Nicotine's Effects on the Brain & Body & How to Quit Smoking or Vaping

Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.

欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。

I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。

Today we are discussing nicotine.

今天我们讨论的是尼古丁。

Nicotine is one of the most commonly consumed substances on the entire planet.

尼古丁是整个地球上最常消耗的物质之一。

There are literally billions of people that ingest nicotine on a daily basis.

实际上有数十亿人每天摄入尼古丁。

Most of those people consume nicotine via smoking, and in particular, smoking tobacco.

其中大多数人通过吸烟，特别是吸烟，消耗尼古丁。

Tobacco contains nicotine, and it contains a bunch of other things as well, which we will talk about.

烟草含有尼古丁，还含有许多其他物质，我们将讨论这些物质。

And the burning of tobacco liberates nicotine and makes it accessible to the various cells and tissues of the body.

烟草燃烧会释放尼古丁，使其进入身体的各种细胞和组织。

But of course, there are other sources of nicotine as well.

当然，尼古丁还有其他来源。

Some people consume nicotine through dip, that is placing tobacco on the inside of the lip or in the cheek.

有些人通过浸渍方式摄入尼古丁，即将烟草放在嘴唇内侧或脸颊上。

Some people consume nicotine via snuff, which is literally the shoving of tobacco leaves up the nostrils and allowing the tobacco to access the nervous system and other areas of the body by permeating into the mucosal membranes, as is the soft lining of the nasal passages.

有些人通过鼻烟摄入尼古丁，这实际上是将烟叶推入鼻孔，让烟草渗透到粘膜（如鼻道的柔软内衬）中，从而进入神经系统和身体的其他部位。

And of course, there are nicotine patches, nicotine gum, there's nicotine in pill form, there are toothpicks dipped in nicotine, et cetera.

当然，还有尼古丁贴片、尼古丁口香糖、药丸形式的尼古丁、浸有尼古丁的牙签等等。

Today we are going to separate our discussion of nicotine from a discussion of smoking and vaping and the other forms of delivery for nicotine.

今天，我们将把对尼古丁的讨论与对吸烟和电子烟以及其他尼古丁输送形式的讨论分开。

We will be talking about smoking and vaping and other routes of nicotine administration, both for sake of highlighting their detriments to health, and believe it or not, in certain cases, keep in mind, very specific certain cases, the possible health benefits of delivering nicotine through specific modalities.

我们将讨论吸烟和电子烟以及其他尼古丁给药途径，都是为了强调它们对健康的危害，无论你相信与否，在某些情况下，请记住，在非常具体的某些情况下，通过特定方式提供尼古丁可能对健康有益。

Turns out those modalities do not include smoking cigarettes or vaping.

事实证明，这些方式不包括吸烟或电子烟。

And we are going to pay particular attention to vaping today because vaping use is on the rise, in particular in young people, and vaping use and the fact that most tobacco that's consumed through vaping includes quite amount of nicotine, has created a scenario where nicotine, because of its ability to change certain chemicals in the brain, can actually lead to addiction for a number of other substances related to vaping and vaping-associated behaviors.

今天我们要特别关注电子烟，因为电子烟的使用正在增加，特别是在年轻人中，而且电子烟的使用以及大多数通过电子烟消耗的烟草都含有大量尼古丁这一事实，已经造成了这样一种情况：尼古丁由于其能够改变大脑中的某些化学物质，实际上可以导致对与电子烟和电子烟相关行为相关的许多其他物质的成瘾。

If all of that seems like a lot to get your arms and your mind around right here at the outset, don't worry, I'll walk you through this.

如果一开始所有这些对于让你的手臂和思想都集中起来似乎很困难，别担心，我会引导你完成这个。

Regardless of whether or not you have a background in biology or not, I promise that you'll come through at the end of this episode with a deep understanding of how nicotine works in the brain and body, some of its benefits, some of its potential drawbacks, and you'll have clear optics as to why smoking and vaping and other forms of nicotine delivery have the effects that they do on your biology and psychology.

无论您是否有生物学背景，我保证您在本集结束时将深入了解尼古丁在大脑和身体中的工作原理、它的一些好处、它的一些潜在缺点，并且您将清楚地了解为什么吸烟、电子烟和其他形式的尼古丁输送会对您的生物学和心理产生影响。

Before we go any further, I just want to highlight a key takeaway from a previous episode, which is our episode on focus, and in fact was a toolkit for focus.

在我们进一步讨论之前，我只想强调上一集的一个关键要点，这是我们关于焦点的一集，实际上是一个焦点工具包。

So during the toolkit for focus episode, we talked about a large number of behavioral, pharmacologic, and other interventions that you can use to increase your level of concentration and focus for whatever purpose, cognitive endeavors, learning languages, focusing in school, on work, et cetera, or physical pursuits.

因此，在注意力集中工具包中，我们讨论了大量的行为、药理学和其他干预措施，您可以使用它们来提高注意力水平，无论出于什么目的，认知努力、学习语言、专注于学校、工作等或身体追求。

Now, one of the key takeaways is that there are really two key protocols that I believe everyone should understand and know about and why they work, because they are so effective and also because they dovetail nicely with some of the information that we're going to talk about today, which will explain why nicotine is so effective in increasing focus.

现在，关键的要点之一是，我相信每个人都应该理解和了解两个关键协议以及它们为何有效，因为它们非常有效，也因为它们与我们今天要讨论的一些信息很好地吻合，这将解释为什么尼古丁在提高注意力方面如此有效。

And these two protocols are as follows.

这两个协议如下。

Data based on studies done in Wendy Suzuki's lab at New York University, and of course, Wendy was a guest on this podcast, so you can check out that episode if you like.

数据基于纽约大学 Wendy Suzuki 实验室所做的研究，当然，Wendy 是这个播客的嘉宾，所以如果您愿意，您可以查看该集。

But studies done in her laboratory point to the fact that a daily, very brief, in fact, only 13-minute meditation can vastly increase focus and focus ability, not just immediately after the meditation practice, but at all other times as well.

