Tobacco as a self-medication and 'wellness'

Thomas Lifson
Today's article on smoking restrictions and the "wellness" movement makes no mention of a politically incorrect truth: some people smoke because they find net positive benefits in it. Nicotine is not just an addictive drug, it is a powerful drug which affects the mind in ways that are often positive.

Now let me add that I do note advocate people taking up smoking. I have no financial interest in tobacco, have never owned a tobacco stock, and if tobacco companies have advertised on American Thinker, I have not noticed it. (I would not get rid of their ads if they did, either. Unless an ad is obscene or patently offensive, we do not screen it out.) My beloved mother died young of lung cancer after trying and failing at quitting cigarettes for a couple of decades. I do not have particularly tender feelings for the industry.

But I do not like bullying, and I loathe dishonesty in the public discussion of issues. And it appears that for some people, smoking is not just a pleasant experience, it is self medication. Eric at Classical Values writes: 

Most people who suffer from schizophrenia smoke. A lot.

This is one of those stereotypes that not only happens to be true, but there's a special reason why schizophrenics smoke:

Cigarette smoking may improve attention and short-term memory in persons with schizophrenia by stimulating nicotine receptors in the brain, according to a study by Yale School of Medicine researchers in the June issue of The Archives of General Psychiatry.

This explains not only why they smoke, but why they smoke so much more than people who don't have schizophrenia. They are engaged in self medication.

Persons with schizophrenia smoke two to three times more than smokers without mental illness, said the researchers. They found that when study subjects with schizophrenia stopped smoking, attention and short-term memory were more impaired, but, when they started smoking again, their cognitive function improved. No effects from stopping or resuming smoking were observed in smokers without mental illness.

Participants with and without schizophrenia were then asked to smoke while taking a drug called mecamylamine, which blocks nicotinic acetylcholine receptors in the brain, preventing the nicotine from acting on those receptors. Mecamylamine blocked the ability of smoking to improve cognitive deficits in schizophrenia, but not in persons without mental illness. The findings suggest that when people with schizophrenia smoke, they may in part be self-medicating with nicotine to remedy cognitive deficits.

Calls like this have been made for more studies, and new, nicotine-like drugs have been proposed, but never offered.

I have a silly moralistic question, based on what many people would call "fairness." Considering the evidence that as many as 88% of these unfortunate people are resorting to self-medication with a legal drug, and considering the medical evidence that it helps them, is it really fair to punish them with punitive taxes aimed at making cigarettes unaffordable?

A few months ago, I ventured into related territory, commenting  on the startling news that Christopher Hitchens had suddenly given up smoking.

Christopher Hitchens has always been a puzzle and delight to me. He brings equal passion to being appalled by Bill Clinton and Mother Teresa, an odd coupling, and is always eloquent and funny, even when dead wrong. A legendary drinker and smoker, he has always struck me as a man whose use of nicotine and alcohol, the traditional lubricants (and devils) of literary genius, was integral to the productive, free-wheeling state of mind he must maintain. Alcohol lowers assorted kinds of barriers, while nicotine sharpens certain faculties.

Both substances can be addictive and harmful, but some believe them almost necessary to the occupation. Which is not to say that observant Mormons can't be literary geniuses. Not everyone needs to drink and smoke to be a great wit. However there is a category of human beings who are funnier, more free-wheeling and in some ways faster, with a drink and a smoke, or (depending on the setting) chaw, dip, or a little snuff up the nose. These days there is even the Patch.


So it is with a certain shock that I learn from Edward Luce of the Financial Times that Hitch has given up smoking. In the course of a description of a long lunch at a restaurant specififcally chosen because outdoor tables allow smoking, Luce learns Hitch has stopped, quoting him:

"I've tried many different methods over the last few months -- everything, absolutely everything; therapy sessions, various classes and groups -- none of them worked at all," Hitchens continues, oblivious to what he has unleashed. "Then I woke up yesterday and said: ‘Enough.' By the way, don't let me stop you from smoking," he adds airily. "Doesn't bother me. I feel no temptation at all." And so the meal begins with a unilateral cigarette.

Of course, I do want the best for Mr. Hitchens, and hope to enjoy his wit for as long as possible. I should hope Hitch would do what is best for his health. And a big part of me is very happy that he has made this important choice and seems set on succeeding.

But I can't help wondering if altering his blood chemistry will affect Hitch's thinking and productivity. After all, there is a delicate balance between the stimulative and depressive elements of the two drugs. Will Hitch lose his edge? A friend of mine is currently about a month into kicking the habit, and she is as sharp as ever (which is saying a lot), though not much of a drinker.


Judging by the many comments Hitch made in his conversation (Luce wondered how he could eat at all, given how much talking he did), so far, so good for him, too. Hitch covers a lot of ground, from what triggered his exit from the left to the Clintons and his ethnic identity as a new American. This is a great read.

Don't mistake my intentions. I would never urge anyone to start smoking in a way likely to lead to addiction. My own use of tobacco is limited to an occasional cigar, which relaxes and yet sharpens my mind. I don't think I have smoked one for nearly two weeks, which should show that I am not addicted. But I want to acknowledge the truth that there are benefits to limjited tobacco use. As with alcohol.
Today's article on smoking restrictions and the "wellness" movement makes no mention of a politically incorrect truth: some people smoke because they find net positive benefits in it. Nicotine is not just an addictive drug, it is a powerful drug which affects the mind in ways that are often positive.

