So Wellbutrin being the
Him again be prone is what
they'll be prescribed. Instead with the caveats of seizure risk, renal disease, liver disease, Etc. The outcomes with you Wellbutrin for smoking. Cessation or pretty good. I mean if you think about an increased from 5% to 20% that's pretty dramatic. And yet I also want to refer back to the incredible success of the clinical
hypnosis approach. Again you can find that at reverie.com
the clinical hypnosis is approach. Has a success rate of 23%. So it's
Very closely aligned with, if not exceeding, the
success rate with bupropion,
of course, there are other pharmacologic
approaches to quitting smoking or vaping.
All of them generally Circle back to increasing dopamine and or norepinephrine in order
to offset some of the withdrawal symptoms of smoking, sensation or vaping cessation.
A very common approach for people to try and quit smoking or vaping is to use nicotine itself to try and prevent people from seeking nicotine.
Threw a cigarette or a vape pen when I mean by
that is people using a
nicotine patch or nicotine gum or
other nicotine delivery
device. That is not cigarettes and not vaping in order to maintain levels of nicotine in their bloodstream, which, of course means maintain levels of nicotine in their brain and
body to the same extent that they would. If they were smoking or vaping, maybe even gradually taking down the
total amount of nicotine in there.
Brain and body by
reducing
the number or size of nicotine gum pieces, that they ingest each day, or keeping the patch on for a shorter amount of time, or getting a lower dose patch that releases less nicotine total or over time,
all of those approaches have been shown to be reasonably successful, get
to the numbers in a few minutes, but reasonably successful, in allowing people to quit smoking or vaping
again. Most of the data is on cigarette smoke.
Because vaping is a relatively new phenomenon, although quite troublingly. It's a very rapidly increasing Behavior, especially in the young population. That's why I'm kind of lumping these two things together, because I
think very soon, we are going to
need an all-out campaign for how to counter vaping addiction.
So what do we know about smoking? Cessation, using nicotine itself is
the patch. Best is nicotine
gum best. Turns out that a combination of
approaches.
Is is
best so, somewhat surprising. But it is very clear from the literature that I was able to find that using nicotine patches for some period of time and then switching to a gum and then perhaps
switching to an a nasal
spray that's going to be the most effective. Then, the question is, how long to continue each of those and whether or not to overlap them? It seems as if doing one for about a week and then switching to another for about a week and then switching to another is
one rational and reasonable approach, that many people have used successfully.
Why would that be? Well, it all has to do with the different rates of absorption of nicotine into the bloodstream and then the downstream consequences
of that on the dopamine, acetylcholine epinephrine and other systems of the brain and body. And
while there hasn't been an extremely detailed study of the exact kinetics of,
you know, how the nasal sprays versus the transdermal patches versus the gums, Etc work.
There's a logical structure
to it. That will immediately make sense to you.
First of all, the transdermal patches provide, a fairly steady state dopamine release,
Nice across the day. And often times people are wearing them at night as well. This is relevant because if people are ingesting nicotine by way of smoking and vaping, you know, hopefully they're not waking up in the middle of the night just to smoke or vapor believe or not, some people do that. But of course while people are asleep they are not smoking or vaping. It was so you don't fall asleep with a cigarette in your mouth. You burn the whole house down, but exceedingly rare
to have people are smoking in their sleep. So people wake up in the morning and because the
If of nicotine from smoking or vaping is very short anywhere from one to
two hours, they are essentially in a state of withdrawal at the point where they wake up in the morning. How
can I say that? Well, remember withdrawal sets in about four hours after the
last ingestion of nicotine by cigarette, were by inhalation, from the vape pen. So people are waking up
in nicotine withdrawal and then immediately going into the behavior of
ingesting nicotine or very soon after waking for most people. So nicotine
patch is going to be very effective for a week or so, again, talk to your physician about the best approach.
For this. But then switching to a nasal spray or switching to nicotine gum for about a week which is going to change the kinetics
of that nicotine absorption into the bloodstream and change, the release of dopamine and other neural chemicals within the
brain, that's going to keep the system intentionally off balance so that it never comes to expect one single pattern or amplitude of dopamine release. And that is a very powerful way for a
Let's just call it a quitting
method to work. Because as I've always said, the most powerful schedule of dopamine is going to be this random intermittent reward. This is what's used in the casinos in order to take your money and
generally they do on average they take your money more than you take theirs and they take more of it, not just more often because they use
this random intermittent schedule. The random intermittent schedule is one in which you don't really know when the Peaks and dopamine are going to arrive
and so there isn't this.