但在她的实验室进行的研究表明，每天进行一次非常简短的冥想（事实上，只有 13 分钟）可以极大地提高注意力和集中能力，不仅是在冥想练习后立即进行，而且在所有其他时间也是如此。

So again, this is a meditation practice done daily for just 13 minutes.

再说一遍，这是每天进行的冥想练习，每次只需 13 分钟。

It's a very simple meditation practice where one sits or lies down, closes your eyes, and directs your attention to a place just between your two eyes and right above it, so on your forehead, but just inside of that.

这是一种非常简单的冥想练习，人们坐下或躺下，闭上眼睛，将注意力转移到两眼之间及其正上方的位置，也就是额头上，但就在额头的内部。

And please understand that your brain does not have sensory receptors, so unlike focusing on your fingertips and the sensations there, if you focus on your brain, you can't actually sense anything in your brain except your thoughts.

请理解，你的大脑没有感觉受体，因此与专注于你的指尖和那里的感觉不同，如果你专注于你的大脑，你实际上无法感知大脑中除了你的想法之外的任何东西。

So the idea then is that you continually bring your focus back to that location, just about an inch behind your forehead over and over again, and it's the refocusing of your attention to that location after it drifts that succeeds in increasing your focus ability, again, not just during the meditation and afterward, but at other times as well.

因此，你的想法是，你不断地将你的注意力带回那个位置，就在你的额头后面大约一英寸处，一遍又一遍，当你的注意力转移到那个位置后，重新将注意力集中到那个位置，成功地提高了你的专注能力，不仅是在冥想期间和之后，而且在其他时候也是如此。

So this 13-minute-a-day meditation is exceedingly simple and exceedingly effective.

所以这个每天13分钟的冥想非常简单而且非常有效。

It should be performed every day, but if you miss a day, just go back to doing it.

它应该每天执行，但如果你错过了一天，就回去执行。

Don't despair too much, and you will see these positive effects, say the data.

数据显示，不要太绝望，你会看到这些积极的影响。

Also increase effects on mood and other positive aspects of mental health and performance.

还可以增加对情绪以及心理健康和表现的其他积极方面的影响。

So that's the first tool and protocol.

这就是第一个工具和协议。

The second tool and protocol relates to the general, what I call the arrow model of focus.

第二个工具和协议与一般相关，我称之为焦点箭头模型。

This was a model that I created in order to simplify the vast amounts of data on focus and concentration and how they are created by the various chemical systems within your brain.

这是我创建的一个模型，目的是简化有关注意力和注意力的大量数据，以及它们是如何由大脑内的各种化学系统创建的。

We're going to hear a lot about these chemical systems again today in the context of nicotine, and they are as follows.

今天我们将在尼古丁的背景下再次听到很多关于这些化学系统的信息，它们如下。

You can think about focus on any goal or any endeavor as an arrow.

您可以将专注于任何目标或任何努力视为箭头。

So just imagine an arrow which has an arrowhead and a shaft, and we'll add a third component to it in a moment.

因此，想象一下有一个箭头和一个箭杆的箭头，我们稍后将向它添加第三个组件。

The head of the arrow, meaning the direction of your focus, is largely set by acetylcholine, which is a chemical in the brain.

箭头的头部，意味着你的焦点方向，很大程度上是由乙酰胆碱决定的，乙酰胆碱是大脑中的一种化学物质。

The shaft of the arrow is set by a chemical called adrenaline, also called epinephrine.

箭杆是由一种叫做肾上腺素（也称为肾上腺素）的化学物质设定的。

Those are the same thing.

这些是同一件事。

In the brain, typically, it's referred to as epinephrine, and in the body, it's more commonly referred to as adrenaline, but those are the same neurochemical.

在大脑中，它通常被称为肾上腺素，在体内，它更常被称为肾上腺素，但它们是相同的神经化学物质。

Epinephrine/adrenaline represents the shaft of the arrow, and it's Providing the energy for which to focus.

肾上腺素/肾上腺素代表箭杆，它提供集中的能量。

And then we can put behind that arrow a little propeller or a motor if you like, and the propeller or motor in the context of this neurochemistry model is dopamine, which provides ongoing motivation.

然后，如果您愿意，我们可以在箭头后面放置一个小螺旋桨或电机，而在该神经化学模型中，螺旋桨或电机是多巴胺，它提供持续的动力。

It pushes that arrow forward continually as you strive to focus on a particular thing.

当你努力专注于某件特定的事情时，它会不断地向前推动箭头。

This particular arrow model, that is, your ability to increase your focus, can be enhanced therefore by increasing acetylcholine, epinephrine, and dopamine simultaneously.

因此，可以通过同时增加乙酰胆碱、肾上腺素和多巴胺来增强这种特殊的箭头模型，即提高注意力的能力。

And there are a lot of different ways to do that, but one of the more effective ways to do that via supplement protocols is so-called alpha-GPC.

有很多不同的方法可以做到这一点，但通过补充方案实现这一点的更有效方法之一是所谓的 alpha-GPC。

Alpha-GPC taken in 300 milligram form, 10 to 30 minutes before a bout of cognitive work or a bout of physical work will increase your focus by way of increasing acetylcholine and to some extent increasing epinephrine as well.

在进行认知工作或体力工作前 10 至 30 分钟服用 300 毫克的 Alpha-GPC，会通过增加乙酰胆碱并在一定程度上增加肾上腺素来提高您的注意力。

The dopamine increase will have to be achieved either through cognitive processing, that is telling yourself you're doing a good job and moving forward because thoughts really do impact your levels of dopamine or some other sort of pro dopamine or dopamine increasing protocol.

