The FDA is considering regulating menthol in cigarettes, saying it makes it easier to start and harder to quit, and makes smoking more attractive to young people. We also consider a new study showing how smoking increases the likelihood of drinking more, and the way the dopamine reacts in the brain.
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Howard: Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions, I am Howard La Mere. There were a couple of articles about smoking I think we should talk about today. we’re going to focus on today. Also, a couple of things – just some highlights from the news here a new anti-addiction compound, although Darryl says we talked about it before acting on the kappa opioid receptor and it sounds like the drug might somehow be related to Salvia How do you say that?
Darryl: Salvia divinorum psychedelic purple sage.
Howard: Purple sage, right. Also.there were a number of stories suggesting that sex addiction isn’t real… and a couple of interesting smoking studies. The FDA is moving towards banning or severely regulating, at least, menthol in cigarettes a subject we talked about before and the discussion actually prompted a comment from a tobacco company saying what you said about menthol was not true. There was another study on rats, of course poor rats…. we put them through such torture…..showing the relationship between smoking and alcohol. So Darryl, where should we go first?
Darryl: They’re all interesting. You found some good stuff this week, Howard. Let’s start with salvia divinorum, it is of course, a psychedelic and it’s legal in some states and some states have banned it. It’s been on the list of drugs and chemicals of concern from the Drug Enforcement Administration for some time but is not banned because it’s heavily used as a psychedelic and creates a short term major entactogen, empathogen…entheogen all those names mean a major LSD type psychedelic affect for a short time after you smoke it. And, it must be smoked or taken under the tongue because it’s destroyed by stomach acid. It’s been known for a long time that it does its psychedelic effects through impacting the kappa receptor which is an opiate receptor that when activated with anything like dextromethorphan DM or DXM.it creates psychedelic effects. Recent studies are focusing it as a potential blockage of opiate addiction the kappa receptor turns off the long term potential of dopamine which is what reinforces the development of addiction. and there are other drugs that aren’t as psychedelic. BNI is one that is being developed to treat addiction, especially opiate addiction, by impacting that receptor and modifying the effects of dopamine release and the long term potential of GABA. And so this recent study linking salvia divinorum to that same effect is not surprising, although I think it comes at a heavy price because it may cause some people to have major psychedelic effects from the dosages.
The articles that really interested me were the various nicotine stories that came out in this past couple of weeks. The FDA’s move toward controlling or banning menthol in cigarettes is big. The biggest criticism, the biggest response we’ve ever gotten as a result of this podcast was when we reported research showing that there was a higher propensity of African Americans favoring menthol compared to other types of cigarettes – we got a tremendous amount of criticism a lot of it from the nicotine industry.
Howard: Although it turns out to be true.
Darryl: Well, the way this was presented was that there are a lot more non African American menthol users than African American users – and that’s true, but when you look at the proportion of those ethnic groups that smoke cigarettes.the proportion of African Americans smoking mentholated cigarettes is much higher than the portion of Anglo Americans or Asian Americans smoking.
Howard: But overall the percent of mentholated cigarettes is between a quarter and a third.
Darryl: Right. A quarter of all the cigarettes sold today are mentholated cigarettes and the FDA is examining studies that show that the mint flavoring makes it much easier for people to start smoking and to cope with all the negative effects that are typical with a first exposure to nicotine and so people are more likely to start smoking on mentholated or mint cigarettes and have a harder time quitting. So the FDA is looking at the research, conducting hearings and examining this closely and it is being done while the tobacco industry claims these cigarette flavorings are not a direct attempt to addict anybody or focus on any ethnic population. I think there’s enough validation in what the government is doing to make it all real. But in the face of all of that, there is an opposite opinion and some people say that what’s happening with menthol is really an attempt at a payback for the United States banning clove cigarettes because they were predominantly targeted to underage smokers.
Howard: Wasn’t tobacco a component?
Darryl: In some of them, but many just contained clove.
