The “Smoking” Gun

Today’s article is a fun one, and not as controversial as it will seem at first blush. Smoking is bad for you. This, rather like vaccinations and statins being good for you and saturated fat being bad for you, is just one of those things we all know. Only a fool could think that smoking might provide benefits… But wait! After all, we’re seeing significant evidence that statins and some vaccinations are either bad or very bad, and that saturated fat is either harmless or beneficial, and very beneficial compared to most PUFAs. Could smoking have health benefits? Before you turn away in disgust, give me a few minutes and explore this with me.

Over the last several decades, it has become popular to examine the Blue Zones, those places, and those communities where people tend to live the longest and be mostly free of many of the leading causes of death. The idea being that if we all lived and ate like they do, we’d all live to be 100 or more. Research from the Blue Zone in Loma Linda California, consisting of mostly Seventh Day Adventists, who are predominantly vegetarians or vegans, became part of the vegetarian/vegan mythology. This group ate virtually no meat and outlived their carnivorous neighbors living only a few miles away. Well heck, you might say; it worked for them, it should work for me.

But while all elephants are gray, not all gray things are elephants. The fact that a community of vegetarians live longer than omnivores who live nearby does not constitute proof that their lack of dietary animal protein is the magic bullet. Perhaps it’s their monastic lifestyle, the praying and the attitude of gratitude and love. After all, we know that anger and hatred have deleterious effects on brain chemistry, and changes in brain chemistry can cause many physical illnesses. The fact that Quakers and the Ahmish live longer may support their back-to-the-basics lifestyle, but let’s not forget that they never get into high-speed automobile accidents, nor DUI crashes into trees and buildings. Quantifying the magic ingredient requires study.

The problem here was that there were more pieces to this Adventist puzzle than just their diet. The jury is still out on whether vegetarianism is the key, or whether certain blood types might be the best adapted for vegetarianism, and whether the absence of meat in their diet is the key ingredient for longevity, or just an accident of chance. But today’s post isn’t about that. It’s about a different Blue Zone, Okinawa Prefecture, in Japan.

Although the conversion of Japanese youth, many now aging up through adulthood to middle age, to a more western/American diet, including fast food and convenience foods, soda, and the like is causing a decrease in life expectancy for the Japanese, I believe that part is a no brainer. Don’t eat junk, and don’t eat stuff that isn’t actually food, but someone’s science project.

But an interesting characteristic of the Okinawans is that not only do they regularly live to 100, they are among the world’s leaders in tobacco consumptions, smoking! Surely there has to be some weird twist that can be explained away by other factors: A stoic lifestyle that includes martial arts and meditation, eating lots of fermented foods, eating lots of rice and seafood. Perhaps these things ameliorate the effects of tobacco smoke. Is there a magic fruit, like the Goji berries loved by Chinese and Tibetans. Or perhaps Japanese cigarettes are unique… they aren’t. Other “smoky” Blue Zones include Sardinia and the Icaria region of Greece. Why do American smokers suffer higher cancer rates and dramatically reduced life expectancy, but these folks don’t?

What research is telling us, and it is early to draw strident opinions, is that the nicotine in cigarettes may be as good for you as the tar is bad for you. Tar from cigarette smoke can paralyze the cilia in your lungs that helps clear out dust and other undesirable substances that we breathe in daily. After years of smoking, the accumulation of toxic matter, including tobacco residues, in the lungs can lead to all sorts of negative conditions. But the nicotine, aside from being somewhat addictive, is showing some very interesting positive effects. Nicotine has been shown to upregulate uncoupling protein 1 (UCP1) a highly beneficial metabolic cofactor, viz: Uncoupling proteins, dietary fat and the metabolic syndrome. While there are other methods for enhancing UCP1, it would appear that nicotine, if separated from cigarette smoke, may be the simplest.