Now let me add that I do note advocate people taking up smoking. I have no financial interest in tobacco, have never owned a tobacco stock, and if tobacco companies have advertised on American Thinker, I have not noticed it. (I would not get rid of their ads if they did, either. Unless an ad is obscene or patently offensive, we do not screen it out.) My beloved mother died young of lung cancer after trying and failing at quitting cigarettes for a couple of decades. I do not have particularly tender feelings for the industry.

But I do not like bullying, and I loathe dishonesty in the public discussion of issues. And it appears that for some people, smoking is not just a pleasant experience, it is self medication. Eric at Classical Values writes: 

Most people who suffer from schizophrenia smoke. A lot.

This is one of those stereotypes that not only happens to be true, but there's a special reason why schizophrenics smoke:

Cigarette smoking may improve attention and short-term memory in persons with schizophrenia by stimulating nicotine receptors in the brain, according to a study by Yale School of Medicine researchers in the June issue of The Archives of General Psychiatry.

This explains not only why they smoke, but why they smoke so much more than people who don't have schizophrenia. They are engaged in self medication.

Persons with schizophrenia smoke two to three times more than smokers without mental illness, said the researchers. They found that when study subjects with schizophrenia stopped smoking, attention and short-term memory were more impaired, but, when they started smoking again, their cognitive function improved. No effects from stopping or resuming smoking were observed in smokers without mental illness.

Participants with and without schizophrenia were then asked to smoke while taking a drug called mecamylamine, which blocks nicotinic acetylcholine receptors in the brain, preventing the nicotine from acting on those receptors. Mecamylamine blocked the ability of smoking to improve cognitive deficits in schizophrenia, but not in persons without mental illness. The findings suggest that when people with schizophrenia smoke, they may in part be self-medicating with nicotine to remedy cognitive deficits.

Calls like this have been made for more studies, and new, nicotine-like drugs have been proposed, but never offered.

I have a silly moralistic question, based on what many people would call "fairness." Considering the evidence that as many as 88% of these unfortunate people are resorting to self-medication with a legal drug, and considering the medical evidence that it helps them, is it really fair to punish them with punitive taxes aimed at making cigarettes unaffordable?

A few months ago, I ventured into related territory, commenting  on the startling news that Christopher Hitchens had suddenly given up smoking.

Christopher Hitchens has always been a puzzle and delight to me. He brings equal passion to being appalled by Bill Clinton and Mother Teresa, an odd coupling, and is always eloquent and funny, even when dead wrong. A legendary drinker and smoker, he has always struck me as a man whose use of nicotine and alcohol, the traditional lubricants (and devils) of literary genius, was integral to the productive, free-wheeling state of mind he must maintain. Alcohol lowers assorted kinds of barriers, while nicotine sharpens certain faculties.

Both substances can be addictive and harmful, but some believe them almost necessary to the occupation. Which is not to say that observant Mormons can't be literary geniuses. Not everyone needs to drink and smoke to be a great wit. However there is a category of human beings who are funnier, more free-wheeling and in some ways faster, with a drink and a smoke, or (depending on the setting) chaw, dip, or a little snuff up the nose. These days there is even the Patch.


So it is with a certain shock that I learn from Edward Luce of the Financial Times that Hitch has given up smoking. In the course of a description of a long lunch at a restaurant specififcally chosen because outdoor tables allow smoking, Luce learns Hitch has stopped, quoting him:

"I've tried many different methods over the last few months -- everything, absolutely everything; therapy sessions, various classes and groups -- none of them worked at all," Hitchens continues, oblivious to what he has unleashed. "Then I woke up yesterday and said: ‘Enough.' By the way, don't let me stop you from smoking," he adds airily. "Doesn't bother me. I feel no temptation at all." And so the meal begins with a unilateral cigarette.

Of course, I do want the best for Mr. Hitchens, and hope to enjoy his wit for as long as possible. I should hope Hitch would do what is best for his health. And a big part of me is very happy that he has made this important choice and seems set on succeeding.

But I can't help wondering if altering his blood chemistry will affect Hitch's thinking and productivity. After all, there is a delicate balance between the stimulative and depressive elements of the two drugs. Will Hitch lose his edge? A friend of mine is currently about a month into kicking the habit, and she is as sharp as ever (which is saying a lot), though not much of a drinker.


Judging by the many comments Hitch made in his conversation (Luce wondered how he could eat at all, given how much talking he did), so far, so good for him, too. Hitch covers a lot of ground, from what triggered his exit from the left to the Clintons and his ethnic identity as a new American. This is a great read.

Don't mistake my intentions. I would never urge anyone to start smoking in a way likely to lead to addiction. My own use of tobacco is limited to an occasional cigar, which relaxes and yet sharpens my mind. I don't think I have smoked one for nearly two weeks, which should show that I am not addicted. But I want to acknowledge the truth that there are benefits to limjited tobacco use. As with alcohol.