
Tobacco and Psychosis: not quite a smoking gun - DanBC
http://anp.sagepub.com/content/49/10/859.long
======
Turing_Machine
Wait: if tobacco use were actually the _cause_ of psychosis, wouldn't we
expect to see a dramatic reduction in the prevalence of psychosis in the
United States, given that the smoking rate in the US has declined by over
fifty percent in recent decades?

As far as I know, there has been no such decline.

What we _have_ seen is a large increase in the incidence of depression, and
tobacco has been persuasively shown to have antidepressant effects. Nicotine
is, of course, a powerful stimulant, and tobacco also contains monoamine
oxidase inhibitors (which also have antidepressant effects).

~~~
TylerE
I wonder if there is any correlation with the obesity epidemic as well, since
nicotine's appetite suppression is also well documented.

~~~
Turing_Machine
Good question.

~~~
simplemath
Grab your white jumpsuit and fire up a heater.

------
mgraczyk
Hypothesis: All mind-altering substances precipitate the onset of, and worsen
the symptoms of schizophrenia. The strength of the effect depends on
interactions between the substance and brain systems we do not yet adequately
understand.

There may be nothing special about nicotine except that it is psychoactive. We
will need to learn a whole lot more about the brain before we can figure out
why nicotine might have a more profound effect than, for example, caffeine.

~~~
loceng
Some stream of consciousness writing: I would add to that that the body,
brain, mind are in part pressure-based systems and normally if all systems are
functioning and energy is flowing as it needs to - then pressure in one or
multiple areas won't rise, however if those energies aren't flowing for
whatever possible causes - then problems can occur and worsen over time as the
brain has its natural systems that will keep evolving and applying pressure;
if "you" understand Qi (chi) and how energy can become stagnant in the body,
this may be easier to comprehend -- stagnant energy, blocks or buildups, in my
experience leads to actual pain sensations in the body, and a simple
acupuncture session can help alleviate or eliminate the pains (until perhaps
the energy buildsup again); this doesn't necessarily mean it will reduce the
baseline of existing causes, that would require more work.

~~~
nilved
Qi does not exist.

~~~
colordrops
Qi doesn't exist the same way that software doesn't exist. It's an abstraction
that labels an emergent phenomenon. Software is made up if zeros and ones
which actually don't exist but are labels we give to certain states of
organized matter and energy. The same goes for Qi. It's the perception of a
composite of the various aspects of a body's state as well as mental awareness
of that state, such as relaxation in a specific part of the body. It's more
detailed than explained here, but that's the jist.

~~~
austinjp
Qi is neither necessary nor sufficient to explain or describe any physical,
emotional, cognitive, social or "spiritual" phenomena. It is certainly not
emergent (nor is software). To paraphrase Dawkins, you already don't believe
in homunculi, aether, or many other previous attempts to explain our
experience of being ourselves. Qi is just another thing to not believe, try
it.

~~~
colordrops
> Qi is neither necessary nor sufficient to explain or describe any physical,
> emotional, cognitive, social or "spiritual" phenomena

Care to be more specific? How do the terms "necessary" and "sufficient" come
into play? It's not a binary "all" or "nothing" distinction. If something
helps you even a little bit, then it's valuable. An easy to grasp model of
your body's state can help you maintain awareness of that state, and thus
improve it.

