Malaria and Nicotine

[sethoflagos]

I've been a heavy smoker since I was 19. Just background fact.

After maybe 17 malaria-free years in Nigeria, I eventually came down with it in 2016 (P. falciparum) and running 40⁰ C I was immediately hospitalised for 3 days on a combination quinine/paracetamol drip. This repeated 2 years later.

On both occasions, I had three days of no urge to smoke whatsoever, which was a really big deal to me. Normally two hours abstention pushes me into a tense, hyperactive somewhat sociopathic state that can alarm those around me. Basically. I smoke to stay in employment (and married!). So any way out of this circular trap would be highly beneficial. Of course, I discussed this with the medical staff responsible for my treatment, but they showed not the slightest interest whatsoever. Which didn't impress me much. I doubt that it's malaria that will kill me in the long run. When the treatment finished, immediate cold turkey.

A third infection a couple of years ago I self-medicated with artemisinin/lumefantrine combination (+paracetamol as antipyretic) which worked but didn't give the same respite from my nicotine addiction.    

Has anyone the slightest inkling of what may be behind the addiction respite? I can't find anything relevant online, and I've looked. Numerous times.

[iNow]

Withdrawal symptoms were masked by your body fighting the malaria. Within about 48-72 hours, the physical withdrawal tends to ebb and the only remaining factor is overcoming the psychological parts… replacing the behavior with something more healthy. 

I don’t think your meds had anything to do with it. I think you did have withdrawal but it was drowned out by the noise of the malaria fight.

With only marginal exceptions, even alcoholics stop drinking when they’re throwing up and have diarrhea. Smoking is just easier. 

[sethoflagos]

Bump.

[guidoLamoto]

Bump again (I'm bored today.)

My fantasies about smoking and cessation based on 40 yrs of observations practicing medicine  among a large urban, working class population (ie- a lot of smokers):

Short answer to the OP's situation-- he has made the superstitious association between two episodes of acute illnees and a loss of desire to smoke. It wasn't the malaria. It was the hospitalization  itself with it's other worries, points of attention and probably hard fast rules preventing smoking....I've never seen a pt who insisted on smoking while hospitalized.

Nicotine is not really an addictive chemical, when we define addicitng as the combination of two phenomena--  tachyphylaxis (a need to continually increase doses to obtained the desired effect) and withdrawal (a rebound effect with eaggerated physiological response upon sudden discontinuation of the drug. Cf- the DTs- wild neurological firing after discontinuing the tranquilizing ethanol)...

Nicotine is a stimulant in the first place, so stopping it should cause a calming of the nerves upon withdrawal, not increased nervousness if it was a "rebound," and you don't need to keep on smoking more cigs each day. Most smokers have a habitual smoking pattern (note the word habitual)-- one pack a day seems to be the norm-- for years on end.

The ritual of smoking, tapping one out of the pack, knocking the loose tobacco out (you alewya see that in the Film Noir movies), lightining it, all the hand manipulations as you go to your mouth, to the ash tray, etc It becomes mindless habit....It's a RITUAL and when forced to abandon the ritual, the smoker feels like he's forgetting something and has the urge to keep the ritual going.

I think nicotine gum or patches are areally just placebos, if effective at all. My pts had some more success if they used aversion therapy-- either sucking down a half dozen cigs in rapid succession causing some nausea, tachcardia etc, or by saving the butts in a small container for a day or two, adding some water to make a sloppy slurry, then inhaling that deeply every time they wanted to light up over the course of a day or three...can work pretty well, at least for awhile.

The problem for the rest of us is that those who quit often become as insufferable as Born Again Christains or Vegetarians. Sheesh. Give us a break.

[sethoflagos]

4 hours ago, guidoLamoto said:

Bump again (I'm bored today.)

My fantasies about smoking and cessation based on 40 yrs of observations practicing medicine  among a large urban, working class population (ie- a lot of smokers):

Short answer to the OP's situation-- he has made the superstitious association between two episodes of acute illnees and a loss of desire to smoke. It wasn't the malaria. It was the hospitalization  itself with it's other worries, points of attention and probably hard fast rules preventing smoking....I've never seen a pt who insisted on smoking while hospitalized.

