Science is conclusive: Tobacco increases work capacity

Science is conclusive: Tobacco increases work capacity

March, 2011: Original Danish article from Klaus K blog: Forskere er sikre: Tobak øger arbejdsevnen

Nicotine improves human brain performance
Is the bad reputation of smoking undeserved?
Professor: About time the positive side of tobacco is emphasised

By Niels Ipsen, environmental biologist & Klaus Kjellerup, researcher

NEW ANALYSIS SUMMARY: UPDATE OF 40 YEARS OF NICOTINE RESEARCH

- According to public health officials, tobacco has no benefits at all: "A harmful and unnecessary product," says the WHO (World Health Organization), which has lobbied national governments to combat tobacco use since 1975 (1).

The Danish anti-smoking lobby wants a total ban on tobacco: "We can not see what tobacco contributes," said the Cancer Society. "A smoke-free society should not be an unreasonable policy objective," they say in the Danish health directorate (2).

Since the 1960’s authorities worldwide have focused exclusively on the health hazards of tobacco, and thus given it a very negative image. Their many anti-smoking campaigns may have made the world forget that tobacco use also has positive aspects. But as we know, any issue always has at least two sides, and now the positive effects of tobacco have resurfaced in the scientific literature:

- After 40 years of scientific research on the effects of nicotine, researchers now say that they have sound scientific proof that smoking and nicotine have a significant positive effect on human brain performance.

The brain works better when it gets nicotine - almost like an optimized computer. Nicotine is a "work-drug" that enables its consumers to focus better and think faster. The brain also becomes more enduring, especially in smokers: Nicotine experiments show that smokers in prolonged working situations are able to maintain concentration for many hours longer than non-smokers.

This seems like a paradox considering the smoking bans imposed on workplaces in many countries - but it is nonetheless the picture emerging from hundreds of scientific studies of smoking and nicotine. It seems very unlikely that companies would be able to stop smoking in workplaces with many smokers without experiencing a decline in labor productivity.

Generally nicotine boosts the brain to work 10-30% more efficiently in a number of areas. This is especially true for smoking - but also true when using smokeless nicotine. But at the same time, when smokers and nicotine users abstain, they experience a perhaps equally great decline in the effect. This is called the "withdrawal effect" - a nicotine craving, especially for smokers.

Thus the difference between smoking and smoking abstinence is very pronounced for a smoker - a difference of perhaps as much as 50%. And, according to the scientists, this answers the question: Why do people smoke? The answer is simple: Because smoking boosts their brain power.

Nicotine boosts attention,
precision, motor skills,
speed and memory

- In 2010 the U.S. government published a groundbreaking meta-analysis, which summarizes the last 40 years of knowledge about tobacco and nicotine effects on the brain. The analysis was conducted by the National Institute on Drug Abuse, headed by researcher Stephen Heishman: Meta-analysis of the acute effects of nicotine and smoking on human performance. Abstract: (3) - full text (4).

The results in Heishman's analysis gives the clear impression that it could turn out to be a very bad idea to try to "eradicate" tobacco. For nicotine has positive impacts in the areas of motor skills, attention, focus, speed and memory - and the effect is significant, the researchers say: The results are not due to statistical chance.

Heishman's team examined all 256 published non-medicinal nicotine tests carried out since 1994 when they conducted a similar study. The tests measured both the effect of cigarettes on smokers - and the effect of non-smoking nicotine on non-smokers.

- 48 of the best quality trials were selected for the meta-analysis following strict scientific criteria: They had to be placebo controlled - with nicotine-free patches and nicotine-free cigarettes - and double blinded, so no subjects knew whether they had received nicotine or not.

Furthermore only trials in which none of the smokers were craving tobacco were used. Thus Heishman excluded the risk that smokers may have performed unusually well because of their relief from the withdrawal effect.

The analysis paints a picture of nicotine as an effective and fast acting drug, which improves the brain's performance in work situations - a genuine "work-drug". Unlike drugs such as alcohol, cannabis, cocaine and heroin, which are not useful during work.

So apart from the health hazards of cigarettes, it seems the only drawback of nicotine is the addictive effect, although this is still controversial among scientists, and should not be confused with dependence on narcotics. And although pure nicotine is poisonous in large doses, there is no evidence of health risks from nicotine in the amounts in which it is consumed using tobacco.

Why are many scientists,
athletes and artists smokers?

- The positive effect on the brain may explain why many of history's greatest scientists have been avid smokers - for example Niels Bohr and Albert Einstein, both of whom praised the effect of tobacco on their scientific thinking.

Furthermore, it is known that many athletes, creative people, stage performers, writers, musicians and artists through time have been smokers. The nicotine in cigarettes appears to have been particularly important for people who need to produce something unique or competitive in their work.

