Nicotine formula on blackboard with inhaler and stethoscope. Nicotine formula on blackboard with inhaler and stethoscope.

Why Does the Brain Confuse Nicotine for Acetylcholine?

Nicotine, the main ingredient in tobacco, makes you crave it and depressed when you try to stop it (withdrawal). It acts like other addictive drugs, especially ones that make you think better. I’m telling you this because if you are also consuming it in any form, it’s time to be alert. This I’ll explain to you further in this article.

Nicotine works by attaching to special receptors in your brain called “nicotinic acetylcholine receptors.” This boosts different signaling chemicals called neurotransmitters. Neurotransmitter acetylcholine, and another called “dopamine,” makes you feel good.

This good feeling, according to scientists, makes you crave nicotine and keep using it, even though it’s bad for you. Some other brain chemicals also play a role in this.

Let’s Find Out How Nicotine Affects the Brain

Nicotine copies the work of certain messengers in the brain. This is because it has the same shape as one of the messengers. The messengers are known as neurotransmitters, and specifically, we are talking about acetylcholine. Nicotine also activates signals related to pleasure, particularly dopamine, making you feel good.

It mimics due to the shape similarity which is accepted by the nicotinic receptors, and as time goes on. The brain adapts to the increased activity by decreasing the number of acetylcholine receptors, which leads to a tolerance to nicotine; so you need more to feel the same effects.

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Nicotine also triggers the brain’s pleasure zones, acting like dopamine, so your brain links using nicotine with feeling happy because nicotine binds with nicotine receptors. 

According to the National Institutes of Health, smoking and inhaling nicotine changes your brain, causing withdrawal symptoms when you try to quit. This can bring about other side effects like anxiety, irritability, and a strong urge for nicotine. Regrettably, when these symptoms hit, many people light up another cigarette to ease withdrawal effects.

The brain changes caused by this cycle create a reliance on nicotine because your body gets used to having it, turning it into an addiction that can be tough to break. Although the effects of nicotine on your brain may take time to notice, problems related to the heart and lungs are usually the first signs a smoker might observe.

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Joshua Collins, LCSW, LCADC, CCS, Clinical Director at SOBA New Jersey, talked to the Icy Whiz team about nicotine addiction. Here is what he had to say:

Joshua Collins, LCSW, LCADC, CCS
Joshua Collins, LCSW, LCADC, CCS

“Nicotine’s influence on the brain is extensive and critical, particularly concerning its role in addiction development and the ensuing withdrawal symptoms.

It triggers the release of dopamine, leading to temporary pleasure or stress relief but ultimately culminating in addiction. Withdrawal from nicotine is challenging, often marked by symptoms such as mood swings, cravings, and a noticeable decrease in cognitive function.

The broader implications of nicotine use are also significant for both brain health and public health. Prolonged nicotine use can lead to neurological changes that might affect cognitive abilities, mood regulation, and susceptibility to brain diseases.

On a societal level, nicotine addiction contributes to major health issues, such as cancer and heart disease, which strain public health resources and affect workforce productivity.

In terms of cessation strategies, Cognitive Behavioral Therapy (CBT) is particularly valuable. It helps individuals identify and change thoughts and behaviors associated with smoking. By addressing the psychological roots of addiction, CBT can reduce the likelihood of relapse.

You need to encourage a healthy diet, regular exercise, and adequate sleep to improve overall well-being to help withdrawal symptoms. Physical activity, for instance, not only improves health but also releases endorphins, natural mood lifters that can reduce cravings.

Reducing smoking prevalence also involves legislative and societal interventions. Increasing taxes on tobacco products, implementing strict advertising bans, and promoting tobacco cessation programs in communities can lead to significant decreases in smoking rates.”

I’ll Tell You About Nicotinic Agonists

Nicotinic agonists are not commonly used in treating animals. The typical nicotinic agonist, which is nicotine itself, is used by people for recreation in various ways.

When used in amounts typically taken for fun, there’s usually little to no impact on certain nerve connections in the body. Small doses of nicotine stimulate the release of many brain chemicals, creating a feeling of alertness.