Also, what do homunculi, aether, etc have to do with Qi? Qi is a useful
abstraction. I've never claimed that it exists as an objective property of the
universe.

~~~
austinjp
Hi there.

Sure --

"Necessary" and "sufficient" are technical terms:
[https://en.wikipedia.org/wiki/Necessity_and_sufficiency](https://en.wikipedia.org/wiki/Necessity_and_sufficiency)

You described Qi as "the perception of a composite of the various aspects of a
body's state as well as mental awareness of that state". I'm saying Qi is
neither necessary nor sufficient to perceive these things.

Similarly, I could say "Aether carries the mental awareness of my body's
state". Or "Tiny homuncli exist in my brain, and it's the job of one of them
to make me aware of my body's state". These things are neither necessary nor
sufficient to explain awareness of ones own body. Consequently they could
detract from explanations that may be genuinely useful.

It seems difficult to point to exactly what Qi is, and how it's different from
similarly vague postulations.

Whether your idea of Qi helps you or not wasn't mentioned in your previous
comment, so I wasn't responding to that.

If Qi is simply an "abstraction" then we can call it whatever we want. Why
call it Qi?

If Qi is not "an objective property of the universe" is it entirely a
subjective property of whoever believes in it? If that's the case, I'd
struggle to understand how "useful" it is.

Certainly, I can see that things like self-awareness, relaxation, mindfulness,
stillness and so on are "useful". They can be potent, restorative, healthful,
etc, and we can demonstrate those effects through experiment. Unfortunately
concepts like Qi tend to unravel in the light of experiment because they are
so indefinable. Or more accurately: the definition constantly seems to shift.

Not everything is definable, of course. I have no issue with finding beauty,
wonder and awe in life. In fact -- that's probably one important element in
living well.

Ultimately I don't particularly mind if you believe in something called Qi,
although I find it odd, and I hope you have a happy life :)

------
kruhft
Nicotine is a powerful _anti_ -psychotic. This has been known for many years
and was one of reasons doctors used to prescribe smoking to patients. Most
schizophrenics use it for that effect; the idea it causes it is somewhat
ludicrous.

------
neverknowsbest
They didn't address the confounding variable that these disorders are caused
by dopaminergic issues, which are present even before becoming floridly
psychotic. High levels of dopamine = low levels of arousal, so the slight
elevation caused by tobacco smoking is probably pretty appealing.

Only first person experience, here, but I can say antipsychotics (which are
dopamine-receptor antagonists... hence the "thorazine shuffle") cause these
bouts of sedation that are made much less uncomfortable by simply having a
smoke.

~~~
DanBC
The hydrocarbons in cigarette smoke interact with the anti-psychotics - it's
well known that people who smoke need to take larger doses of their meds.

------
bjourne
But wait a second. An easy counter argument to the theory is that smoking has
significantly decreased all over the Western world. So, if the number of
schizophrenics hasn't decreased proportionally, then tobacco smoking can't be
a major factor.

~~~
irremediable
Agreed, with the caveat that mental illness diagnosis has become more common
over the past century. (Though I'm not sure whether people have become more
willing, in the past couple of decades, to diagnose schizophrenia
specifically.)

------
vonklaus
Here is a paper that really exemplifies Paul Graham's _Write Like You Talk_
article, which is currently on the FP. I wish these articles were written for
the public and were at least somewhat easy to digest.

~~~
DanBC
It's a shame you got downvoted, because you make a good point. This article
doesn't have to use as much jargon as it does; it doesn't have to use English
in the confusing way it does.

I want MH trusts to go smoke free. That involves me telling people why that's
a good idea, and that would be much easier for me to do if articles like this
were written in plainer English.

Some jargon would still need to be used. For example they're talking about
psychosis and first episodes of psychosis so that needs to stay.

~~~
vonklaus
Thanks. I smoke and I found the title and subject matter interesting. I am not
a genius but am perfectly capable of understanding the article. It is just
mentally taxing trying to wade through a sentence structure that seems aimed
at a goal of obfuscating knowledge and proving the writer is intelligent
rather than disclosing the information in a terse digestible way. Below,
someone pointed out that there are many grammatical errors as well. I have
thought a lot more about long form articles in publications like the New
Yorker and NYT, etc. While often criticized for over simplifications and lack
of understanding of subject matter, they often present articles in a way
casually interested parties will understand. I don't have a problem with the
jargon, large/obscure word use (to the extent it is reasonable) or otherwise
employing tactics to get the point across. It is just that, as someone
casually interested (not an academic looking for citations) I don't really
know what to do with this sentence: > Cannabis use almost always predates
psychosis, is associated with an earlier age at onset (Donoghue et al., 2014;
Myles et al., 2012b) and heavier and more potent cannabis users have an
increased risk of developing psychosis (Di Forti et al., 2009) and do so at an
earlier age than people smoking milder cannabis (Di Forti et al., 2014). I
wish they would just use superscripts for citations, as a significant portion
of that sentence is citations. If academics would just edit the papers, dump
them into Tufte CSS or LaTEX with sitations as footnotes or sidenotes and
adapt a style human beings could digest without collapsing to rest from the
boredom and dull overly-complex structure I think they may find a readership
base that exceeds the single digits it currently has. Do you know of a place
with interesting articles written for non-academics? I think that would be a
cool thing and sure it exists? Cheers.

------
werber
> Researchers have often overlooked the obvious – that almost all cannabis
> users also smoke tobacco

Is that obvious? Out of the people in my life that smoke pot, less than half
smoke cigarettes.

~~~
neverknowsbest
This is my experience too- the overlap isn`t that pronounced at all. All the
pot smokers I know don`t smoke cigarettes, don`t like cigarettes, and while
they`ll light up a joint in their own home, ask cigarette smokers to do their
tobacco smoking outdoors