多巴胺的增加必须通过认知处理来实现，即告诉自己你做得很好并继续前进，因为思想确实会影响你的多巴胺水平或某种其他类型的前多巴胺或多巴胺增加方案。

Also discussed in the toolkit for focus and our episode on dopamine for motivation and drive.

工具包中还讨论了如何集中注意力，以及我们关于多巴胺如何提高动力和动力的章节。

So the key thing here to understand is that the 13 minute a day meditation is a very effective way to increase focus capacity, and then in the short term if you want to provide a boost now and again to focus, 300 milligrams of alpha-GPC can be very effective.

所以这里要明白的关键是，每天 13 分钟冥想是提高注意力的非常有效的方法，然后在短期内，如果你想时不时地提高注意力，300 毫克的 α-GPC 会非常有效。

There are various sources for that, and we'll link to one of them in the show note captions.

有多种来源，我们将在节目注释标题中链接到其中之一。

By no means am I saying that you need to take alpha-GPC.

我绝不是说您需要服用 alpha-GPC。

A number of people will certainly opt not to, and a number of people might be saying, "Well, I've heard that alpha-GPC can increase focus by way of increasing acetylcholine and norepinephrine or epinephrine, but it can also increase TMAO, which is a kind of a negative marker of cardiac health and cardiovascular health." For that reason, I and many others will take 600 milligrams of a garlic capsule, which can offset that TMAO increase.

许多人肯定会选择不这样做，并且许多人可能会说，“嗯，我听说 α-GPC 可以通过增加乙酰胆碱和去甲肾上腺素或肾上腺素来提高注意力，但它也会增加 TMAO，这是心脏健康和心血管健康的一种负面标志。”因此，我和其他许多人会服用 600 毫克大蒜胶囊，这可以抵消 TMAO 的增加。

It remains uncertain as to how much alpha-GPC one needs to take before increasing TMAO levels to a point where it's of concern that you would even need to take the garlic capsule, but I just mention it in any case because it's a pretty simple fix.

目前还不确定需要服用多少 α-GPC，才能将 TMAO 水平提高到甚至需要服用大蒜胶囊的程度，但无论如何我只是提到它，因为这是一个非常简单的解决方案。

Garlic has other health benefits too, of course, and for most people, 300 milligrams of alpha-GPC taken every once in a while.

当然，大蒜还有其他健康益处，对于大多数人来说，每隔一段时间就服用 300 毫克 α-GPC。

I certainly don't encourage people to take alpha-GPC every time they want to focus.

我当然不鼓励人们每次想要集中注意力时都服用 alpha-GPC。

I always emphasize behavioral tools first, then focusing on nutritional tools, and on occasion using supplement-based tools to encourage increased levels of focus.

我总是首先强调行为工具，然后关注营养工具，有时使用基于补充剂的工具来鼓励提高注意力。

And then of course there are a various number of different prescription compounds that if you're working with a board-certified physician, they could prescribe you if you need additional tools for focus, things like Ritalin, Adderall, modafinil, armodafinil, Vyvanse, et cetera, for many people are going to be important and maybe even necessary for people with ADHD, et cetera, but that's a category unto itself, and as I always say, I'm not a physician, so I don't prescribe anything.

当然，如果你与经过委员会认证的医生合作，他们可以给你开一些不同的处方化合物，如果你需要额外的工具来集中注意力，比如利他林、阿得拉、莫达非尼、阿莫达非尼、Vyvanse等等，对很多人来说都很重要，甚至对于患有多动症的人来说可能是必要的，等等，但这本身就是一个类别，正如我总是说的，我不是医生，所以我不要开任何处方。

I'm a professor, so I profess many things.

我是一名教授，所以我有很多东西。

And today I just wanted to pass along or redirect your attention to that episode on focus and highlight those two tools, the 13 minute a day meditation and 300 milligram alpha-GPC for increasing focus capacity and for acutely, that is temporarily giving an additional boost for a bout of focus.

今天，我只是想将您的注意力转移到焦点集中的那一集上，并重点介绍这两个工具，即每天 13 分钟冥想和 300 毫克 α-GPC，以提高集中能力，而实际上，这可以暂时增强集中注意力。

And of course, if you choose not to use those protocols, that's perfectly fine too.

当然，如果您选择不使用这些协议，那也完全没问题。

There's certainly no obligation.

当然没有义务。

They are simply available to you should you choose to try them, and if nothing else, you now have in mind the neurochemistry of acetylcholine, epinephrine/adrenaline, and dopamine, and that will really set the stage for understanding just how effective and why nicotine is so effective at increasing focus, motivation, and even as you'll soon hear, working memory and cognitive capacity.

如果您选择尝试的话，您就可以使用它们，如果没有别的，您现在已经想到了乙酰胆碱、肾上腺素/肾上腺素和多巴胺的神经化学物质，这将真正为理解尼古丁在提高注意力、动机，甚至您很快就会听到的工作记忆和认知能力方面的效果和原因奠定基础。

Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

在开始之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。

It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public.

然而，我的愿望和努力的一部分是向公众提供有关科学和科学相关工具的零成本消费者信息。

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

为了与这个主题保持一致，我要感谢今天播客的赞助商。

Let's talk about nicotine and how nicotine impacts our brains, our bodies, our mental performance, our mental health, our physical performance, and our physical health.

让我们来谈谈尼古丁以及尼古丁如何影响我们的大脑、我们的身体、我们的精神表现、我们的心理健康、我们的身体表现和我们的身体健康。

Now, once again, I want to remind everybody that we really need to separate out a discussion about nicotine from the discussion about the delivery device for nicotine.

现在，我想再次提醒大家，我们确实需要将有关尼古丁的讨论与有关尼古丁输送装置的讨论分开。

In other words, when we're talking about nicotine, we are not necessarily talking about smoking, although we might be.

