Summary of Huberman Lab Podcast Episode: Nicotines Impact on Brain & Body: Quitting Smoking & Vaping | Huberman Lab

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Introduction

• Dr. Andrew Huberman, Ph.D. is a Professor of Neurobiology and Ophthalmology at Stanford University School of Medicine. His lab focuses on neural regeneration, neuroplasticity, and brain states such as stress, focus, fear, and optimal performance.
• In this episode of the Huberman Lab podcast, Andrew Huberman takes a deep dive into all things nicotine: how it impacts the brain and body, positive uses when not smoked, differences across delivery methods, and how to quit.
• Host: Andrew Huberman (@hubermanlab)

Refresher: Neuroscience Of Focus

• Epinephrine/adrenaline, acetylcholine, and dopamine work together to facilitate the ability to get focused, direct focus, and stay focused over time
• Epinephrine/adrenaline is released in the brain and body and increase energy and alertness (but not focus)
• Epinephrine is necessary but not sufficient for focus
• Acetylcholine released in the brain highlights specific neurons that should be active at certain timepoints
• Acetylcholine directs attention and focuses to a specific spot
• Dopamine is necessary for ongoing focus
• When all else fails, maybe supplement with alpha-GPC: more acetylcholine is synthesized after ingesting; a dose of 300mg prior to workouts or work bouts – 10-20 minutes prior to when it’s needed

What Is Nicotine?

• Nicotine does not mean talking about or encouraging smoking cigarettes
• Nicotine is found in the tobacco plant & in low doses in nightshades (e.g., tomatoes, eggplant, sweet peppers, potatoes)
• Nicotine is used as a pesticide because it renders insects infertile so is useful as the protection of plants
• Burning tobacco increases the availability of nicotine – this is why smoking & vaping are popular forms of ingestion

Nicotine & The Brain

• There are nicotinic receptors (in the acetyl cholinergic family) in the brain to which nicotine can bind and exert its effects
• The main effects of nicotine in the brain are through the binding of the alpha-4-beta-2 receptor (this is why nicotine suppresses appetite, more on that later)
• Nicotine can be protective against certain types of cognitive impairment
• Nicotine takes about 2-4 minutes to hit the bloodstream is chewing or getting through means other than smoking which is much faster
• Nicotine can pass through the blood-brain barrier
• 4 major effects of nicotine on the brain and neural circuits: (1) mesolimbic reward pathway: triggers release of dopamine and increases levels; (2) increases availability of acetylcholine: increases attention, focus, and concentration; (3) increases epinephrine & norepinephrine: net effect is an increase in alertness and arousal; (4) appetite suppression
• The stimulation of dopamine release through the mesolimbic reward pathway & reduction of Gaba is what makes dopamine so hard to quit

Nicotine & The Body

• The effects of nicotine on the body happen in parallel to the effects on the brain
• Nicotine is fat soluble so can move relatively free through the brain and body
• Effects on the body: increase in heart rate, increase in blood pressure, increase in contractability of heart tissue – puts the body in a state of alertness & physical readiness
• Paradox: nicotine has a global effect of increasing readiness but also relaxes skeletal muscle
• Nicotine will not help physical performance but can help cognitive focus in the short term
• There may be benefits to ingesting nicotine (not through smoking, vaping or dipping) so long as the brain and body aren’t developing (don’t use if 25 or younger)

Dangers Of Vaping

• When you’re vaping, you’re not getting tobacco – vape pen design is liquid + low heat to vaporize nicotine and allow it to enter bloodstream quickly
• Vaping delivery method (not potency, delivery method) is similar to smoking crack cocaine – both deliver very rapid increase in concentration in the bloodstream
• Because of its speed of onset, dopamine rapidly spikes, causing it to be extremely habit-forming and addictive
• Youth under 25 are vaping at alarmingly high rates – their brains are getting wired for the dopamine release
• Side effects of vaping: (1) increased levels of depression because with repeated use, eventually dopamine drops below baseline; (2) permanent impairment of the dopamine system; (3) harder to quit than smoking

The Harms Of Nicotine Ingestion By Delivery Method

• “For every pack of cigarettes smoked per day, you can estimate a 14-year reduction in lifespan.” – Dr. Andrew Huberman  
• Smoking & vaping reduce penis size and can hinder the ability to get an erection by reducing blood flow to the tissue
• Smoking, vaping, dipping, and snuffing negatively impact every organ and cell of the body because they damage endothelial cells (which are responsible for delivering blood throughout the body)
• Smoking & vaping increase rates of heart attack, stroke, and cognitive decline (short-term memory lapses, working memory declines)
• Downside of chewing tobacco/dipping: 50% increase in mouth cancer, increased risk of cancer of the mucosal lining
• 12-25% of people ingest tobacco despite the fact that it’s one of the most preventable leading causes of death in the world

Quitting & Withdrawal Symptoms

• About 70% of smokers say they want to quit but the addictive properties & withdrawal effects make it tough – this is not reflexive, it takes work: only 5% are successful at quitting, and 75% relapse within the first week
• Within 4 hours of cessation feelings of agitation and craving (because of a drop in dopamine that dips below baseline)
• Hypnosis: self-hypnosis has a 23% success rate after just one time (check out Reveri for the smoking cessation hypnosis)
  • Try Getting Hypnotized – The Train Ride to Greatness by Joshua Lisec
• Pharmacological approach: about 20% success rate with Bupropion AKA Wellbutrin which helps with withdrawal symptoms (side effects: seizure, contraindications with benzodiazepine)
• A nicotine patch or gum maintain levels of nicotine in the bloodstream (maybe eventually tapering)
• Transdermal patches provide a steady state of dopamine throughout the day
• Cycle methods: intermittently rewards dopamine system by cycling approaches each week – patches, then gum, then nasal spray
• Risk of alcohol: there’s a high relapse of smoking if you’re drinking, be cognizant of this if your goal is to quit
• Note: the smoking cessation methods are really targeted at smokers – it’s likely vapers will need something much more aggressive

Resources

• Articles
  • Predictors of smoking abstinence following a single-session restructuring intervention with self-hypnosis (The American Journal of Psychiatry)
  • Effect of hypnotic suggestion on cognition and craving in smokers (Addictive Behaviors Reports)
  • Pharmacological Approach to Smoking Cessation: An Updated Review for Daily Clinical Practice (High Blood Pressure & Cardiovascular Prevention)
• Apps
  • Reveri