Last week I finished reading one of the most quirky books- The Tipping point by this even quirkier guy Malcolm
Gladwell. The book in overall is an interesting read. Malcolm's
idiosyncratic opinions on topics like social epidemics and popular trends are
worth contemplating. His dissection of various case studies seems distinctive
and engrossing (even if it’s not completely scientific but its close!). The
book will be a good read for anyone interested in marketing world, human
behavior and social psychology in general.
While near the end of the book (chapter seven), Malcolm talks
about teen suicides in Micronesia and smoking issue currently prevalent across
all cultures in the world with America as a reference. It is the latter
that intrigued me the most. Malcolm eloquently presents the case of smoking
epidemic; he goes through the cause of it, the erroneous solutions to the
problem, and what makes smoking addictive among people.
The main reason he argues that people, teenagers more so take up
smoking is: to look cool, they try to imitate people who are either their peers
who smoke, and are famous or popular among other kids, or someone in their
family/society who is sensation seeking, adventurous and risk taker, impulsive,
defiant and indifferent to opinion of others- basically a person adolescents usually
look up to. The problem arises when one tries to fight this problem of teenage
smoking by making adolescents aware of the dangers of smoking, or by trying to convince
them that smoking isn’t cool. It has failed terribly in both cases! For example
in the case of former, when teenagers were asked to report on the possible decrease
in average life span of a smoker compared to someone say a non-smoker, majority
of them replied with 9 years which was more than the actual answer which was
6-7 years. It is clear that teenagers knew about the dangers of smoking, what
is amusing is that they actually overestimated them! In the case of latter
however, the result is the same. Telling teenagers that smoking isn't cool doesn’t
help, because they already know that smoking isn’t cool, for them it is the smoker who is cool! (We all know how
cool and dashing Johnny Depp looks while smoking or how intellectual Christopher
Hitchens looked with a cigarette; more so how we have managed to completely
convince ourselves that smoking to create art is a prerequisite).
Another important thing to point out here is that among the
majority (75%) of people described their first smoking experience as unpleasant.
And only a handful among these went on to try it again. The rest became
aversive to smoking. The other 25% however described it as pleasurable. They
felt a buzz (a phrase that every smoker is aware of). Most of them went on to become
heavy smokers. This difference is truly incredible according to me. Now one
might ask that why such a difference was there? Why one type of people felt the
buzz and others didn’t? What was going on in the Brain/Body of these two
people? The catch here my friend is that the ones who described their experience
as unpleasant were the ones who were genetically predisposed to be sensitive to
nicotine; simply put, their bodies could not handle nicotine beyond a certain
level as it became toxic. And the ones who described a feeling of buzz had a
much more tolerance for nicotine. It is very obvious then, the more nicotine
one can tolerate, the more one smokes. It is similar to for example alcohol
consumption; people who have higher tolerance for alcohol drink much more than
people who are sensitive to alcohol ( I belong to the first category and have
had a first-hand experience in this, damn!).
The way nicotine works at the cellular level has been extensively
studied in the cholinergic neurons in the Brain. Nicotine mimics the neurotransmitter
acetylcholine and enters the neuron through these acetylcholine receptors and
causes them to release huge amounts of serotonin and norepinephrine, both of
which are known to lead to happiness and mood elevation (well, that explains
the buzz!). Certain drugs like bupropion which was originally an antidepressant,
interestingly came to be helping people quit smoking by making use of this
mechanism. By avoiding the reuptake of norepinephrine and serotonin in neurons.
Hence there was much more serotonin lying around in the brain so the feeling of
happiness and euphoria remained longer. And people had no desire or need to
smoke (because they were already high without a cigarette). It has also been reported by some research groups that for heavy smokers it is not actually the nicotine from the cigarette that gives them a buzz but its the anticipation of smoking that starts releasing serotonin their brain even before they took the first puff (classical conditioning at play here). It tells us how vulnerable we all are when it comes to chemicals and the brain. It also helps to explain why people with depression revert to smoking, for in depression the neurons in the brain release less dopamine and serotonin, hence by smoking the subjects are actually treating themselves (well only for a short while) by releasing enough serotonin in the brain which compensates for feeling low. (but could smoking be a solution for treating patients with parkinsons? as they too have less dopamine in their brains. well we leave that for now).
Eureka! It struck me then that there could be two possible
solutions to this problem! 1. Why not make tobacco companies increase the
amount of nicotine in a cigarette from 1mg nicotine/cigarette to 3-4 mg
nicotine / cigarette? so the people who were smoking say 20 cigarettes a day
would now be smoking less because they get enough nicotine through fewer cigarettes.
However, this is a sort of suppressive measure, one which might lead to people
being still smoking but less; it would not solve the epidemic but reduce the
number of deaths.
2. The second and a more potent solution is why not give people an
anti-nicotine shot. Like the one you get for vaccines during childhood (Obviously
you would give this one to teenagers and above). But imagine a shot which -irrespective
of the genetic makeup of an individual- would make him highly sensitive to
nicotine, reduce their threshold to nicotine. Basically you take bottoms up approach and create a scenario wherein
even if a person smokes, they get an unpleasant feeling because of artificially
induced nicotine sensitivity. We just have to find a biological mechanism to
fine-tune or alter to make this a real, possible, less risky and an applicable
solution, which is more than possible with the current biological information
and technology humans possess! This technique could also be applied to people
who already smoke as well. But most importantly we would be successful in rendering
the upcoming generation free of smoking. Now I don’t deny the fact this is
indeed is a long term solution and needs a lot of research and careful scrutiny.
Moreover, it might not be the best solution available. But, it is definitely
better than trying to make smoking uncool by ludicrous advertisements or employing
huge taxes on cigarettes, banning them in public since they all seem to be totally
ineffective.What all these approaches have failed to recognise is that teenagers will look up to these cool people, they will experiment with smoking, one cannot stop it. Instead what we should make sure is that their experimentation does not have further consequences. I see the solution of anti-nicotine shots as one that truly has huge potential with minimal or no consequences
and is worth pursuing further. You can consider it like we are giving full
freedom to a person: go on and try smoking and smoke as much as you would want,
but the question is would you want to?
I am not an expert on nicotine or smoking but then again
non-experts are the ones who create the most disruption! As an ex-smoker and
one who has gone through all of the typical phases of smoking, I can say we
might finally have a solution to the smoking
epidemic.
Thanks for reading.
And as always stay curious and remember: smoking kills, and if you
die you lose a very important part of your life! --I don’t know who
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