换句话说，当我们谈论尼古丁时，我们不一定是在谈论吸烟，尽管我们可能是在谈论吸烟。

There are things associated with smoking and with vaping and other means of getting nicotine into our system that have their own effects, both negative and in some cases positive.

有些与吸烟、电子烟以及其他让尼古丁进入我们系统的方式有关的东西都有其自身的影响，既有负面影响，在某些情况下也有正面影响。

Indeed, later we will talk about how you can actually use nicotine to get over smoking addiction.

事实上，稍后我们将讨论如何实际使用尼古丁来克服烟瘾。

This won't come as a surprise to many people, but what perhaps will come as a surprise is the fact that many people actually use nicotine-like substances or nicotine itself in order to relieve nicotine addiction.

这对很多人来说并不奇怪，但令人惊讶的是，许多人实际上使用尼古丁类物质或尼古丁本身来缓解尼古丁成瘾。

So we'll talk about that and what that looks like and offer various protocols for you later in the episode.

因此，我们将在本集稍后讨论这一点及其外观，并为您提供各种协议。

I also want to mention here at the outset that I have a long-standing interest in nicotine.

首先我还想提一下，我对尼古丁一直很感兴趣。

In fact, early in my scientific career, I did research on nicotine and its role in brain development, and I've had a long-standing interest in neuroplasticity, the brain's ability to change in response to experience.

事实上，在我科学职业生涯的早期，我研究了尼古丁及其在大脑发育中的作用，并且我长期以来对神经可塑性（大脑根据经历做出反应的能力）产生了兴趣。

And so experiments that have been done by close colleagues and friends of mine have really emphasized the fact that acetylcholine, and in particular when acetylcholine activates so-called nicotinic receptors, something you'll learn more about in a little bit, that can actually serve as a gateway or a trigger for directed rewiring of the brain.

因此，我的亲密同事和朋友所做的实验确实强调了这样一个事实：乙酰胆碱，特别是当乙酰胆碱激活所谓的烟碱受体时，您稍后会了解更多，它实际上可以作为大脑定向重新布线的门户或触发器。

So this is fascinating.

所以这很有趣。

We think of nicotine as something that we take, but actually we have receptors, that is locations in the brain to which nicotine binds and can exert its effects, and those receptors did not come about because of the existence of tobacco or the existence of vaping pens or because of the existence of anything in the outside world.

我们认为尼古丁是我们服用的东西，但实际上我们有受体，即尼古丁在大脑中结合并发挥其作用的位置，而这些受体的产生并不是因为烟草的存在或电子烟笔的存在，也不是因为外界任何事物的存在。

The fact that there are nicotinic receptors in our brain and body tells you that Acetylcholine and nicotine themselves have very important roles in normal brain and body function.

我们的大脑和身体中存在烟碱受体的事实告诉您，乙酰胆碱和尼古丁本身在正常的大脑和身体功能中具有非常重要的作用。

So much so that I often like to point to an anecdote of a very well-known Nobel Prize-winning neuroscientist.

以至于我经常喜欢引用一位著名的诺贝尔奖获得者神经科学家的轶事。

I won't reveal who they are.

我不会透露他们是谁。

They're not a faculty member at Stanford, but many neuroscientists know of this person, and many people in the outside world know of this person, and they are also well-known for their love of nicotine.

他们不是斯坦福大学的教员，但很多神经科学家都知道这个人，外界也有很多人都知道这个人，而且他们也以对尼古丁的热爱而闻名。

I once sat in this person's office, and he, I will reveal that it is a he, consumed no fewer than three pieces of nicotine gum during that relatively short conversation of about 45 minutes.

我曾经坐在这个人的办公室里，他，我透露一下，是一个他，在那个相对较短的大约45分钟的谈话中，吃了不少于三块尼古丁口香糖。

And that was surprising to me, and I asked him why he was taking so much nicotine through nicotine gum, and he replied that for years he had been a chronic smoker, which, on the one hand, had greatly impaired his cardiovascular health and his fitness.

这让我很惊讶，我问他为什么通过尼古丁口香糖摄入这么多尼古丁，他回答说，多年来他一直是一个长期吸烟者，一方面，这极大地损害了他的心血管健康和身体素质。

No surprise there, and we'll talk a little bit more about what the underlying reasons are.

这并不奇怪，我们将更多地讨论根本原因是什么。

But most everyone, if not everyone, knows that smoking cigarettes or smoking in general really impairs lung health.

但大多数人（如果不是每个人）都知道吸烟或一般吸烟确实会损害肺部健康。

There's just simply no question about it.

毫无疑问。

There are some more or less unhealthy ways to smoke, but the quite honest message is that smoking of any kind is going to disrupt lung endothelial function, lung function, blood vessels, and so forth.

有一些或多或少不健康的吸烟方式，但相当诚实的信息是，任何形式的吸烟都会破坏肺内皮功能、肺功能、血管等。

It's going to make it harder to breathe with vigor, take deep breaths, deliver oxygen to tissues, et cetera.

这将使有力呼吸、深呼吸、向组织输送氧气等变得更加困难。

That said, he also pointed out that the data on nicotine specifically are pointing to the fact that nicotine can be protective against certain forms of cognitive impairment, and that is why he continued to chew nicotine-containing gum.

尽管如此，他还指出，有关尼古丁的数据特别指出，尼古丁可以预防某些形式的认知障碍，这就是他继续咀嚼含尼古丁口香糖的原因。

And he swore by the focus-enhancing and motivation-enhancing effects of nicotine-containing gum.

他对含尼古丁口香糖的增强注意力和增强动力的作用深信不疑。

Now, that is not a call to arms for you to run out and start chewing or consuming nicotine-containing products.

现在，这并不是在号召您跑出去开始咀嚼或食用含尼古丁的产品。

We will talk about those products later in the episode, some of their potential advantages, some of their potential disadvantages.

