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What nicotine does to your brain

52 points| runeks | 3 months ago |economist.com

https://archive.ph/rC5UB

93 comments

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michelpp|3 months ago

I caught covid for the first time in jan of 2024, the illness itself wasn't that bad for me, like a common cold, but the aftereffects lingered for months. Eventually my ability to smell and taste came back in a few weeks, but the mental brain fog would not let go. I would sleep over 12 hours a night and still be tired. According to my fitness tracker my daily step and energy burn counts were cut in half. It was so bad I forgot my own phone number at one point and my gmail password. Looking at a screen of code was impossible, I couldn't focus for more than a few seconds. My friends commented on the noticeable changes in my acuity and behavior.

Based on some online anecdotal evidence, I decided to try nicotine "therapy". I bought 4mg smoking cessation mints, cut them in half with a pill cutter, and took 10-12 2mg doses per day at roughly one hour intervals. The effect was immediate and brain fog lifted in less than a week. It was like coming out of a long dream, or like I had been stoned for six months and then suddenly I was sober again. My fitness stats have exceeded where I was before I got sick.

This is just my own anecdotal experience, and there have definitely been some downsides. The mints are about $50/month. My dosage has ticked up a bit and I'm certainly addicted, at least once a day I take a full mint instead of a half for an extra kick. I'd like to taper off, but I'm not sure if I do how to know if any effects are withdrawal or resumption of the covid brain fog. I have a light caffeine habit (2 cups every morning) and I don't see the mints being any more harmful than the coffee, so I think I'm just going to stick with it.

ogig|3 months ago

I suggest you to never try a real cigarette if you haven't already. Given that you are already addicted to nicotine the kick of the real deal could be too much to handle. And you don't want that habit, talking by experience. It's good that you found a drug that helps you, just don't inhale it.

jovial_cavalier|3 months ago

I have a similar average intake to you, and I've been on it much longer, about 3.5 years. I have had periods where I go off the stuff entirely, including a whole month and a half earlier this year. I've also had periods where my intake has spiked much higher.

The withdrawal symptoms are actually strangely pleasant to me as long as I'm in the right mood and have something interesting to focus on. You will get irritable at things you shouldn't, but as long as you keep that in mind, you should be able to stop yourself from totally flying off the handle. In terms of "fogginess," I find that it's actually mostly in your head. As in, I feel like my mind is dulled, yet when I present myself with a task I somehow find it solved to about the same standard that I'm used to. If you end up feeling foggy coming off of the stuff, give yourself at least a week or two to adjust.

xtiansimon|3 months ago

Curious, have you noticed any change in gum health?

I was chewing the gum (not mints) for half a year going from 2mg to 4mg several years ago. I experienced receding gum line from inflammation.

mentos|3 months ago

Out of curiosity what brand of gum did you choose? A few years back I had tried nicotine gum to see if it might encourage my sense of smell to improve, it’s been muted since Covid. It helped but the larger effect I noticed was one day in particular my word recall was phenomenal where usually I struggle and always grasping.

fragmede|3 months ago

I caught Covid march 2020 and it broke my brain. watching Netflix was too difficult. I'm better now through a wide variety of things, but nicotine, via patches for me (half of a 7mg patch - don't want to get used to too much), gave me my life back. That, and a vagus nerve stimulator.

zingababba|3 months ago

Lol, exact same story here except I caught covid very early days and started nicotine in 2023 after I stumbled upon the trials and anecdotes for the first time. Although unlike you I have tried quitting a few times and my brain fog absolutely comes back. The reason I would prefer not to do nicotine is for me (it seems like this is not the case for you) there is a very clear inflammatory aspect I cannot deny which impacts my exercise.

What is actually quite interesting to me is over the two years since I started nicotine I have grown increasingly disgusted with caffeine to the point where I just prefer not to take it any longer.

sph|3 months ago

I am diagnosed ADHD. I have used dexamphetamine as prescribed which worked pretty well, in moderate dosages because I am sensitive, but I came to dislike the effect it had on me: I felt like I was attached to a horse that kept pulling me around even when I just wanted to stop and take a break. And the fact that I would crash 5 hours later.

