Survey on smoking (2)

After reading the front-page article about the smoking survey I couldn't help wonder the impact on Maltese smoking rates and youth peer pressure if the front-page headline had instead read "Are 30 per cent of Maltese citizens nicotine addicts?"

The Sunday Times missed a golden opportunity to teach "why" nearly 30 per cent of those surveyed smoke nicotine - the fact that nearly all daily nicotine smokers are true drug addicts in every sense, the honest reality that the rising tide of anxieties begin to hurt when they wait too long between feedings.

Here in the US we just witnessed the media give the Virginia Tech mass murderer exactly what he wanted - his picture on the front page. Have you handed nicotine addiction industry executives a gift? On five different occasions the article comforts enslaved readers with warm and fuzzy "habit" assertions such as "smoking is nothing but a bad habit". It must have left industry executives smiling from ear to ear. I submit that Sunday's coverage may actually contribute to an increase in Maltese youth smoking.

Try to think like a teenager. Imagine a front-page story telling you that 60 per cent of smokers "picked up the habit" to foster friendships with other teens, that others did it because it's a "desirable lifestyle". If you were a teen never-smoker, nearly friendless and feeling totally undesirable, such news might seem God-sent. But most disturbing is teaching them that chemical dependence on smoking nicotine is nothing more than a nasty little "habit".

What is a child's definition of a "habit?" Using too many bad words, not wearing seatbelts, talking back to adults, drivers not using turn signals? In their minds, how long does it take to establish a habit and what physical symptoms are experienced by at last buckling-up or not using bad language?

Research has shown that a substantial percentage of youth show signs of dependence after smoking only a couple of times. A 2005 study found that 87 per cent of youth smoking at least once daily were already dependent by DSM-IV mental health dependence standards. Two adult studies put adult dependence at nearly 90 per cent under DSM standards.

The key difference between heroin, alcohol and nicotine intoxication is that instead of experiencing a numb or drunken dopamine high, the nicotine addict's dopamine high is alert. But why do only about 10 per cent of regular alcohol drinkers and 15 per cent of powdered cocaine users become addicted while nearly 90 per cent of regular nicotine smokers become enslaved? It's probably a combination of genetics, the arrival speed (eight to 10 seconds) and size of the bolus striking the brain's dopamine pathways, with the fact that nicotine somehow turns off a key dopamine clean-up or killjoy enzyme (Mayo B) allowing the dopamine "aaah" sensation to linger far longer than with other drugs.

Although your survey shared findings on the amount of nicotine smoked, it failed to mention why. It's called "tolerance" and we know it is somehow related to the brain, over time, growing millions on millions of extra nicotinic type acetylcholine receptors in at least 11 different regions, requiring the gradual smoking of more and more nicotine to again achieve the previously remembered effect.

All drug addiction, including nicotine, is about the brain's "pay attention" dopamine pathways, the mind's priorities teacher, being taken hostage by an external chemical. All memory of the beauty of a once nicotine-free life gets quickly buried under a pile of the most salient memories the mind appears capable of generating.

Obtaining that next nicotine fix quickly becomes the number one priority in life, more important than eating, accomplishment, friends, sexual relations, getting cancer, that approaching heart attack or doing harm to the deve-loping fetus inside the expectant mother.

I encourage The Sunday Times to devote the journalism needed to alter Maltese "group think" on why people smoke. Flavour, taste? There are no taste buds inside human lungs. Pleasure? Those enslaved don't smoke because they like smoking but because they don't like what happens when they don't smoke. To calm stress? Anxiety generates acid and nicotine is an alkaloid. Nicotine simply satisfies its own absence.

Knowledge truly is power. Imagine watching 50 per cent of adult smokers actually smoke themselves to death, here in the US an average of about 13 years early. Treating nicotine dependence as a true addiction puts a bright line in the sand for both dependence prevention and cessation. There's only one rule that 100 per cent guarantees neuronal freedom to all youth and adults... no nicotine today!