Howard: Cloves are remarkably hard on your body – they are sharp like diamonds, that’s part of the effect.
Darryl: I think the effect is not the hardness of cloves, but the spice flavor it add to the tobacco. Some people are claiming, based on the World Trade Organization ruling, that the United States was getting pay-back for the ban on clove cigarettes – and now they want us to stop selling mentholated cigarettes not only in this country, but throughout the world. Mentholated cigarettes are the growth segment of the cigarette industry because studies show it encourages use. It is something like the free based nicotine that we talked about some time ago.something that makes nicotine have more impact on the user and promotes more addiction. So that was a fascinating story, I must admit.
Howard: Yes it will be interesting to see how this plays out because there are a lot of menthol smokers and they’re not going to like it if they don’t have their mentholated cigarettes anymore. Let’s move on to some of these other stories. A few weeks ago we talked about how the packaging of cigarettes has an effect on people a remarkable effect actually – there are plain packages and in some places there are very graphic, very scary images on the package those make the cigarettes a lot less attractive. Anyone who smokes or frequents bars – especially before cigarettes were banned in bars is aware of the natural relationship between smoking and alcohol perhaps even excessive alcohol drinking. A new study backs that up and it actually had some surprising conclusions about the dopamine levels so, Darryl you want to fill us in on that?
Darryl: Both of those topics are interesting. Australia is crediting the stark advertising showing the negative impact smoking has on your health – the images are of diseased lungs or amputations or something equally as unpleasant – with the dramatic decrease in the number of smokers there. And I think that story really is more about the tremendous advertising and marketing power used to control and create people’s appetites, create people’s needs and wants and promote their products – especially here in the United States. A few weeks ago we talked about the flavoring in electronic cigarettes which may enhance the effects of nicotine. Manufactures are coming out with all these exotic flavors to entice people, but it’s also the marketing because people in Paris line up and can’t wait for the next flavor to come out. But the other thing you mentioned really peaks my interest was a study Dr. John Dani, a researcher at Baylor College conducted on rats. He set up little cocktail parties for rats to see how nicotine effects the rat’s appetite for alcohol. It has been known for some time that people who smoke are more likely to drink and people who drink are more likely to smoke and people who smoke and drink are more likely to have alcohol problems than those who don’t. Well, these little rat cocktail parties validated that. He gave a little bit of nicotine to rats prior to offering them alcohol and over time the rats became addicted to nicotine and began to drink more and more alcohol. The researchers believed the increase in alcohol consumption was because both nicotine and alcohol release dopamine so you end up with higher amounts of dopamine, especially in the reward/reinforcement pathway and in the conscious brain, making you want it more and more. But upon further study of the impact of both alcohol and nicotine on the brain they found that actually a lower amount of dopamine was being released. I’ve always believed that to be true. I think initially in either an animal or a human being, the brain is going to release extra dopamine to give you this false promise that these 2 things (nicotine and alcohol) are going to produce the best satisfaction ever, but constant exposure to both those substances actually depletes dopamine and addiction is the result. Using drugs decreases dopamine and that is when the craving happens – people seek drugs to get that dopamine effect just to feel normal. This is what happens when you start twisting these neurochemicals around – whether it’s hyperactivity or hypoactivity or a different diverted activity. It reminds me of trying to fix my car when I was growing up. I’d get twisted up and bent up underneath a car or inside an engine and I wouldn’t know which way I was turning the bolt. I’d get all confused and that seems to be what the science on neurochemistry is right now. Back to the rats – the study found that lower dopamine levels were released in rats who were given nicotine and alcohol – hypnotizing that nicotine mutes the effect of dopamine release when alcohol is consumed. So when somebody drinks alcohol and they’re expecting a certain effect and it does not happen – they are likely to continue to drink to make it happen. The more they drink, the more toxic it is the more they smoke they end up with a combined nicotine and alcohol addiction which is very common. Oregon banned smoking in treatment programs – but the ban does not stop clients from smoking – just from smoking while you are physically in a treatment facility – you have to go off site to smoke. It’s hard to get people to give up both but the reality is unless you get them to stop both, it’s harder to stop either one. So it’s a catch 22 situation until we come to grips with it but I like the rat experiments. I like that it shows that nicotine and alcohol are definitely related in their addictive properties and can be linked together as codependent on each other.