Rotation and craving and then all of a sudden when dopamine is released
its extremely high. That's how they get you to continue playing. Even though basically you're losing money and your dopamine is dropping. They elevated every once in a while,
nicotine replacement can be used in a similar way but in a benevolent way, in order to help you get over smoking or vaping by keeping the total amounts of dopamine variable
around the clock.
And by changing the amount of dopamine, that's released. It seems to help people behaviorally and psychologically because they don't come to expect.
T', having a particular amount of
dopamine in their brain and blood at any given time. And this is an
important point because it brings us to this notion of homeostasis. Homeostasis is this tendency for biological systems
to try and reach equilibrium? What goes up goes down etcetera, and to some extent, to the same degree. So, I'll talk about this right now in the context of nicotine use withdrawal
and then the period in which people no longer
crave nicotine.
So, you can imagine that if we were to measure your heart rate your blood
Sure in your overall levels of alertness and well-being and mood, let's just give that some value. Let's say runs from 0 to 10 Again. Arbitrary units, let's just take all those physiological measures and the subjective measure of your mood and let's measure it, you know, four times an hour
across the day, across the waking hours, what
we would find is a line that would kind of squiggle a bit, maybe some nice text comes in that. You really like maybe you get a, you know, not so good news and your your kind of autonomic arousal is all over the place. But on average is kind of a squiggly line where
Isis in the morning because that's typically when body temperature and autonomic arousal increase. And then towards the afternoon, it's going to come sloping down. And then right before sleep, they'll be an increase. Again, you know, if you've ever felt that
you kind of run around a lot before
sleeping, then it goes down. That's kind of the typical Contour of autonomic
arousal mood etcetera across the day. Removing, of course, life events and things like psychiatric illness and, you know, depression and
Etc. That's the typical Arc of that. Now let's superimpose on whatever that Contour is for you.
Team. So get a little
Bolas as we say, a little bit of nicotine from smoking a cigarette, or from taking the Elation on a vape pen, what ends up happening, is there an increase in blood pressure? Increase in heart
rate, increase in mood, increasing alertness, all things we talked about earlier
over time, the body starts to adjust so that the Baseline upon, which that nicotine induced increase
in arousal would occur
is actually reduced,
right? Why would that
Be well, the body and the Brain, your physiology seeks homeostasis. So if there's a big increase in all those things, like blood pressure, and mood etcetera, typically your Baseline will drop a little bit to compensate for
that over time after a couple days or even weeks of ingesting nicotine. So, let's say you
wake up. You're typically take an
inhalation off your Vape or you have a
cigarette around 9:00 or 10:00
a.m. you do that daily. You
get used to a certain level of mood and alertness and wellbeing for
that time of day and then, if you smoke,
And in the afternoon, let's say you also get accustomed to a certain level of mood and
alertness. And wellbeing for that time of day again, it'll vary depending on life events, but your
system sort of gets used to it and your Baseline will drop to compensate for those Peaks so that the Peaks aren't quite as high as they were when you first
started using nicotine.
Now, you decide to quit. So now what we're talking about is transitioning from the consumption
to what we're going to call the withdrawal phase. Now, what happens is you say, that's
it. I'm going cold turkey, I know there's only
five percent success rate but I'm going to
Just go, cold
turkey or somebody will say, no, I'm gonna use the reverie app or somebody says, no. I'm going to use a few
proper own or another method or nicotine patch or something of that sort.
Well, setting aside the nicotine patch or the nicotine delivery device and only focusing on approaches for
getting through withdrawal that have no Direct effects on nicotine, okay? So not using the team patch, but say the hypnosis or be proper
own, which can increase dopamine, but it doesn't
increase nicotine directly.
What happens the day that you quit that homeostatic mechanism in your brain and body that sets your level of mood and arousal etcetera. Does not know and hasn't adjusted to the fact that you're not
bringing in nicotine. You're not having that cigarette, you're not having that inhalation on the vape pen. So
what ends up happening is that Baseline which has been adjusted down to
offset the increases in mood and alertness Etc. When you smoke or vape is
lower than it, normally would be
So that 9 a.m. cigarette time or vaping Elation time, no longer feels above
Baseline. It actually
feels below Baseline
because what you're seeing
is the lower amplitude of arousal, that was there to offset, the increased you were getting from vaping or smoking and then in the afternoon, if normally, you have a kind of phase of your afternoon, you really enjoy you go outside. You have a vapor cigarette, you normally are
feeling relaxed or you go out at night, you like to vaping? Say, no, I'm not going to do that
anymore.
You're going to feel much much worse
than you would have had you never started smoking or vaping.