In 2020, before even knowing I had ADHD, let alone being medicated, I managed to quit my (vaped) nicotine habit after using progressively smaller patches; meanwhile my executive dysfunction grew so much, during the most stressful time of my entire life, that I literally had a major nervous breakdown. It took years of therapy, diagnosis with ADHD, medication, to connect the two factors: I had been self-medicating with nicotine by entire life, and as I reduced the amount of it in my bloodstream, the more scattered I became [1]

Then I tested my theory: I bought some nicotine patches, cut at very low dosage. And lo! it was as effective as dexamphetamine was, with much fewer of the side-effects, no pulling effect [2] and cheaper. It's been now a year and a half and honestly it's been working great. I slap on a small patch in the morning, it lasts MUCH longer than a pill, and it even allowed me to move and still lead a productive life in a country where ADHD is not even recognised. I asked my psychiatrist and they confirmed that nicotine is known to work as a third-line medication but usually amphetamines are preferred.

This is not medical advice, yadda yadda, but worked for me, and I've always wanted to write a post about it. Regarding addiction: pretty much none, patches take too long to take effect to create addiction (i.e. caused by a predicable spike in dopamine). My dosage (~7.5mg patch cut out from a larger one) has been the same for the past 18 months, and trying larger doses just makes me sleepy (nicotine has a U-shaped effectiveness curve). Nicotine is much maligned, but if you do the research, avoid the smoking and inhalation devices but only use patches, maybe you'll find it helps you as well.

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1: I read that cigarette smoke during the formative years is associated with lifelong ADHD, and my pet (silly) theory is that the increasing stigma surrounding smoking of the past ~30 years might be one of the many factors we see ADHD on the rise. We might have 2 or 3 generations of smoking parents that were themselves self-medicating because of growing up in times where smoking was commonplace.

2: if I need to feel like a productive machine for a couple hours, coffee and a tyrosine pill can recreate the amphetamine feeling pretty well

r_singh|3 months ago

As someone who can relate: nicotine spray has been a great alternative for me with the following advantages:

- better dose control for sensitive people, since you can use just one puff (unlike a patch, which delivers the full dose)

- much faster onset

Downsides: strong flavour and the need to spit it out if you have a sensitive stomach.

0xAFFFF|3 months ago

Fellow ADHDer here, I'm not a smoker but long before I was diagnosed, lyrics from a song of my favorite band/artist hit me particularly hard. It was Drag by Joey Cape/Lagwagon, a song about the struggles of smoking. Here's the part, especially the last two lines.

  The drag on the next one
  Is something I can look forward to
  Something to slow the synapse
  Something to do with my hands
I'm lucky enough to be properly medicated now and to have been shielded from smoking by a combination of favorable family environment, a great pediatrist back then and great prevention efforts in school, because if not I'm pretty sure I would have been a heavy smoker. The need for mental peace and focus was just too strong.

nandomrumber|3 months ago

My experience parallels yours. I’ve been intermittently using cutdown patches, and B vitamins + magnesium, in an effort to have fewer complete nut-job breaks from reality.

Nicotine is a CNS stimulant, and cigarettes are somewhat of a fidget spinner, and social lubricant. What’s not to like.

For most people, long term nicotine use is probably less deleterious than long term amphetamine use.

More recently I starting testosterone, and that’s made me feel heaps less like a histrionic toddler.

Knufen|3 months ago

Not a doctor, but can recommend methylphenidat any day over amphetamine. It is a much less "angry" version and the slow release evens the effect.

actionfromafar|3 months ago

That pet theory might have legs. I like it.

Pilottwave|3 months ago

I was just recently talking to my fellow ADHD friends on the benefits that i felt when i started vaping this summer. It was like i was medicating away my ADHD. I turned to AI to investigate further, its response seemed to underwrite this observation

Gemini output: Research is exploring nicotinic acetylcholine receptor (nAChR) agonists as a potential non-stimulant treatment for ADHD, sidestepping the issues of pure nicotine's high addiction liability.

The mechanism focuses on boosting dopamine (DA) and acetylcholine (ACh) release in brain areas governing attention and executive function, primarily by targeting the alpha4beta2 and alpha7 nAChR subtypes.

The goal is highly selective compounds that target the cognitive benefits (linked to alpha4beta2) while avoiding undesirable side effects and addiction pathways.

Selective alpha4beta2 Agonists (e.g., ABT-418, ABT-894/Sofinicline): These were developed to strongly activate the receptor most associated with DA release. Pilot and Phase II studies showed a signal of efficacy in adults with ADHD, with effect sizes similar to non-stimulant medications like atomoxetine.