Nicotine is not really an addictive chemical, when we define addicitng as the combination of two phenomena--  tachyphylaxis (a need to continually increase doses to obtained the desired effect) and withdrawal (a rebound effect with eaggerated physiological response upon sudden discontinuation of the drug. Cf- the DTs- wild neurological firing after discontinuing the tranquilizing ethanol)...

Nicotine is a stimulant in the first place, so stopping it should cause a calming of the nerves upon withdrawal, not increased nervousness if it was a "rebound," and you don't need to keep on smoking more cigs each day. Most smokers have a habitual smoking pattern (note the word habitual)-- one pack a day seems to be the norm-- for years on end.

The ritual of smoking, tapping one out of the pack, knocking the loose tobacco out (you alewya see that in the Film Noir movies), lightining it, all the hand manipulations as you go to your mouth, to the ash tray, etc It becomes mindless habit....It's a RITUAL and when forced to abandon the ritual, the smoker feels like he's forgetting something and has the urge to keep the ritual going.

I think nicotine gum or patches are areally just placebos, if effective at all. My pts had some more success if they used aversion therapy-- either sucking down a half dozen cigs in rapid succession causing some nausea, tachcardia etc, or by saving the butts in a small container for a day or two, adding some water to make a sloppy slurry, then inhaling that deeply every time they wanted to light up over the course of a day or three...can work pretty well, at least for awhile.

The problem for the rest of us is that those who quit often become as insufferable as Born Again Christains or Vegetarians. Sheesh. Give us a break.

Superstitious? Me?

Your post strikes me as a long-winded, pretentious version of "I don't know but trust me, I'm a doctor"

No useful content like 'at least vaping exposes you to nicotine only'. Please feel free to relieve your boredom by other means.

[guidoLamoto]

Before calling me pretentious, read my first line again-- "My fantasies about..."

I realize my data was not sytematically collected nor critically analyzed....You should be aware that no "treatment" for the various addictive behaviors has a very good success rate beyond a few weeks or months. AA is the best among them and is a continuing process, not a short session.

My intention was to point out that for smoking, the chemical part is probably not as  important as the behavioral component- a point easily deduced along the lines I described ("nicotine is a stimulant....)

"Superstitious behavior" is when a strong coincidental occurrence is mis-interpreted as a cause & effect relationship. As I pointed out, most hospitalized smokers do well without their nicotine for a short duration, even if malaria is not involved. Your questioning the relationship in your experience doesn't make you superstitious. It represents the legitimate formation of a hypothesis to be tested.  I apologize if the term got your shorts in a bunch.

It's your lungs and arteries. Do what you like. Smoking is a difficult habit to break and has a powerful impact on health. While "only" 15% of smokers go on to develop lung cancer, that disease that doesn't show itself until the 6th or 7th decade of life. Many more smokers succumb to CAD in their 5th or 6th decade, before they have a chance to get cancer....and besides, it stinks. Literally. 

[iNow]

6 minutes ago, guidoLamoto said:

I realize my data was not sytematically collected nor critically analyzed.

Do you?

 

7 minutes ago, guidoLamoto said:

no "treatment" for the various addictive behaviors has a very good success rate beyond a few weeks or months

Nonsense

 

9 minutes ago, guidoLamoto said:

the chemical part is probably not as  important as the behavioral component

Your comments are probably also worth ignoring until they're supported with the aforementioned systematic collection and analysis of empirical data. 

[guidoLamoto]

19 minutes ago, iNow said:

Do you?

"Oh, Yea?"..."Yea."...clever argument.

Nonsense

What do you consider an acceptable  "success rate?"

https://www.sciencedaily.com/releases/2019/04/190423133753.htm  Success rate of nicotine gum &/or lozenges- <17%

https://www.gov.uk/government/statistics/substance-misuse-treatment-for-adults-statistics-2017-to-2018/alcohol-and-drug-treatment-for-adults-statistics-summary-2017-to-2018   See section #10-- success rates for treatment for various chemical addictions in the 50% range to complete the course of treatment free of the chemical use, but relapse rates in the 50%+ range, so, over-all <25% success rate.

If you search the topic, the first many pages returned give sites with self-serving info from orgnizations with profit motives. They give the same info as the site above, but often  disengenously presented.  Caveat lector.

 

 

 

[iNow]

And telephone counseling session leads to numbers above 30%. You said "very good" and "acceptable," and your definition seems different from mine...

You must also compare the success rate of these interventions against the success rate of people who use none, NOT against "perfection."