我们将在本集稍后讨论这些产品，它们的一些潜在优点和一些潜在缺点。

Now, I share this anecdote because it nicely separates nicotine from the delivery device through which nicotine arrives.

现在，我分享这个轶事，因为它很好地将尼古丁与尼古丁到达的输送装置分开。

Now, I haven't talked to this individual in a few years to see whether or not the nicotine is working to stave off any kind of Alzheimer's or neurodegenerative or cognitive impairment that would come with age.

现在，我已经好几年没有和这个人交谈过，想看看尼古丁是否能预防任何一种老年痴呆症、神经退行性疾病或随着年龄增长而出现的认知障碍。

This gentleman is getting up in the years and seems quite sharp nonetheless, but then again, was always exceedingly sharp.

这位先生已经上了年纪了，看起来虽然很犀利，但话又说回来，总是极其犀利。

The point is, nicotine is a substance that can both promote cognitive function and, under some conditions, if taken to inappropriate, or I should say to extreme dosages, can also impair cognitive function.

关键是，尼古丁是一种既可以促进认知功能的物质，在某些情况下，如果服用不当，或者我应该说极端剂量，也会损害认知功能。

So today, we really need to have a nuanced conversation about nicotine, one that includes some of the benefits, some of the drawbacks, in particular for children, certainly for people that are pregnant, for people that have addictive tendencies, and for people that have depression and any other kind of mood disorders.

因此，今天，我们确实需要就尼古丁进行一次细致入微的对话，其中包括一些好处和一些缺点，特别是对于儿童，当然是孕妇，有成瘾倾向的人，以及患有抑郁症和任何其他情绪障碍的人。

What I will tell you soon is that nicotine can be very powerful as a mood modulator, and many people who have tried to quit nicotine, mainly through the form of smoking, will find that their mood can drop substantially.

我很快就会告诉你，尼古丁作为情绪调节剂非常强大，许多尝试主要通过吸烟形式戒掉尼古丁的人会发现他们的情绪会大幅下降。

So nicotine does a lot of things in the brain and body, and so I'd like to begin by talking about what exactly nicotine is and how it impacts your brain and body.

尼古丁对大脑和身体有很多作用，所以我想首先谈谈尼古丁到底是什么以及它如何影响你的大脑和身体。

So what is nicotine and where is it found?

那么尼古丁是什么？它在哪里发现？

Now, obviously, nicotine is found in the tobacco plant, but nicotine is also found in nightshades, that is tomatoes, eggplants, and sweet peppers.

显然，尼古丁存在于烟草植物中，但尼古丁也存在于茄属植物中，即西红柿、茄子和甜椒中。

Although the concentrations of nicotine in tomatoes, eggplants, and sweet peppers is vastly lower than it is in the tobacco plant.

尽管西红柿、茄子和甜椒中的尼古丁浓度远低于烟草植物中的尼古丁浓度。

You actually can also find nicotine in potatoes.

实际上，您还可以在土豆中找到尼古丁。

Now, why is nicotine present in potatoes and tomatoes and in the tobacco plant at all?

现在，为什么尼古丁存在于土豆、西红柿以及烟草植物中？

Well, nicotine is a plant alkaloid.

嗯，尼古丁是一种植物生物碱。

We'll get into alkaloids a little bit later.

稍后我们将讨论生物碱。

But it is thought that these alkaloids evolved in plants as a way to prevent insects from eating them.

但人们认为这些生物碱在植物中进化是为了防止昆虫吃掉它们。

And without going into a lot of insect biology, the reason or the rationale behind this explanation is that nicotine is not only a substance in tobacco that people use or in the various medications that people use, but it's also used as a pesticide because it can dramatically disrupt the nervous system of insects.

在不深入了解昆虫生物学的情况下，这种解释背后的原因或基本原理是，尼古丁不仅是人们使用的烟草或人们使用的各种药物中的一种物质，而且它还被用作杀虫剂，因为它可以极大地破坏昆虫的神经系统。

It can render them infertile, which is not to say that it renders humans infertile.

它可以使他们不育，这并不是说它使人类不育。

We want to say again, it is not the case that nicotine renders humans infertile, but it can make certain insects infertile.

我们要再说一遍，尼古丁并不是使人类不育，但它可以使某些昆虫不育。

It can actually disrupt their motor function and their brain function, and the reasons that it has such different effects on insects, in other words, it can kill them or prevent them from reproducing, and therefore explains why plants probably evolved to have this plant alkaloid, nicotine.

它实际上可以扰乱它们的运动功能和大脑功能，以及它对昆虫产生如此不同影响的原因，换句话说，它可以杀死它们或阻止它们繁殖，因此解释了为什么植物可能进化出这种植物生物碱，尼古丁。

In humans, because of the differences in receptors for nicotine, where they are located and the types of receptors, the effects of nicotine on humans is quite a bit different.

在人类中，由于尼古丁受体的位置、受体类型的不同，尼古丁对人体的影响也有很大不同。

And again, it does not cause infertility in humans.

再说一次，它不会导致人类不育。

Although I will talk a little bit later about some double-blind peer-reviewed studies conducted in humans that indicate that, for instance, nicotine can reduce penile girth, that is the girth of the penis, and can lead to certain forms of sexual dysfunction, and those changes are largely downstream of changes in blood flow and endothelial cell function.

尽管我稍后会谈论一些在人类中进行的双盲同行评审研究，这些研究表明，例如，尼古丁可以减少阴茎周长，即阴茎的周长，并可能导致某些形式的性功能障碍，而这些变化很大程度上是血流和内皮细胞功能变化的下游。

Endothelial cells are the cells that make up blood vessels and other vascular-type tissues within the brain and body.

内皮细胞是构成大脑和体内血管和其他血管型组织的细胞。

So nicotine is found in these plants, and what we can know for sure is that at some point in human evolution, somebody or some group of people either, and here I'm completely guessing, it's a just-so story, but someone or some group must have inhaled the smoke from the tobacco plant or put the dried leaves of the tobacco plant against some mucosal tissue, any of the different mucosal linings of their body by which Substances can pass through, that's right.