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However, taking higher doses of nicotine reverses this stimulating effect. You can see the side effects in the body, such as a faster heart rate, higher blood pressure, and reduced movement in the gut. You can feel a light-headed sensation being a new smoker because nicotine activates certain nerve receptors, especially those in the carotid body.

The Icy Whiz team talked to Ashley Murry, Chief Clinical Officer at Sana Lake Recovery, on the issue of nicotine addiction. Here is what she had to say:

Ashley Murry
Ashley Murry

“Being an addiction expert, one pattern that I observed in patients at our recovery center was repeated exposure to nicotine resulted in the brain becoming tolerant and needing an extra hit of nicotine to get a pleasurable sensation.

Not only in patients, we can observe this in individuals around us who smoke regularly. They start with a couple of puffs, and addiction leads them to consume a pack of cigarettes every day.

Such powerful is the addiction symptoms of nicotine; it may get difficult with withdrawal symptoms if you’re planning for a cessation. A chain smoker can go through issues like irritability, anxiety issues, and sweating if they don’t get their nicotine dose.

Long-term nicotine consumption has been linked to changes in the structure of the brain and some amount of decrease in the brain’s volume (worst-case scenario).

Such changes can lead to cognitive decline and raise issues for patients with dementia, lack of focus, etc. The lower your consumption of nicotine is, the more powerful and sharp your memory & focus becomes.

Out of all the smoking cessation techniques, our patients have found better results with nicotine replacement therapy (NRT), where nicotine is consumed through alternative sources like gums, nasal sprays, or some kind of medication.

Our recovery center has provided nicotine gums (We used LUCY mint 2mg) to patients, and it helped them control their smoking urges.”

You Must be Aware of the Side Effects of Nicotine

Nicotine consumption has ill effects on the adrenal glands, limbic system, and peripheral nervous system. Here are some common ways that nicotine addiction and smoking can affect the brain.

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  1. Cognitive Decline– As you grow older, it’s normal for memory and thinking abilities to decline somewhat. Smoking, however, can speed up this decline, especially in men, and studies have proved that middle-aged male smokers experience faster cognitive decline than nonsmokers or female smokers.
  2. Increased Risk of Dementia– Smokers have a higher risk of developing dementia, a condition affecting memory, thinking, language, judgment, and behavior, and research comparing smokers and nonsmokers found that smokers were 30 percent more likely to develop dementia. Quitting smoking reduced this risk to that of a nonsmoker.
  3. Loss of Brain Volume– The longer you smoke, the greater your risk of age-related brain volume loss. Smoking negatively affects the structure of certain brain regions, leading to more significant age-related volume loss compared to nonsmokers.
  4. Higher Risk of Stroke– If you are a smoker, you may face a higher likelihood of experiencing a stroke compared to nonsmokers, and smoking increases the risk of stroke two to four times in both men and women. Quitting smoking can significantly reduce this risk within five years.
  5. Higher Risk of Cancer– Smoking introduces harmful chemicals into the brain and body, some of which can cause cancer, and continued exposure to tobacco smoke can lead to genetic changes in the lungs, throat, or brain, increasing the risk of developing cancer. Smoking cessation/ nicotine withdrawal is a positive step in reducing this risk.

In an interview with the Icy Whiz team, Michaela Ramirez, MD, Founder of O My Gulay, discussed several side effects of nicotine. Here is what she said:

Michaela Ramirez, MD - Featured
Michaela Ramirez, MD

“Nicotine, the addictive chemical found in tobacco products, enters the bloodstream when you smoke, chew, or vape. Once in the body, it quickly reaches the brain and triggers the release of chemicals like dopamine, which make you feel good.

This sensation of pleasure reinforces the desire to use nicotine again. Over time, your brain adjusts to the regular influx of nicotine, becoming dependent on it to function normally.

When you try to quit or cut back on tobacco, you may experience withdrawal symptoms because your brain and body crave nicotine. These symptoms can include irritability, anxiety, difficulty concentrating, and increased appetite.

On a larger scale, tobacco use is a leading cause of preventable illness and death worldwide, contributing to various health problems like heart disease, lung disease, and cancer.

Additionally, secondhand smoke exposure harms not only smokers but also those around them, making it a public health concern.