Varenicline (Chantix/Champix): This is a partial alpha4beta2 agonist, FDA-approved for smoking cessation. Smaller trials suggested improvements in ADHD symptoms, but large-scale development for ADHD has been limited or terminated, and it is not approved for this indication.

Bupropion (Wellbutrin/Zyban): An established non-stimulant ADHD treatment (NDRI) and smoking cessation aid. While its main action is norepinephrine-dopamine reuptake inhibition, it also acts as a nicotinic receptor antagonist (blocking it), which is believed to help reduce nicotine craving. It is an approved non-stimulant option for ADHD.

elcritch|3 months ago

I can't read the article unfortunately.

However nicotine also seems somewhat palliative to a range of mental illnesses like schizophrenia, bipolar, anxiety, etc. I once read a paper that said something like 90% of schizophrenics were chain smokers who were self-medicating.

By that lens the widespread amount smoking in the past makes sense in eras before other pharmaceuticals.

cluckindan|3 months ago

You’d be chasing dopamine hits too if the system forced you to take antidopaminergic medication.

xyzal|3 months ago

Interesting, I remember sometimes actually 'getting' anxiety after a cig when I used to smoke.

johnisgood|3 months ago

Nicotine has lots of benefits, as per many articles on PubMed. That said, tobacco is still one of the worst (unhealthiest) ways to consume nicotine.

qmr|3 months ago

I take 2mg gum 0 to perhaps 8 times a day. Usually 2-3.

When box empties, I take a week or two off.

Slightly sharpens thought and suppresses appetite in combination with caffeine. Helpful for getting reducing body fat and getting abs in my advanced age. Supposedly neuroprotective effects as well.

andy_ppp|3 months ago

TLDR;

• Nicotine boosts attention, memory and alertness by releasing dopamine and other neurotransmitters.

• It’s far less harmful than tobacco but highly addictive.

• Some evidence hints at therapeutic effects in Alzheimer’s, Parkinson’s and schizophrenia models.

• Developing brains (foetus, adolescence) show lasting harm in animal studies.

eru|3 months ago

Gwern's page (https://gwern.net/nicotine) and personal anecdata seems to go against the claims of nicotine by itself being addictive, especially 'highly addictive'.

Smoking (or even vaping) might be 'highly addictive'. But nicotine as eg patches that you glue on your skin doesn't seem to cause much addiction, if any at all.

ramon156|3 months ago

Brain fog for me became a lot less prevalent recently. I got no idea what it is but I don't want it to stop.

I honestly think brain fog is mostly a mentality thing, but I have no evidence to back this up. It doesn't really matter what I eat. The only thing I changed was I started gymming again and I'm taking creatine. I still eat garbage food

nandomrumber|3 months ago

Is it not well established that the single most beneficial activity to improve cognition & sense of wellbeing is weight training?

dsego|3 months ago

Creatine is supposedly good for cognitive performance, at least that's what I took from a couple of youtube videos I watched.

wtk|3 months ago

It does seem to help with focus, but my attempts to curb adhd and brain fog happily didn’t stop at nicotine. Niacinamide (B3) seems to do much better job for me, without the smell, nausea, and it works longer.

scroogey|3 months ago

How much do you take?

mamonster|3 months ago

Honestly, now that you have all-white snus, basically all of the issues of cigarettes are gone (and they are so fking expensive in Europe) and you get all of the benefits of nicotine. I don't need to go outside the office, just sit at my desk and continue working. Now that the market is developed you can vary nicotine dosage at will.

Maybe someone else here heard something different, but my dentist told me that there don't seem to be any dental issues associated with oral pouches, at least so far ?

wohoef|3 months ago

Find a new dentist. Nicotine pouches are incredibly bad for oral health. Huge risk of oral cancer. And it’ll make your gums recline, exposing your nerves (this hurts). Also nicotine itself is quite bad for you to begin with (cardiovascular health, anxiety, etc).

Sure snus is better than smoking, but that’s just because most things are better than smoking.

roschdal|3 months ago

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Lapsa|3 months ago

untrue. pure nicotine does near nothing to your lungs. although it does affect pulse and blood circulation somewhat negatively. perhaps you meant smoke and tar