因此，在这些植物中发现了尼古丁，我们可以确定的是，在人类进化的某个时刻，某人或某群人，在这里我完全猜测，这是一个故事，但某人或某群人一定吸入了烟草植物的烟雾，或者将烟草植物的干叶子放在某些粘膜组织上，物质可以通过的任何不同的粘膜衬里，这是正确的。

Any of the mucosal soft lining tissues of the body will allow certain substances, not all, certain substances to pass in.

身体的任何粘膜软衬组织都会允许某些物质（不是全部）进入。

That's why people can put tobacco in their mouth, and a certain amount of nicotine makes it into the bloodstream, put tobacco up their nose, certain amount of nicotine gets into the bloodstream.

这就是为什么人们可以将烟草放入口中，一定量的尼古丁进入血液，将烟草放入鼻子中，一定量的尼古丁进入血液。

I haven't heard of people putting tobacco in other orifices of their body containing mucosal tissue, and I'm certainly not suggesting people do that, but you get the idea on how nicotine gets from these plants, these dried leaves into the bloodstream.

我还没有听说过有人将烟草放入含有粘膜组织的身体其他孔口中，我当然不是建议人们这样做，但你知道尼古丁是如何从这些植物、这些干燥的叶子进入血液的。

Burning tobacco leads to a heat-induced change in the availability of nicotine, and this is why smoking tobacco or vaping tobacco simply by heating it up allows the nicotine to be liberated and go into the bloodstream simply by inhaling it into the lungs.

燃烧烟草会导致尼古丁的可用性发生热引起的变化，这就是为什么吸烟或吸电子烟只需将其加热即可释放尼古丁并通过将其吸入肺部而进入血液。

We will get back to smoking of various kinds later, but right now let's just keep our attention on how nicotine is pulled from these plants and into the human body.

稍后我们将回到各种吸烟问题，但现在我们只关注尼古丁如何从这些植物中提取并进入人体。

Now, whether by inhalation or whether or not by placing it in contact with the mucosal tissue of the mouth or other mucosal-containing orifice of the body, the nicotine then gets into the bloodstream, and once it's in the bloodstream, it only exerts its effects because it binds to certain so-called nicotinic receptors.

现在，无论是通过吸入，还是与口腔粘膜组织或身体其他含有粘膜的孔口接触，尼古丁都会进入血液，一旦进入血液，它就会发挥作用，因为它与某些所谓的烟碱受体结合。

Okay, so the nicotinic receptors are of the acetylcholinergic variety.

好的，烟碱受体属于乙酰胆碱能受体。

I know this is a lot to think about and a lot to hear if you haven't heard about this, but it's actually quite simple.

我知道如果您还没有听说过的话，这需要考虑很多，也需要听到很多，但实际上非常简单。

Anyone can understand this.

任何人都可以理解这一点。

Acetylcholine is a molecule, a chemical that is, that's released in the brain and body, and when it binds to receptors, that is the little parking spots on cells, it changes the way those cells behave.

乙酰胆碱是一种分子，一种化学物质，在大脑和身体中释放，当它与受体（细胞上的小停车位）结合时，它会改变这些细胞的行为方式。

Those cells can increase their activity and release other chemicals.

这些细胞可以增加其活性并释放其他化学物质。

They can become electrically active.

它们可以变得具有电活性。

They can do any number of different things.

他们可以做许多不同的事情。

When we ingest nicotine, it gets into the bloodstream, and eventually some of that will get into the brain, and some of it gets into the body, and in both the brain and body, there are these so-called nicotinic acetylcholine receptors.

当我们摄入尼古丁时，它会进入血液，最终一部分会进入大脑，一部分会进入身体，而在大脑和身体中，都有这些所谓的烟碱乙酰胆碱受体。

Now, the so-called family, and indeed they are a family, this is how we refer to groups of receptors of related design and genetic background, just like humans.

现在，所谓的家庭，实际上他们是一个家庭，这就是我们指代具有相关设计和遗传背景的受体群体的方式，就像人类一样。

You have a family of these acetylcholine receptors that are of the nicotinic variety.

您有一个烟碱型乙酰胆碱受体家族。

So maybe on one street in your neighborhood, you know the Joneses, on another street you know the Chows, on another street.

所以也许在你家附近的一条街上，你认识琼斯一家，在另一条街上，你认识周家，在另一条街上。

Well, in your body, you have the nicotinic acetylcholine receptors, and then you have the so-called muscarinic acetylcholine receptors.

嗯，在你的身体里，有烟碱乙酰胆碱受体，然后还有所谓的毒蕈碱乙酰胆碱受体。

Today it's really simple.

今天的事情真的很简单。

Nicotine only binds to the nicotinic acetylcholine receptors, and there are a bunch of different ones on a bunch of different tissues, and the differences in those receptors dictate what sorts of effects the nicotine will have on those tissues.

尼古丁仅与烟碱乙酰胆碱受体结合，并且在许多不同的组织上有许多不同的受体，这些受体的差异决定了尼古丁会对这些组织产生什么样的影响。

So let's talk about what those effects are, and let's do that by dividing the effects of nicotine into effects on the brain, so everything from the neck up, and on the body, the so-called central nervous system and the periphery.

那么，让我们来谈谈这些影响是什么，让我们把尼古丁的影响分为对大脑的影响，即从颈部以上的所有影响，以及对身体的影响，即所谓的中枢神经系统和外周。

Although I want to point out that your spinal cord is part of the central nervous system, so in fairness to the reality, your brain and spinal cord are all central nervous system.

虽然我想指出你的脊髓是中枢神经系统的一部分，所以公平地说，你的大脑和脊髓都是中枢神经系统。

Everything else is considered the periphery.