- Top footballers, in particular, have often surprised the media when it emerged that they were avid smokers, while they were at the peak of their careers. For example, the puritanical British media people couldn't imagine that a top player like Wayne Rooney would be able to deliver top performances for his team, when they revealed it as a scandal, that Rooney is a smoker (5).

- The truth is however, that some of the world's most creative stars - like Zinedine Zidane, Diego Maradona, Johan Cruyff, Ronaldo, Dimitar Berbatov and many other players from the highest levels of football - were avid smokers while they were at the top of their careers - including the Danish 80's hero, Preben Elkjaer.

Cigarettes have also always been an indispensable part of soldiers' field rations, and still are. A war cannot be won without cigarettes, soldiers said (6) - so in 2009 the Pentagon had to drop a proposal to ban smoking in the U.S. Army after very strong protests from soldiers and veterans (7).

According to Stephen Heishman's analysis, there is a very good reason why competitive people smoke. This is because of the nicotine boost to the brain - nicotine helps them produce better performances.

The effects also suggest an answer to the puzzle of why people start smoking and continue on a permanent basis - and the proof comes paradoxically from the results of the effect of nicotine on non-smokers, who also perform better when they get nicotine gum. Heishman writes:

"... [The fact that] the results are also found among non-smokers is an indirect evidence that nicotine performance enhancing effects may be the reason why people start smoking."

Nicotine makes the brain
faster and more precise

The 48 experiments included in Heishman's analysis consisted of several groups of volunteers who had completed a series of standardized computer tests: One half received nicotine, while control subjects received a placebo. With few exceptions, nicotine users did better in all tests, whether they were smokers or non-smokers. This was especially true in the areas of attention, precision, focus, memory and speed - and to a lesser degree of motor skills:

Table 1 - from Heishman and others: The table shows nine performance areas that had enough data for the meta-analysis. Six areas showed significantly improved results for nicotine users (red dots) - in three areas results were insignificant (no dots).

The biggest improvements: Short term memory, accuracy - working memory, response time - attention, accuracy - attention, speed - orienting attention. Minor improvement: Fine motor skills.

(k: number of experiments - N: Number of subjects - Hedges's g: 0.1: Minor improvement. 0.3: Medium improvement. 0.5: Big improvement.)

- The researchers also found other areas where nicotine users had significantly better outcomes - including gross motor skills, long-term memory, semantic memory, arithmetic & complex calculations. But these experiments were not used in the analysis because there are still too few experiments in these areas.

Are smokers better
drivers and pilots?

- This applies to experiments demonstrating that smoking and nicotine have a significant positive effect on one’s ability to drive a car (8) and fly flight simulators (9). Smokers and other nicotine users will score better in driving tests, both in overview, focus and steering maneuvers - and they respond quicker on the brakes, when required compared to non-nicotine users.

These experiments however could not be standardized for the other trials in the analysis, so Heishman calls for more standardized driving and flight tests with nicotine to get an accurate picture of nicotine effects on motorists and pilots.

Stephen Heishman and the research team conclude in the study:

"The significant effects of nicotine on motor abilities, attention and memory, likely represent true performance enhancement because they are not confounded by withdrawal relief. The beneficial cognitive effects of nicotine have implications for initiation of smoking and maintenance of tobacco dependence."

Put another way: Smokers smoke and keep on smoking because their brains work better when they smoke. This is probably also the reason that it is hard to quit smoking. And since experimental animals in laboratories have shown similar results, there is no longer any doubt among scientists:

Nicotine - the active substance in the world's most unpopular plant - the tobacco plant - is paradoxically a "wonder drug" that leads to better job performance. A gift for the working human being?

- Tobacco Harm researcher Professor Brad Rodu from Louisiana University says that Heishman's analysis is a breakthrough in understanding tobacco and nicotine effects. In his article "The Proven Positive Effects of Nicotine and Tobacco" (10) on his blog, Tobacco Truth, he writes:

"This analysis will not please anti-tobacco extremists. It’s time to be honest with the 50 million Americans, and hundreds of millions around the world, who use tobacco. The benefits they get from tobacco are very real, not imaginary or just the periodic elimination of withdrawal."

Brad Rodu has spent many years working in the branch of tobacco science known as Tobacco Harm Reduction. He is a proponent of allowing all use of smokeless tobacco, for example snus and chewing tobacco, which he believes is "almost 100% safer than cigarettes." (11) Rodu conducts his own research into the health effects of smokeless tobacco, with funding from an annual "no strings attached" grant from the tobacco industry to Louisiana University.

“It’s time to abandon the myth that tobacco is devoid of benefits, and to focus on how we can help smokers continue to derive those benefits with a safer delivery system," Rodu writes.

