I saw this recent tweet from a “Tobacco Education Specialist" in Montana. It makes a few big claims (sans evidence, naturally) that I’d like to deal with.

The first is easy, so I’ll start there.

#1. Tobacco culture didn’t start by chance

Now, far be it from me to question a “Tobacco Education Specialist", but this is a gross oversimplification. It’s also rather pointed.

Tobacco and humans have a long history. It was used in Colombia around 1000BC by Indigenous Americans, though it was largely as part of a medical and ritualistic heritage. I mentioned all this because it’s evidence of nicotine's clear utility. If we want to go further, the earliest fossil evidence of tobacco as a plant dates to about 2.5 million years ago; for humans using tobacco, the earliest solid evidence dates to about 12,300 years ago.

It’s easy to look at things through this lens. It even passes as analysis in some circles.
The overall narrative here is that post-1490s Europeans encountered tobacco, adopted it, and by the 1500s were sending it back across the Atlantic, alongside the Spanish and Portuguese, if I have my history right. However, it wasn’t until the mass industrialisation of the 20th century that we saw what could be termed a worldwide cigarette boom.

Now, I get that it’s very en vogue among the sophisticates to characterise any and all trade as “problematic” or whatever, but you couldn’t have brought just any kind of plant over from the Americas and duped people into thinking it was worth buying. The attempts to portray this as some class of conjuring marketing trick are flat-out silly.

Coffee, which is also a mild stimulant, didn’t reach Europe until the 1500s, before surging in popularity in the 17th Century in Paris, London, Vienna, and so on. Sure, the delivery system was not lethal in the way combustible cigarettes are, but the parallels are obvious to anyone with a basic understanding of how trade and market demand work. People look it up because they got something of value from it.

#2. Does Nicotine Reduce Stress?

This is actually a fairly complicated question. I’ll try to steelman Lamb’s point here first. The basic argument goes that people mistake the relief of their withdrawal symptoms from nicotine as being relief from stress. Nicotine triggers a quick release of dopamine and adrenaline that can feel calming or pleasurable.

So, let’s think about it for a moment. What is the question we are asking here? Let’s indulge Lamb, and look at what would happen to a stressed-out non-smoker who wanted to quieten their troubles by using nicotine.

Say someone has an argument with their partner. They are feeling stressed and having trouble focusing. They use a nicotine pouch, which gives their brain a quick chemical jolt that changes how they feel for a bit. For a short while, they feel more awake and a little less emotionally overwhelmed. If we look at things that way, it’s clear that nicotine can reduce stress.

There is also another thing that is worth mentioning: the, as they say, “lived experience” of smokers. Anyone who smokes or has previously smoked knows that a cigarette does reduce stress. While the precise mechanism might not strictly support the statement, it feels like it does and, therefore, works for the purpose.

#3. Does smoking boost mood?

This ties into point #2. Nicotine reaches the brain quickly. Once there, it stimulates nicotinic acetylcholine receptors, triggering the release of dopamine and other neurotransmitters tied to:

A person holding a nicotine pouch between their fingers.

  • Pleasure
  • Reward
  • The regulation of mood.

Attempting to characterise this as a myth is a real blow to Lamb’s credibility. Now, of course, whether this approach is sustainable or should even be seen as a positive thing is a totally different question. Sadly, as we know, combustible cigarettes are really corrosive to health. To put it another way, the trade-offs here do not make sense. That equation becomes a little more interesting when we find ways to access nicotine without all the tar, benzene, carbon monoxide, and other cancer-causing chemicals.

Final thoughts

The idea of a mental health doctor prescribing cigarettes as a mental health intervention is absurd. But so too are the arguments presented by Quit Now Montana. I think they’d find more success if they stopped talking down to the people they are trying to help, and instead, meet them with a more pragmatic and honest approach.