Now, that's not much help to anyone who's already started, smoking or vaping. But I say this because it's very important to understand that the reason why relapse rates are so high within the first week 75% of people relapse within one week and overall failure rates are 95%, is because people don't expect to feel even
worse than they did prior to ever smoking or vaping.
So that first week is absolutely
Lee critical, and the beauty of understanding this is that, if you can get through that first week, either by sheer grit, or by finding other methods to increase, dopamine healthy methods.
I would hope and certainly cold,
showers ice baths have been shown to do that, by the way.
This was described in doctor on a lemke's book. Dopamine Nation,
cold showers can increase. Dopamine exercise, positive social interactions. It's very likely that people will need to use other healthy methods to
offset that reduction in dopamine if ever they
To get through that first week. And again, if you can get through that first week, chances are
quite a bit higher that you'll be able to
maintain the cessation of smoking or vaping and of course, hypnosis things like be prone. Can also assist in that be privately owned by way of increasing dopamine pharmacologically hypnosis
through changes in neural circuitry that aren't completely understood but seemed to involve a remapping of some of the so-called default networks. And some of the networks that are
involved in kind of understanding of
Your own
internal State. This stuff gets a little bit complicated. We're going to return to this and
a upcoming episode of the human Lab
podcast, but there are indeed legitimate changes in neural circuitry caused by clinical hypnosis that can at least partially explain why it is so
effective in helping treat or allow people to stop smoking and vaping.
So for those of you out there that either here or are saying yourselves, I just can't seem to quit smoking or vaping or dipping, or snuffing hopefully an
Standing of how that homeostasis process works. And the time course of nicotine, depending on the delivery device, hopefully, understanding that will allow you to develop a protocol.
Maybe it involves hypnosis, maybe it involves just understanding
that the typical times in, which you
ingested nicotine through any of the different approaches of bringing it into your system are going to be
particularly hard. But I don't just mean particularly hard. I mean, particularly hard and you're going to need to do something specific
to offset that decrease.
He's in overall autonomic arousal and dopamine
etcetera. Hopefully, an understanding of that will allow you
to get through that first week and if you can make it past that first week, you stand a very good chance of never going back.
However, I did consult with dr. David Spiegel and anticipation in this episode, regardless of the method that you used to
quit smoking or vaping snuffing or dipping. There's good evidence that a
routine, maybe once a month or even once a week,
Gnosis type approach to replenish or even enhance. The neural circuits that are allowing you to stay away from nicotine is going to be a very
good idea
and given that it's a purely behavioral intervention. I
can see no reason as to why people wouldn't want to do that. Go in and reinforce you tighten, the bolts on that circuitry that are allowing you to not feel the impulse to smoke, not feel the impulse to vape and just
a very brief mention.
There is a vast literature on the fact that when people have
quit smoking,
Smoking or vaping or other form
of consuming nicotine that when they consume alcohol, there's a much higher probability of relapse, their interactions between alcohol, and nicotine, that will cover in future
episodes. But for those of you that want to quit, I want to assure you despite the fact that 95% of people fail with the appropriate tools and I like to think with an additional understanding of the
underlying, biology and psychology, and what you can expect and when to really dig your heels and when to reinforce your system, with more dopamine through any, of the number of the different protocols and tools that we've offered here in the you
Find elsewhere in other episodes of huberman loud podcast. I have high degree of confidence that you can quit smoking or vaping dipping or
snuffing. So today, typical of frankly, all episodes of The huberman Lab podcast, we covered a lot about the biology
of a particular system. We talked about the
biology of nicotine in particular, we talked about vaping and smoking dipping, and snuffing and the negative Health consequences associated with those.
I want to re-emphasize that nicotine is not
not what causes cancer. It is the delivery device that causes cancer and the other negative health effects that is not to say that
people should be ingesting nicotine through any different methods, simply to get a cognitive boost. There are certain circumstances where that might be appropriate. You know, for the occasional work about, certainly not for physical exercise
given what we talked about
earlier. But of course, there are more and more approaches to increasing, not just nicotine, but acetylcholine generally in order to
achieve cognitive enhancement or physical enhancement, or I should say physical performance.
It's enhancement. Some of those we talked about earlier such as Alpha GPC
in any event nicotine. It should now be clear is an immensely
powerful substance. One of the most commonly ingested substances on the face of the Earth and has been for a very long time and now that you understand the underlying biology and the way in which is changes your Psychology and Physiology that should come as no surprise. If
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during today's episode and on various previous episodes of the human lot podcast. We talk about supplements, while supplements are necessary for everybody. Many people drive tremendous
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So, once again, I'd like to thank you for joining me today for a
discussion about the biology and psychological effects of nicotine, this incredibly powerful substance
and as always,
thank you for your interest in science.