Smoking gives
the brain
more stamina

- Other nicotine tests show results that seriously question the idea of smoking bans in workplaces. Several studies show that smokers' brains have more stamina in long work situations compared to non-smokers, providing the smoker can smoke while working. Smokers can maintain concentration for long hours without getting tired, while non-smokers concentration quickly breaks down.

This phenomenon was brought to US public attention in 1976 when environmental activist Ralph Nader suggested in a TV program that pilots should be prohibited from smoking on U.S. airplanes for safety reasons. Immediately after this proposal, the news media received a warning from Dr. Norman Heimstra: "A bad idea," he wrote. (12)

Dr. Norman Heimstra had done the world's first primitive nicotine experiments back in 1967 (13). Three groups of people spent six hours in a car simulator - smokers, non-smokers and "abstemious" smokers. Result: The abstinent smokers fared worst in all tests - but the experiment also showed that smokers fared best when the first three hours had passed. At the same time the study revealed that smokers showed no aggressiveness while driving and handled emergency situations better than the other two groups.

"In a critical situation the smoking pilot might well be the best pilot," Dr. Heimstra wrote to the media.

"I would much rather climb into an airplane piloted by a chain-smoker than one piloted by a smoker deprived of cigarettes for a number of hours - not allowed to smoke during flight," he ended his warning in 1976 - and subsequently the proposal of a smoking ban among pilots was dropped.

Thirty years after Heimstra's primitive experiments other tests have confirmed that nicotine gives smokers' brains more stamina.

It is illustrated for example in the trial, The effects of cigarette smoking on overnight performance (14) of Parkin & Hindmarch 1997, where smokers and nonsmokers were to do five different computer tests from 8 o'clock in the evening to 12 hours later. In all tests the non-smoker concentration levels broke down after two hours - while smokers could maintain concentration until 4 o'clock in the morning thanks to the nicotine in the cigarettes:
Figure 1 - Parkin & Hindmarch, 1997: - Results from smokers and non-smokers in the test "Critical Flicker Fusion"- used to measure attention: Non-smokers (lower line) became inattentive at 10.00 pm, while smokers (top line) maintained their attention level until 4.00 am even improving their baseline level at 10.00 pm. Not until 8.00 in the morning did the smokers level drop to the non-smoker level 10 hours earlier.

- For years scientists have discussed the "withdrawal" effect in smokers - the phenomenon that smokers themselves describe as "concentration difficulty" when they have not smoked for several hours. In the anti-smoking lobby it is believed that the phenomenon is a simple abstinence effect that smokers can lift by smoking a cigarette again, and thereby return to the same level of performance as "normal people".

But this theory no longer holds true after the Heishman analysis. Nicotine in itself creates better performance compared to placebo, whether smokers or non-smokers. But there are scientists who do not believe that the "withdrawal" effect has been proven.

One of them is nicotine researcher, Professor David Warburton of Reading University, who in a double experiment in 1994 first demonstrated that 100 "abstinent" smokers and 100 non-smokers achieved similar results in three specific figures tests. In experiment no. 2 he repeated the same three tests with only the smokers who were divided into two groups - one that had been "abstinent" for 12 hours, while the second group had smoked one hour earlier: Improvements in performance without nicotine withdrawal (15).

Both groups were divided into two subgroups, one receiving regular cigarettes, while the other had fake cigarettes. In one task, participants were told to enter the correct numbers in a certain sequence in 20 minutes - and after the first five minutes they should light up a cigarette and take one puff every minute. The results are shown here:
Figure 1 - Warburton & Arnall, 1994: - The scale shows the number of correct answers, minute by minute. Participants smoked one puff per minute in the period between the dotted lines, from the 6. minute to the 15. minute. The two top lines are the results for nicotine groups - the bottom two are from non-nicotine groups. Each group consisted of one abstinent group & one non-abstinent group.

Result: The number of correct answers rose in the two nicotine groups with approx. 30% from the third cigarette puff. There was, however, no difference in responses between the "abstinent" and the non-abstinent participants. The two nicotine groups had also significantly 10-15% faster reaction time, (not shown in graph).

- The Warburton trial shows specifically that cigarettes' effect on attention and response time is particularly strong in the ten minutes during which the actual smoking takes place, and in the following minutes.

He is one of the pioneers of modern nicotine research, after the invention of nicotine pills and chewing gum that allowed scientists to make nicotine trials in non-smokers. It soon became clear however, that the effect of nicotine gum is not as strong as the effect of smoking. As concluded in 1983 by Warburton and Wesnes in a scientific article: Smoking, nicotine and human performance (16):

"[Smoke-free] nicotine produces improvements in mental efficiency, which are qualitatively similar to the improvements produced by smoking, although our findings on vigilance and rapid information processing indicate that the improvements are quantitatively smaller than those produced by smoking."