其他一切都被视为外围。

Now, there are a lot of different nicotinic acetylcholine receptors, but for those of you that want to know, you aficionados or if you're ultra curious about this, the main effects of nicotine in the brain are mediated by nicotine binding to the so-called alpha four beta two receptor.

现在，有很多不同的烟碱乙酰胆碱受体，但是对于那些想知道的人、爱好者或者对此非常好奇的人来说，尼古丁在大脑中的主要作用是通过尼古丁与所谓的α4β2受体结合来介导的。

Alpha four beta two receptor.

α四β二受体。

Even if you don't care about receptor subtypes, that's going to come up later when we discuss why nicotine suppresses appetite.

即使您不关心受体亚型，当我们稍后讨论尼古丁为何抑制食欲时，也会提到这一点。

In fact, one of the major reasons why people don't want to quit smoking, or they quit smoking or another form of ingesting nicotine, and then they relapse, they go back to smoking or ingesting nicotine in some other way, is because indeed nicotine will increase metabolism and reduce hunger in large part by binding to this alpha four beta two receptor in a particular area of the brain.

事实上，人们不想戒烟，或者他们戒烟或以其他形式摄入尼古丁，然后又复发，又重新吸烟或以其他方式摄入尼古丁的主要原因之一是，尼古丁确实会通过与大脑特定区域的α4β2受体结合，在很大程度上促进新陈代谢并减少饥饿感。

We're going to return to that in a little bit, but if you've ever heard that nicotine kills the appetite, indeed it does.

我们稍后会回到这个话题，但如果您听说过尼古丁会抑制食欲，那么它确实会抑制食欲。

It's not the behavior of smoking itself.

这不是吸烟本身的行为。

It's not because you always have a cigarette in your mouth that you're not eating more food, although I suppose that might be a minor effect.

这并不是因为你嘴里总是叼着一支烟，所以你没有吃更多的食物，尽管我认为这可能是一个微小的影响。

There are direct effects of nicotine on both appetite, that is, it reduces appetite, and direct effects on metabolism, that is, it increases metabolism through its effects on some other areas of the brain and body we'll talk about in a moment.

尼古丁对食欲有直接影响，即降低食欲，也对新陈代谢有直接影响，即通过对大脑和身体其他区域的影响来增加新陈代谢，我们稍后将讨论。

Now, within the brain, nicotine binds to this alpha four beta two receptor in various locations in the brain, and there are three, and maybe a fourth that we'll talk about, neurochemical effects of nicotine after you ingest it.

现在，在大脑中，尼古丁与大脑不同位置的α4β2受体结合，摄入尼古丁后，我们将讨论三种（也许还有第四种）神经化学效应。

First things first, when you ingest nicotine by smoking nicotine-containing tobacco, or if you place tobacco in contact with the mucosal lining of the nasal passages of the mouth, takes about two to 15 minutes for that nicotine to enter the bloodstream.

首先，当您通过吸食含尼古丁的烟草摄入尼古丁时，或者如果您将烟草与口腔鼻道的粘膜接触，尼古丁大约需要 2 到 15 分钟才能进入血液。

Smoking hits the bloodstream faster, vaping even faster, I should mention, for a variety of reasons, and placing tobacco directly in contact with the mucosal lining is going to be the slowest.

我应该提到，由于多种原因，吸烟对血液的影响更快，吸电子烟的速度更快，而将烟草直接与粘膜内层接触将是最慢的。

Now, as I mentioned before, nicotine gets into the bloodstream, and then because nicotine can pass through the so-called blood-brain barrier, the BBB, which is basically a fence around the brain.

现在，正如我之前提到的，尼古丁进入血液，然后因为尼古丁可以穿过所谓的血脑屏障，即 BBB，它基本上是大脑周围的栅栏。

Because it can pass through the blood-brain barrier, it's going to have very rapid effects on the brain in these four major categories of neurochemicals and neural circuits.

因为它可以穿过血脑屏障，所以它会对大脑的这四大类神经化学物质和神经回路产生非常迅速的影响。

The first of those categories, and this is a very important one.

第一个类别，这是一个非常重要的类别。

This is one that was brought up in the episode on dopamine motivation and drive, and I think not just all scientists, but all human beings should know that within their brain, they have what is called the mesolimbic reward pathway.

这是在关于多巴胺动机和驱动力的一集中提到的，我认为不仅所有科学家，而且所有人类都应该知道，在他们的大脑中，有所谓的中脑边缘奖励通路。

The mesolimbic reward pathway, if you just want to call it the dopamine reward pathway, is, as the name suggests, a set of connections between a brain area called the ventral tegmental area.

中脑边缘奖赏通路，如果你只想将其称为多巴胺奖赏通路，顾名思义，是称为腹侧被盖区的大脑区域之间的一组连接。

You don't have to remember the names of these things, of course, but if you want to, that's fine too.

当然，您不必记住这些东西的名称，但如果您愿意，也没关系。

The ventral tegmental area, or VTA, connects to another area called the nucleus accumbens.

腹侧被盖区（VTA）连接到另一个称为伏隔核的区域。

Now, here's what's very important.

现在，这是非常重要的。

Nicotine triggers the release of dopamine from the nucleus accumbens.

尼古丁触发伏隔核释放多巴胺。

This is what gives nicotine its rewarding properties.

这就是尼古丁具有有益特性的原因。

It increases motivation.

它增加了动力。

It tends to give a Not so subtle, but very transient increase in feelings of wellbeing and alertness and motivation, and that's because of the increase in dopamine caused by nicotine directly within the nucleus accumbens.

它往往会带来不那么微妙但非常短暂的幸福感、警觉性和动力的增加，这是因为尼古丁直接在伏隔核内引起多巴胺的增加。

Nicotine also triggers the release of certain neurochemicals from the ventral tegmental area itself, and those impinge on nucleus accumbens and increase dopamine levels further.

