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.
I'm all for measures looking to curb smoking, but the issue is that nicotine seems to be put in the same category, at least judging by PSAs in France. Every nicotine-containing product has scary messages on it, although not to the point of actual cigarettes.
I think it's the general trend of losing nuance in public discourse. Things are either all bad or all good. This only confuses to public who can't be reasonably expected to peruse PubMed and build their own understanding of the subject.
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
There might also be environmental issues, like you mention, that could be creating similar issues but not from the point of a genetic neurological divergence.
That is an important distinction since the treatment for one cause is very different to another.
The incidence rates increasing are very correlated to better diagnoses, 30 years ago most people with ADHD wouldn't be diagnosed unless they fit into the extreme cases of it. That was my experience, as a kid I was very bright but considered "lazy" since I couldn't focus as my peers did out of school, was always interested during classes, and excelled in school even though I could never do my homework or other assignments, constantly forgot important deadlines, it was always stressful but I found ways to manage it. Thirty years later and I fit in the criteria, no idea how my life would've turned out if I knew about it before, my coping/management mechanisms ended up being to lean into the stress and harness it, it made me achieve things but also created a whole other host of issues with anxiety later in life.
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.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.
Provide snippets and references from primary sources or turn off.
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.
- 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.
• 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.
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.
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.
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 ?
Sure snus is better than smoking, but that’s just because most things are better than smoking.
Would you happen to have a source? I mentioned this specifically, he said that he is only aware of gums reclining for very heavy users (5+ pouches a day) and that from the other patients he has 1-2 pouches don't seem to have any noticeable effect.
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.
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.
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
From what I read there are 1001 reasons why this helps, but a few that stuck with me was that working out creates norepinephrine (which influences your focus/attention), and releases BDNF which supports the growth of new braincells.
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edit: to think that such short-form drivel is locked behind a paywall is just sad.
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