Smoking and Adolescent Attention Deficit

Are young smokers risking cognitive impairment as adults?

 Call it “nicolescence.” It’s that time of life when certain 18-and-unders discover cigarettes. Most adult smokers begin their habit before the age of 19, and a majority of adolescents have tried cigarettes at least once. But for some of them—those who were “born to smoke,” in a sense—early exposure to nicotine may influence adolescent cognitive performance in ways that adult exposure to nicotine does not. Furthermore, early exposure may result in “cognitive impairments in later life.”

These provocative notions are raised by a group of researchers at VU University, Amsterdam, The Netherlands, in a paper for Nature Neuroscience. And while the specifics of glutamate activity they have documented are fascinating, the leaps back and forth between adolescent humans and adolescent lab mice are dizzying. Nonetheless, the bold claims made in the paper prompted the scientists “to reconsider our views on the etiology of attention deficits.”

That may be more than many addiction researchers are willing to countenance, but the study makes an intriguing case for long-term effects on attentional processing. The Dutch researchers exposed adolescent rats to nicotine, assessed visuospatial attention and other markers associated with synaptic activity in the prefrontal cortex, and found impaired measures of attention and signs of increased impulsivity in adulthood after five weeks of abstinence. Adult rats exposed to nicotine for the first time did not show similar long-term consequences.

The molecular underpinnings for this phenomenon appear to be reduced glutamate receptor protein levels in the prefrontal cortex. Glutamate is a neurotransmitter involved in attention, among other cortical tasks. Glutamate levels were “altered specifically by adolescent and not adult nicotine exposure” in the lab animals, the researchers found.

The glutamate receptor mGluR2 is the likely culprit.  The researchers report that “a lasting downregulation of mGluR2 on presynaptic terminals of glutamatergic synapses in the prefrontal cortex persists into adulthood causing disturbances in attention…. Restoring mGluR2 activity in vivo in the prefrontal cortex of adult rats exposed to nicotine during adolescence remediated the attention deficit.”

The study concludes: “Not only from a behavioral, but also from a molecular point of view, the adolescent brain is more susceptible to consequences of nicotinic receptor activation.” In other words, there is at least some evidence that the neurotoxic effects of nicotine are potentially more severe in the early developmental stage called adolescence.

The Dutch study is not the only one of its kind. In 2005, Biological Psychiatry published a report on cognition in which adolescent smokers “were found to have impairments in accuracy of working memory performance irrespective of recency of smoking. Performance decrements were more severe with earlier age of onset of smoking.”

And a 2007 study published in Neuropsychopharmocology, based on testing and fMRI scans of 181 male and female adolescent smokers, concluded that “in humans, prenatal and adolescent exposure to nicotine exerts gender-specific deleterious effects on auditory and visual attention…” Boys were more sensitive than girls to attention deficits involving auditory processing, while girls tended to show equal deficits in both auditory and visual attention tasks. 

Counotte, D., Goriounova, N., Li, K., Loos, M., van der Schors, R., Schetters, D., Schoffelmeer, A., Smit, A., Mansvelder, H., Pattij, T., & Spijker, S. (2011). Lasting synaptic changes underlie attention deficits caused by nicotine exposure during adolescence Nature Neuroscience DOI: 10.1038/nn.2770

Photo Credit: http://smoking-quit.info/

When Presidents Smoke

And a word about famous cigarettes that vanish.

I gave Obama a pretty hard time during the campaign and the first half of his presidency, for sneaking off to furtively field-strip the odd Marlboro. So it seems only fair to take a moment and point out the illustrious forefathers that have paved the way for today’s presidential indiscretions.

The source here is an illustrative and very funny book of cigarette history called, straightforwardly enough, “The Cigarette Book: The History and Culture of Smoking,” by Chris Harrald and Fletcher Watkins.

In the preface, the authors write: “One day the last cigarette on earth will be smoked. One final puff will be sent heaven-bound, leaving a lingering, evanescent smoke-ring…. The ubiquity of the cigarette is astounding. But soon it will be no more.”

A few factoids about U.S. Presidents and smoking:

-- John Quincy Adams. Pipe. A prodigy, he took up smoking at the age of eight.

-- Zachary Taylor. Chewing tobacco. Claimed he could hit White House spittoons from a distance of 12 feet.

-- Rutherford B. Hayes. First killjoy to ban smoking in the White House.

-- William McKinley. “Frantic cigar smoker.” Was known to break open cigars and chew the tobacco.

-- Calvin Coolidge. 12-inch cigars. Mrs. Coolidge, with her secret cigarette habit, may have been the first smoking First Lady.

--Herbert Hoover. “Chain-smoker.”

-- Franklin D. Roosevelt. “Paraplegic chain-smoker.”

-- Harry Truman. Banned smoking at official White House events.

-- Dwight D. Eisenhower. Rolled his own. Quit before the inauguration.

-- John F. Kennedy. “Cuban cigars.” Bought 1,200 of them the day before signing the Cuban embargo. Jackie was, it is said, good for up to three packs of Salems a day.

-- Lyndon B. Johnson. Ferocious cigarette smoker. A habit of 60 smokes a day is assumed to have caused the first of three heart attacks.

-- Gerald Ford. “Pipe. Eight bowls a day.”

-- Ronald Reagan. Did not smoke as president, but will be forever remembered for shilling Chesterfields in the 1940s: “My cigarette is the mild cigarette… that’s why Chesterfield is my favorite.”

In most of these presidential cases, the smokers in question were less than fully candid with the general public about their habits. But even more interesting, and rather chilling, are examples of revisionist censorship—making famous cigarettes in famous photographs mysteriously disappear, for the sake of cultural correctness.

The authors of “The Cigarette Book” start out with a swift punch to the midsection: “A recent poster featuring the famous album cover of Abbey Road (1969) removes the cigarette from Paul McCartney’s hand” (Italics mine, to reify the significance of the offense).

And readers of a certain age will recall (or recall hearing of) (or deny knowing anything about) a nude Burt Reynolds as a Playgirl magazine centerfold in 1972, with a cigarette dangling suggestively from his mouth. But when the image was reissued 35 years later, as part of an HD TV ad campaign, the cigarette, the authors tell us, “had been Photoshopped out of existence. Now it would probably be more acceptable to see his genitals than to see him smoking.” (Then again, maybe not.)

And in 1999, the U.S. Postal Service issued a Jackson Pollock stamp, using an iconic photograph from Life Magazine, showing the artist with a cigarette between his lips. “The Postal Service used the photo, but digitally removed the cigarette.” And perhaps added a little collagen to the lips, as well?

Finally, there is the case of chain-smoker Joseph Stalin, and the insane anti-smoker Adolf Hitler. Hitler had a cigarette removed from a famous photo of Stalin circulated at the time of the non-aggression pact. “Hitler felt it was bad for Germans to see such a ‘statesman’ (Hitler’s term) with a cigarette between his fingers.”

Photo credit: LBJ Library