A combination of behavioral counseling and the use of FDA-approved medications can help people quit smoking. Make an appointment with your primary care or mental health provider to get the right medication for you.

Having support from friends, family, or quit-smoking helplines can also provide encouragement and accountability during the quitting process.

To address smoking on a broader scale, public health interventions are crucial. For example, some states have implemented tobacco taxes and strict regulations on advertising, packaging, and sales to discourage smoking. Smoke-free policies aim to reduce exposure to secondhand and thirdhand smoke.

Can Quitting Smoking Make a Difference? 

Stopping nicotine can be good for your brain and other body parts. A study done in 2018 found that people who quit smoking for a long time had a lower risk of dementia. The Mayo Clinic says that when you quit completely, the number of nicotinic receptors in your brain will go back to normal, and cravings should lessen.

Can Quitting Smoking Make a Difference
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Besides benefiting your brain, quitting smoking can also have positive effects on the rest of your body, like bringing the levels of carbon monoxide in your blood back to normal within 12 hours. Also, it improves your circulation and lung function within 3 months, cut your risk of a heart attack by 50 percent within a year, and reduce your stroke risk to that of a nonsmoker within 5 to 15 years. 

We interviewed Carlos Escobar, LMHC, Clinical Director at Real Recovery, on the impact of nicotine on the brain and effective quitting strategies. Here is what he said:

Carlos Escobar, LMHC
Carlos Escobar, LMHC

“Nicotine affects the brain profoundly by mimicking acetylcholine, a natural neurotransmitter, thereby stimulating the release of several neurotransmitters, including dopamine, which enhances mood and concentration.

This dopamine release reinforces the behavior of smoking by linking it to feelings of pleasure, thereby ingraining the addiction.

When nicotine intake stops, the sudden drop in dopamine levels leads to withdrawal symptoms, which can be quite challenging to manage and include mood swings, frustration, anxiety, and difficulty concentrating.

The adverse effects of nicotine extend beyond the individual to the broader public health arena. Prolonged exposure to nicotine can lead to cognitive decline, affecting brain functions such as learning, memory, and attention.

These changes not only diminish quality of life but also increase the burden on health systems due to long-term treatment of nicotine-related health issues.

Public health also suffers from secondhand smoke exposure, which contributes to a range of chronic diseases in nonsmokers, including heart disease and lung cancer, highlighting the far-reaching impacts of nicotine addiction.

For individuals looking to quit smoking, a multifaceted approach is often the most successful.

This includes pharmacological aids like Nicotine Replacement Therapy, which mitigates withdrawal symptoms by supplying controlled quantities of nicotine without the harmful byproducts found in cigarettes.

On the behavioral side, techniques such as cognitive-behavioral therapy help individuals develop coping strategies to deal with triggers and cravings, while structured support programs provide ongoing motivation and support.

Tailoring these approaches to individual needs significantly enhances the likelihood of successfully quitting.”

What Can Make Quitting Easier? 

Here I have mentioned some steps to help you stay nicotine-free for life:

nicotine-free for life
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  • Talk to your doctor: Get advice from a healthcare provider to create a plan for dealing with withdrawal symptoms and cravings.
  • Nicotine replacement therapies: Consider using medications like nicotine gum, patches, or lozenges, and your doctor might recommend a prescription for a nicotine inhaler, nasal spray, or medication that blocks the effects of nicotine in the brain.
  • Counseling support: Individual or group counseling can provide support for dealing with cravings and withdrawal symptoms, especially when others are facing similar challenges.
  • Relaxation techniques: Techniques like diaphragmatic breathing, meditation, and progressive muscle relaxation can help you relax and handle stress while quitting.
  • Lifestyle modifications: Regular exercise, quality sleep, time with friends and family, and engaging in hobbies can support your goals of quitting smoking.

Say NO to Smoking

Quitting smoking can be challenging, but it’s possible; it can lead to positive changes in the structure of the brain’s cortex, although it may take some time. By combining individual cessation support with comprehensive public health strategies, we can work towards reducing smoking prevalence and improving both individual and population health.

Guest Author: Saket Kumar

Last Updated on May 21, 2024 by Pragya


Anushree Khandelwal

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