Tobacco and Psychosis: not quite a smoking gun

http://anp.sagepub.com/content/49/10/859.long

by DanBC • 11 years ago

26 37 11 years ago

anp.sagepub.com

mgraczyk• 11 years ago

Hypothesis: All mind-altering substances precipitate the onset of, and worsen the symptoms of schizophrenia. The strength of the effect depends on interactions between the substance and brain systems we do not yet adequately understand.

There may be nothing special about nicotine except that it is psychoactive. We will need to learn a whole lot more about the brain before we can figure out why nicotine might have a more profound effect than, for example, caffeine.

loceng4• 11 years ago

Some stream of consciousness writing: I would add to that that the body, brain, mind are in part pressure-based systems and normally if all systems are functioning and energy is flowing as it needs to - then pressure in one or multiple areas won't rise, however if those energies aren't flowing for whatever possible causes - then problems can occur and worsen over time as the brain has its natural systems that will keep evolving and applying pressure; if "you" understand Qi (chi) and how energy can become stagnant in the body, this may be easier to comprehend -- stagnant energy, blocks or buildups, in my experience leads to actual pain sensations in the body, and a simple acupuncture session can help alleviate or eliminate the pains (until perhaps the energy buildsup again); this doesn't necessarily mean it will reduce the baseline of existing causes, that would require more work.

jff• 11 years ago

And here we find direct evidence of the effects of over-consumption of cannabis.

nilved• 11 years ago

Qi does not exist.

djtriptych4• 11 years ago

This sort of thing is taught to school children in China, but completely foreign to Western audiences. We might test if these associations vary across cultures. Might Chinese people smoke more yet have a lower incidence of psychosis?

meowface2• 11 years ago

If I were to make a completely blind guess, I'd say it may be the case that drugs which affect dopamine or dopamine receptors directly or indirectly can have some causal or exacerbatory effect on psychotic disorders like schizophrenia.

Lots of different stimulant and psychedelic drugs affect dopamine in some way.

TTPrograms• 11 years ago

Uh, all mind-altering substances? Including the ones they use to treat schizophrenia?

Seems pretty unlikely.

vonklaus2• 11 years ago

Here is a paper that really exemplifies Paul Graham's Write Like You Talk article, which is currently on the FP. I wish these articles were written for the public and were at least somewhat easy to digest.

patcheudor• 11 years ago

It's not even writing like you talk in this case. As an example:

"This study examined smoking in first episode psychosis in order to minimize the any confounding effect of self-medication."

Is there an editor in the house? It gets worse:

"The results were that worldwide, 59% people with first episode psychosis use are regular tobacco users, that people with first episode psychosis have a six-fold greater probability of being smokers than the general population and that smoking initiation occurs on average 5.3 years before the onset of psychosis."

I'll give researchers the benefit of the doubt that these types of mistakes could be related to English as a second, third, or fourth language. Maybe they happened as part of a bad translation? However, these were researchers from South Wales and Australia. As a result I wonder how many mistakes they made in their research. If you produce research which is worth publishing, get an editor.

mehwoot2• 11 years ago

from South Wales

New South Wales is a state of Australia, fyi.

DanBC2• 11 years ago

It's a shame you got downvoted, because you make a good point. This article doesn't have to use as much jargon as it does; it doesn't have to use English in the confusing way it does.

I want MH trusts to go smoke free. That involves me telling people why that's a good idea, and that would be much easier for me to do if articles like this were written in plainer English.