David Warburton results were later repeated in many controlled trials of nicotine, including Parrott & Winder i 1989: Nicotine chewing gum and cigarette smoking: Comparative effects upon vigilance and heart rate (17). As the graph shows, smoking is the most effective nicotine delivery method:

Figure 2 - Parrott & Winder, 1989: Differences in rapid visual information processing using cigarettes, nicotine gum (2 and 4 mg) and placebo.

The authors conclude in the article: "People entering smoking cessation programs, should be warned to expect that vigilance and concentration will probably be reduced when they cease smoking. They should also be advised that nicotine gum will probably aid their concentration / attention, although not to the extent that may have occurred with cigarettes."

- It may seem paradoxical that smokers in countries with workplace smoking bans are sent away from their desk when they smoke. Not only because of the extra time it takes away from work, but because their brains perform most rapidly and accurately when they are smoking and in the minutes that follow.

The indisputable evidence for positive nicotine effects is also in contrast to some companies' policies of not hiring smokers. In 2010 Danish bedding company Jysk asked smokers not to apply when they advertised for new employees (18). According to Jysk's management however, this policy was stopped because of protests from the public.

Other companies have chosen to arrange cessation courses among employees in order to appear to be politically correct "healthy businesses". There is a risk that these companies are not getting the best possible performance from their smoking employees.

Is the smoke-free society
an economic
growth free society?

- Tobacco has become very unpopular in the West in the last few decades, where authorities have become increasingly tough against smoking because of the health risks from long-term smoking, and because the smoke irritates many non-smokers. This is likely why the beneficial effects of tobacco’s active ingredient, nicotine, has been completely overlooked in the media, which have focused exclusively on the negative health effects of smoking.

There still remain many unanswered questions in nicotine research within the scientific community. It is however now an established fact that smoking generally results in better brain performance in smokers, and smokeless nicotine leads to better performance in non-smokers, although to a lesser degree. After Heishman's analysis, it can also be considered to be true that withdrawal effects lead to weaker performance in abstinent smokers and nicotine users.

In a somewhat unscientific way, it is probably safe to say that if non-nicotine users perform 1.0, then nicotine users will perform up to 1.25 - with smokers as the absolute top performers. At the same time nicotine users - especially smokers - who fail to maintain nicotine levels will perform down to 0.75.

- This fact raises the question: Can nicotine have had a beneficial effect on innovation & growth in the economy in the last century? If this is true, it may help to explain why the productivity of labor in the western world has decreased slightly each year since the 1970s, when the official health campaigns began to reduce the number of smokers.

One can also raise questions about whether the numerous smoking bans in workplaces could have contributed to the recent large productivity decline. In Denmark an unexpected and inexplicable collapse in labor productivity was apparent in 2007 and 2008 - right after the state banned smoking in all Danish workplaces. (19 - 20)

There may of course also be other reasons for this decrease, but the issue should be explored, as innovation and economic growth has shown historically weak development in countries that have banned smoking in workplaces. It is very likely that governments simply cannot obtain unilateral advantages with huge interventions like the war on smoking and smoking bans.

Everything has a price, and the advantage of achieving health benefits in the war against smoking may very well be matched by paying a high price in the economy in terms of loss of innovation and economic growth.

The question is, in other words, whether the so-called smoke-free society is an economic growth-free society. And if so, can the irritation of smoke in workplace be solved in other ways? E.g. by splitting the workforce and implementing a better and more efficient ventilation of indoor air in workplaces?

After all, who really wants reduced performance from people who perform vital, concentration intensive tasks in society as in the example of smoking pilots, that Dr. Heimstra mentioned in 1976 (12) - or from smoking surgeons or rescuers?

Translation assisted by Iro Cyr & Frank Davis
References:

1. Socialistisk WHO-masterplan 1975: Lad os gøre passiv rygning “farligt”, KlausKblog, 2009

2. På vej mod et røgfrit Danmark, Information, 2010

3. Meta-analysis of the acute effects of nicotine and smoking on human performance, abstract, Heishman, Kleykamp, Singleton, 2010

4. Meta-analysis of the acute effects of nicotine and smoking on human performance, 2010

5. Wayne Rooney smoking and urinating in the street, Mail Online, 2010

6. Nicotine is a soldier’s best friend, The Daily Beast, 2009

7. Pentagon won’t ban tobacco use in military, CBS News, 2009

8. Effect of cigarette smoking on performance in simulated driving task, Sherwood, 1995

9. Influence of nicotine on simulator flight performance in nonsmokers, Mumenthaler, 1997

10. The Proven Positive Effects of Nicotine and Tobacco, Tobacco Truth, 2010

11. Dr. Brad Rodu on Reduced Harm Tobacco, SnusCentral.org, 2009