tobacco plants
Who would say, tobacco is a plant!
The association between psychosis and smoking tobacco has been observed for a long time. In England alone, 42% of cigarettes are smoked by people with mental health problems, and in the United States, 80% of those with schizophrenia smoke, compared to a national average of 20%. This has focused a debate around what came first, the smoking or the mental illness?


Comment: Has anyone ever thought that these people are actually self-medicating? Is this so hard to understand? From Schrand JR., Does insular stroke disrupt the self-medication effects of nicotine?, Med Hypotheses. 2010 Sep;75(3):302-4:
The Native American population has used tobacco for 2000 years. Tribal shamans used this medicinal herb to treat respiratory disorders [12,13]. In the late 1800's, physicians used tobacco products to treat asthma [14]

A new study, published in The Lancet, suggests that smoking tobacco might be a modest causal factor in psychosis. By completing a meta-analysis of 61 studies, the team found that 57% of people who were first diagnosed with psychosis were smokers, which the researchers claim implies that - at least in some cases - the smoking came first. But of course, there are underlying genetic factors that this fails to take into account, meaning that although a diagnosis may not have been made before they started smoking, they could have had a genetic predisposition for some form of psychosis.


Comment: What a discombobulated way to deny the fact that tobacco has medicinal properties, like a lot of plants out there in the world. Herbal medicine, anyone?

From: Nicotine - The Zombie Antidote
Tobacco has nicotine in it, which is related to acetylcholine, and this fact is very important indeed, as we are going to learn.

Acetylcholine is a neurotransmitter responsible for learning and memory. It is also calming, relaxing and is also a major factor regulating the immune system. Acetylcholine also acts as a major brake on inflammation in the body and inflammation is linked to every known disease. For example, inflammation of the brain is linked to every known mood, behavior and attention disorder and every neuro-degenerative disease.

Receptors for acetylcholine, also known as cholinergic receptors, fall into two categories based on the chemicals that mimic or antagonize the actions of acetylcholine on its many target cell types. In classical studies, nicotine, isolated from tobacco, was one of the chemicals used to distinguish receptors for acetylcholine. That is why there are nicotinic receptors for acetylcholine.

People who smoke often experience cognitive impairment when they stop smoking. This worsening is due to the fact that nicotine acts as an agonist (that is, it mimics) receptors of acetylcholine which are important for learning, memory and cognitive functions. Daily infusions of nicotine actually increase the number of acetylcholine receptors.

As in a kind of 'blessing from above', local and systemic inflammation is calmed down by the brain through what is called the cholinergic anti-inflammatory pathway, which is a mechanism consisting of the vagus nerve and its neurotransmitter acetylcholine, a process dependent on a nicotinic acetylcholine receptor1. Nicotine, the prototypical nicotinic acetylcholine receptor agonist, counteracts inflammatory cytokine production and has demonstrated protective effects in blood poisoning2.

Nicotine has also been used to prevent kidney failure and improve kidney function. Nicotinic receptors in the brain are associated with neuronal plasticity and cell survival, which is why tobacco has been linked with better thinking and concentration. Nicotine has been used to treat ulcerative colitis, a disease characterized by inflammation of the large intestine3. It is clear from available medical literature that the benefits are far-ranging when it comes to this natural compound - nicotine - that acts as an anti-inflammatory and facilitates the creation of new brain cells!
For these reasons, people who have a neurological chemical imbalance or impairment might find smoking very relieving.


It's often been thought that people who suffer from schizophrenia are more likely to take up smoking to alleviate some of the distress caused by the condition, helping ease symptoms like impaired thinking and to counter the side effects of anti-psychotic drugs - in effect self-medicating. But that's not what this study appears to show.

"These findings call into question the self-medication hypothesis by suggesting that smoking may have a causal role in psychosis," a spokesperson from King's College London, where the study was conducted, said in a statement. "People with first episodes of psychosis were three times more likely to be smokers. The researchers also found that daily smokers developed psychotic illness around a year earlier than non-smokers."


Comment: Oh my! What if those who had the strongest impairments took up smoking to palliate their imbalances. After all, if you're fine, you don't need medicine. But that would be just too logical for the authors of this study!

Tobacco is so medicinal that some people really don't do very well when they quit. From Carlé et al. Smoking cessation is followed by a sharp but transient rise in the incidence of overt autoimmune hypothyroidism - a population-based, case-control study. Clin Endocrinol (Oxf). 2012 Nov;77(5):764-72:
"those who quit smoking had a 6-fold increase risk for autoimmune thyroid problems... transition from current to ex-smoker may lead to limitation in activity, to chronic health conditions, to physical and psychological symptoms and to a higher hospital admissions".

An excess of dopamine in the brain is thought to be the best explanation for psychoses like schizophrenia, as too much in the front of the brain can cause delusions and hallucinations. This is backed up by evidence that dopamine-blocking drugs help to soften these symptoms, while those drugs that increase the release of dopamine can worsen them. Nicotine causes the brain to release more dopamine.


Comment: Let us review again the subject of nicotine and acetylcholine. This time, from Wikipedia:
nicotinic receptors [for acetylchiline] can be opened not only by acetylcholine but also by nicotine —hence the name "nicotinic."
And from Nootriment:
Acetylcholine is one of the brain's natural neurotransmitters. It plays a critical part in the formation of memories, verbal and logical reasoning, and the ability to concentrate. Acetylcholine also offers protective benefits and may limit the neurological decay associated with degenerative diseases.
Yes, that is very desirable. Let us not be afraid to admit it.


"The fact is that it is very hard to prove causation without a randomised trial," says Dr. Michael Owen from Cardiff University. The development of mental illness is a complex process and teasing apart all the different factors that might contribute is a vastly difficult task. The researchers stress that while there might be a link, the results are in no way conclusive and more work needs to be done.


Comment: Yes, trying to fit a square peg in a round hole requires endless amounts of work.


"This new study combines previously published scientific data into a statistical analysis which found that smoking cigarettes appears to modestly increase the risk of developing schizophrenia in later life," says Michael Bloomfield, a clinical lecturer in psychiatry at University College London, who wasn't involved in the study.


Comment: Typical.


"However, much more research is needed before scientists can say for certain that smoking definitely increases the risk of schizophrenia since it remains possible that people who would go on to develop schizophrenia are more likely to start smoking."