A couple of very interesting papers have come to my attention recently. The first one was published very recently in Clinical Endocrinology where they found that those who quit smoking had a 6-fold increase risk for autoimmune thyroid problems. There seems to be a complex interaction between smoking and the immune system in that the authors of the paper were speculating that “transition from current to ex-smoker may lead to limitation in activity, to chronic health conditions, to physical and psychological symptoms and to a higher hospital admissions“. Smoking is associated with a low prevalence of thyroid auto-antibodies, and autoimmune thyroid problems is a huge problem in the world today.
The second paper is very fascinating, considering that anti-smoking activists tend to be intolerant and judgmental Authoritarian Follower types. I’m going to quote some excerpts here:
Does insular stroke disrupt the self-medication effects of nicotine?
Schrand JR., Med Hypotheses. 2010 Sep;75(3):302-4.
Abstract
This paper explores the relationship between insular stroke and the disruption of tobacco use. A functional analysis of the role of the insula in maintaining homeostasis suggests that the insula monitors hypoxia and applies dyspnea to motivate the individual to regulate breathing. From its’ early usage, nicotine has been used to treat respiratory disorders. It increases respiratory drive, promoting better breathing. Insular stroke likely interferes with this self-regulation. A new self-medication model is proposed for tobacco use. The effect on public policy is discussed.
Background: the problem
Naqvi et al. [1] found that those who have had an insula lesion have an increased risk for disruption of smoking activity (odds ratio = 22.0) compared to lesions in other areas. [...]
Stress and respiration
Stress occurs when a threat to physiological equilibrium is perceived. It influences constructive behavior change in response to an unbalanced dynamic environment. Mild, short-term stress has a salutatory effect. However, chronic stress has a weakening effect on the neuro-immune systems response to life’s traumatic events and challenges respiration [5]. Recent studies document the particularly devastating effects of severe stress from Adverse Childhood Experiences (ACE’s) [6]. The system is out of balance during the early development years. Childhood stress is related to asthma [7,8] and depression in adulthood [9]. Those with asthma are at increased risk for depression [10]. Those with stress related respiratory disorders are in need of treatment. The insula responds to this need and encourages medication seeking to achieve homeostasis.
Nicotine as self-medication
Functionally, the purpose of tobacco use is to deliver nicotine, a CNS and respiratory stimulant [11]. The Native American population has used tobacco for 2000 years. Tribal shamans used this medicinal herb to treat respiratory disorders [12,13]. In the late 1800’s, physicians used tobacco products to treat asthma [14]. ACE’s have a graded effect on tobacco initiation and use [15], especially in the current population [16]. Those with ACE’s are more likely to be depressed in adulthood [17]. Adolescents with prior or current asthma are 1.5 times as likely to smoke [18]. It has been proposed that nicotine is being used as self-treatment for sleep apnea [19]. It should not be surprising that many are unknowingly using this medicinal herb to treat stress related respiratory disorders. Yes, tobacco use has purpose. However, nicotine improves breathing only temporarily as long as nicotine is in the system.
What is described as ‘‘craving” for nicotine may be no more than chronic mild dyspnea or air hunger. It encourages re-administration as necessary to insure a continuous level of nicotine. Anything that improves breathing is likely to be compulsive to maintain homeostasis. Read more…