Those potential benefits are connected to nicotine in this study: Alterations of Mitochondrial Network by Cigarette Smoking and E-Cigarette Vaping

While this article underscores the negative effects of habitual, long-term cigarette smoking, this nugget several paragraphs in, shows that there are positive effects, and perhaps intermittent smoking may have benefits, as experienced by Okinawan smokers: Interestingly enough, these proadaptive mitochondrial morphology changes were accompanied by increased metabolic activity and ATP levels without causing an increase in mitochondrial superoxidases. The studies thus far indicate the important role that dosage and exposure to CS play. Initial responses triggered by CSE are primarily protective. However, these protective changes can lead to irreversible damage or exacerbate pathological processes in dose and time-dependent manners.

More importantly, the “dose and time-dependent” variables provide us some potential insights. Native Americans, the folks who introduced tobacco to the western world, famously smoked the “peace pipe,” and yet cancer was virtually unknown to them. George Burns smoked cigars, although most of the time he used them as props for his famous delayed punch lines. George lived to be 100. Perhaps the difference being that Native Americans smoked on special occasions, not all day, every day, as is the practice of most modern cigarette smokers. That still doesn’t settle the Okinawan anomaly, meaning that we’ll have to look at what traditional Okinawan habits or diet might have allowed them the benefits without the negative effects.

Mitochondria as a possible target for nicotine action

This article also discusses the negatives of tobacco smoke but has this to say about nicotine via gums or patches designed to assist with tobacco dependence: “evidence is available from studies with up to 5-year follow-up which suggests that ‘pure’ nicotine, in the form available in nicotine replacement therapy (NRT) products, does not pose a significant health risk” (National Institute for Health and Care Excellence 2013). This statement is still under debate and does not consider nicotine’s potential adverse effects during development (England et al. 2017).

So don’t give it to kids, but it would appear to have beneficial effects for adults, subject to the disclaimers above regarding dose and time. In other words, it may be beneficial to get small doses via gum or patches but have negative effects in higher doses. Everything in moderation, as they say. In any event, it seems a commonsense approach to use nicotine replacement products rather than cigarettes.

Which brings us to this rat study, which may explain why cigarette smoking (and nicotine gums or patches) can help with weight loss. Leptin affects appetite, and UCP1 enhances mitochondrial function. Increasing UCP1 expression is one of the chief benefits from Wim Hof and Buteyko breathing exercises (increasing cellular CO2, and reducing the over oxygenation associated with western lifestyles, both stress and sedentariness). Voila!

This gem gives what would appear to be a strong thumbs up to nicotine showing benefits beyond what we’ve seen so far: Overexpression of UCP1 in tobacco induces mitochondrial biogenesis and amplifies a broad stress response

Am I encouraging the use of nicotine patches? While I make no recommendations in that regard, except to say there is no doubt that they are beneficial if it means replacing cigarettes, I can tell you that I, and numerous others in the gerontological space are experimenting with them. Whether you should is not for me to say. Positive effects, in my personal experience, have been observable, but not highly significant. Others have reported more significant beneficial effects, but the evidence to date is still anecdotal. While DBRCTs have been done using humanized rats, that is rats with synthetic gene restructuring to more closely mimic humans, no significant human studies have yet been peer reviewed.

Perhaps a stronger recommendation, studies studies using nicotine patches on covid patients or covid jab recipients who show significant aftereffects, sometimes called long covid, have been extremely positive. So if you happen to be one of those, I won’t advise you (because I’m not a doctor) but I would use it for myself in that case. One of the reasons I am currently experimenting with moderate dose nicotine patches, 14mg used about once a week, that being more in line with the way Native Americans, is that it is impossible to be sure, without expensive testing, whether covid aftereffects are having an effect on you, although if you’re one of those suffering significant fatigue, malaise, lingering cough, and other symptoms, that might be indicative of a covid hangover. Since I was experiencing a recurring excess of phlegm that seems to coincide with my recovery from covid two years ago, I added nicotine patches to my regimen, and while it proves nothing, my “smoker’s cough” went away. Thus nicotine patches are now added to the other ideas that I have suggested in previous postings about covid recovery.

One additional caution. While vaping nicotine has become quite popular, it is this humble writer’s opinion that vape cartridges are likely to include other hazardous materials, as well as being more expensive than gums or patches, as well as causing breath odor.