Some jargon would still need to be used. For example they're talking about psychosis and first episodes of psychosis so that needs to stay.

vonklaus2• 11 years ago

Thanks. I smoke and I found the title and subject matter interesting. I am not a genius but am perfectly capable of understanding the article. It is just mentally taxing trying to wade through a sentence structure that seems aimed at a goal of obfuscating knowledge and proving the writer is intelligent rather than disclosing the information in a terse digestible way. Below, someone pointed out that there are many grammatical errors as well. I have thought a lot more about long form articles in publications like the New Yorker and NYT, etc. While often criticized for over simplifications and lack of understanding of subject matter, they often present articles in a way casually interested parties will understand. I don't have a problem with the jargon, large/obscure word use (to the extent it is reasonable) or otherwise employing tactics to get the point across. It is just that, as someone casually interested (not an academic looking for citations) I don't really know what to do with this sentence: > Cannabis use almost always predates psychosis, is associated with an earlier age at onset (Donoghue et al., 2014; Myles et al., 2012b) and heavier and more potent cannabis users have an increased risk of developing psychosis (Di Forti et al., 2009) and do so at an earlier age than people smoking milder cannabis (Di Forti et al., 2014). I wish they would just use superscripts for citations, as a significant portion of that sentence is citations. If academics would just edit the papers, dump them into Tufte CSS or LaTEX with sitations as footnotes or sidenotes and adapt a style human beings could digest without collapsing to rest from the boredom and dull overly-complex structure I think they may find a readership base that exceeds the single digits it currently has. Do you know of a place with interesting articles written for non-academics? I think that would be a cool thing and sure it exists? Cheers.

Turing_Machine2• 11 years ago

Wait: if tobacco use were actually the cause of psychosis, wouldn't we expect to see a dramatic reduction in the prevalence of psychosis in the United States, given that the smoking rate in the US has declined by over fifty percent in recent decades?

As far as I know, there has been no such decline.

What we have seen is a large increase in the incidence of depression, and tobacco has been persuasively shown to have antidepressant effects. Nicotine is, of course, a powerful stimulant, and tobacco also contains monoamine oxidase inhibitors (which also have antidepressant effects).

TylerE• 11 years ago

I wonder if there is any correlation with the obesity epidemic as well, since nicotine's appetite suppression is also well documented.

Turing_Machine2• 11 years ago

Good question.

TeMPOraL• 11 years ago

Is it the effect of nicotine itself or, like it seems to be the case with addictive properties, a combination of nicotine and other agents present in the cigarette smoke?

I ask because I've been using pure nicotine as a cognitive stimulation agent for some time and I haven't noticed any effect on weight or appetite (INB4 I know, n=1, etc.).

kruhft• 11 years ago

Nicotine is a powerful anti-psychotic. This has been known for many years and was one of reasons doctors used to prescribe smoking to patients. Most schizophrenics use it for that effect; the idea it causes it is somewhat ludicrous.

bjourne• 11 years ago

But wait a second. An easy counter argument to the theory is that smoking has significantly decreased all over the Western world. So, if the number of schizophrenics hasn't decreased proportionally, then tobacco smoking can't be a major factor.

irremediable2• 11 years ago

Agreed, with the caveat that mental illness diagnosis has become more common over the past century. (Though I'm not sure whether people have become more willing, in the past couple of decades, to diagnose schizophrenia specifically.)

werber• 11 years ago

Researchers have often overlooked the obvious – that almost all cannabis users also smoke tobacco

Is that obvious? Out of the people in my life that smoke pot, less than half smoke cigarettes.

neverknowsbest2• 11 years ago

This is my experience too- the overlap isn`t that pronounced at all. All the pot smokers I know don`t smoke cigarettes, don`t like cigarettes, and while they`ll light up a joint in their own home, ask cigarette smokers to do their tobacco smoking outdoors

neverknowsbest2• 11 years ago

They didn't address the confounding variable that these disorders are caused by dopaminergic issues, which are present even before becoming floridly psychotic. High levels of dopamine = low levels of arousal, so the slight elevation caused by tobacco smoking is probably pretty appealing.

Only first person experience, here, but I can say antipsychotics (which are dopamine-receptor antagonists... hence the "thorazine shuffle") cause these bouts of sedation that are made much less uncomfortable by simply having a smoke.

DanBC2• 11 years ago

The hydrocarbons in cigarette smoke interact with the anti-psychotics - it's well known that people who smoke need to take larger doses of their meds.

Tobacco and Psychosis: not quite a smoking gun

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