Howard: What’s your thinking about the symbiotic relationship there that makes them balance out rather than doubling as we’d expect
Darryl: I think it’s that twisting of the wrench. Are you twisting it one way or the other way? Which way are you going because instead of a symbiotic effect, you’re actually getting, I think, an antagonistic effect because you are prevented from experiencing the reward you expected from either drug when you use both drugs and so you take more in order to realize your expectations. It twists itself back into a symbiotic relationship where someone uses more of both drugs because they are actually lessening effects from either drug by using them together.
Another story you mentioned – from the July 18th Frontiers in Psychiatry had to do with the brain circuitry involved with nicotine as it relates to alcohol and other drugs in terms of craving and relapse. Specifically, this study looked at the posterior cingulate cortex and observed diminished activity which affects making decisions. Basically, when someone is in withdrawal and they are craving, there is a high activation of the posterior cingulate and the cingulate body. So again, it’s how these things twist up and maybe cigarettes mute or turn off the cingulate body instead of turning it on but then when you’re without cigarettes, the bonding has occurred and then the cingulate turns on and you’re craving more – this helps explain why there’s such a deep craving for cigarettes and why it’s still the most difficult thing to get off of – more difficult than heroine much more difficult than alcohol much more difficult than marijuana or Vicodin. Nicotine is the most difficult drug to stop altogether because of the craving that it creates. Science is trying to unravel that mystery as well…and they are using rats. I know…we pick on the rats a lot and pick on the mice a lot, but.
Howard: At least they get parties once in awhile!
Darryl: That’s true! You know, they get to have fun while they’re in these research experiments….for a little bit….until they get heavily addicted. The thing is, these animals have 90% of the same genes that humans and all mammals have and even though they’re small they have basically the same brain chemistry and the same brain networks that humans have in the primitive subcortical levels of the brain – and so, many things that we see, especially in the unconscious part of addiction the subcortical part of addiction, because that’s the part where compulsion and obsession sets in, it is in that unconscious area of the brain not in the area that experiences feeling high, but in the unconscious area of the brain.
Howard: Well so much of the whole process goes on in the subconscious part of the brain and as we point out from time to time, you can work on it. It takes a lot of work to address your addictions or whatever you might be working on, simply with your cognitive intelligence because the subconscious part the old brain part is so powerful. So, that’s an ongoing struggle I think for anyone trying to make any kind of change.
Darryl: Well, it’s good you should say that, Howard, because there’s a study that came out in July in the British Journal of Psychiatry that looked at cognitive abilities in people who are smoking and drinking as well and they found that when you combine the two, you get a much more rapid decline in cognitive ability. All drugs turn off the brain. We’ve seen that in brain scans and other studies that have been going on, but this study indicates a 36% faster decline in the cognitive abilities of the brain – meaning that the brain cells have been turned off when heavy drinking with heavy smoking are combined. So cognition is a big issue and although that can come back for most people who are addicted, it takes awhile after they quit before their cognitive levels come back to normal.
Howard: Well fascinating stories all and we’ll hear more about all of them I’m sure. Right now we are out of time. Thanks to all our listeners for tuning in and remember your comments, questions, and suggestions always welcome. Drop us a note on our website, cnsproductions.com. Darryl, thank you very much.
Darryl: Howard, thank you for letting me talk about the rat research stuff! They always seem to excite me!
Howard: Remember to invite them to the next party! That wraps our pod for today. Please check back soon for the next in the series and visit our website, www.cnsproductions.com