尼古丁还会触发腹侧被盖区本身释放某些神经化学物质，这些化学物质会冲击伏核并进一步增加多巴胺水平。

This is what makes the rewarding properties, or sometimes referred to as the reinforcing properties of nicotine, so powerful.

这就是尼古丁的有益特性（有时称为增强特性）如此强大的原因。

This is why so many billions of people ingest nicotine in one form or another.

这就是为什么数十亿人以一种或另一种形式摄入尼古丁。

It's also why nicotine is so hard to quit, because there's a potent increase in dopamine from multiple neural circuit pathways within this mesolimbic reward circuitry.

这也是尼古丁如此难以戒掉的原因，因为中脑边缘奖励回路中的多个神经回路通路中的多巴胺会显着增加。

Now, within the mesolimbic reward circuitry, there's an interesting feature.

现在，在中脑边缘奖励回路中，有一个有趣的特征。

There are accelerators that essentially push out more dopamine, get more dopamine released, and there are breaks of the so-called GABAergic variety.

有些加速剂本质上是排出更多的多巴胺，释放更多的多巴胺，并且存在所谓的 GABAergic 类型的中断。

GABA is an inhibitory neurotransmitter.

GABA 是一种抑制性神经递质。

You don't need to know too much about it, just understand that nicotine both increases dopamine but also decreases the activity of GABA.

你不需要了解太多，只需了解尼古丁既会增加多巴胺，也会降低GABA的活性。

And so this is like pushing on the accelerator for dopamine, but also removing the break.

这就像推动多巴胺的加速器，但也消除了中断。

So there's a two-pronged effect of nicotine on reinforcement reward dopamine-related pathways, the feel-good motivation pathways, and that is an increase in dopamine and a decrease in GABA.

因此，尼古丁对强化奖励多巴胺相关途径（感觉良好的动机途径）有两个方面的影响，那就是多巴胺的增加和 GABA 的减少。

And again, that's all mediated through this mesolimbic reward pathway involving the ventral tegmental area and the nucleus accumbens.

再说一次，这一切都是通过涉及腹侧被盖区和伏隔核的中脑边缘奖赏通路介导的。

So if you can conceptualize even just 5% of what I just told you, or even if you can just remember nicotine increases dopamine and that's why it feels so good, it makes you want more of it, you will have everything you need to know in mind in order to understand both why nicotine is so highly used and indeed abused, why it's so hard to quit, and that will point to avenues as to how to quit or reduce intake, and it also points to how nicotine can actually be used in an antidepressant way should you choose, and we will talk about what the various criteria are for choosing that.

因此，如果你能概念化我刚才告诉你的内容，哪怕只有 5%，或者即使你只记得尼古丁会增加多巴胺，这就是为什么它感觉如此好，它让你想要更多，你就会记住你需要知道的一切，以便理解为什么尼古丁被如此频繁地使用和实际上滥用，为什么它如此难以戒烟，这将指出如何戒烟或减少摄入量的途径，它也指出如何实际使用尼古丁您是否应该选择抗抑郁药物，我们将讨论选择该药物的各种标准。

But just understand nicotine increases motivation, it decreases negative feelings of mood, it increases positive feelings of mood and motivation.

但只要明白尼古丁会增加动机，它会减少情绪的消极情绪，它会增加情绪和动机的积极情绪。

The second major effect that nicotine has in the brain is that it increases acetylcholine.

尼古丁对大脑的第二个主要影响是它会增加乙酰胆碱。

Acetylcholine is a neuromodulator that exists in you and me.

乙酰胆碱是一种存在于你我体内的神经调节剂。

It is released from multiple sites in the brain, and the two major sites are the nucleus basalis, so these are a collection of neurons in the front and base of your brain, and from some brainstem areas.

它从大脑的多个部位释放，两个主要部位是基底核，因此它们是大脑前部和基底以及某些脑干区域的神经元的集合。

And there are a bunch of different ones back there in your brainstem, which is indeed in the back, that release acetylcholine.

在你的脑干后面有很多不同的神经元，它确实在后面，可以释放乙酰胆碱。

That include the locus coeruleus as kind of a minor site, the pedunculopontine nucleus.

其中包括作为次要部位的蓝斑，即脚桥核。

There are a bunch of these different areas.

有很多这样的不同领域。

The parabigeminal nucleus.

副二联核。

There are a bunch of these things back there.

那里有很多这样的东西。

We don't have to go into all the names, but just understand that there are little pockets of neurons, nerve cells, located in the front and the back and to some extent in the middle of your brain, but really in the front and the back of your brain, that can serve two major roles.

我们不必详述所有名称，只需了解有一小部分神经元、神经细胞，位于大脑的前部和后部，在某种程度上位于大脑的中部，但实际上位于大脑的前部和后部，它们可以发挥两个主要作用。

Here they are.

他们在这里。

Acetylcholine released from nucleus basalis leads to a sort of spotlighting or highlighting of particular neural circuits in the brain.

从基底核释放的乙酰胆碱会导致大脑中特定神经回路的某种聚光灯或突出显示。

What do I mean by this?

我这是什么意思？

Well, let's say you're working on a puzzle.

好吧，假设您正在拼图。

Let's say it's a cognitive puzzle.

假设这是一个认知难题。

Maybe you're doing a word puzzle, or nowadays I've heard of this Wordle thing.

也许你正在做一个单词谜题，或者现在我听说过这个 Wordle 的东西。

I'm on Twitter, and people are always posting their Wordle thing, and I have no idea what it is, but I'm guessing it's some sort of puzzle.

我在 Twitter 上，人们总是发布他们的 Wordle 内容，我不知道它是什么，但我猜这是某种谜题。

I'm guessing it's like a crossword puzzle.

我猜这就像填字游戏。

And here, if I'm wrong, I don't know, educate me.

在这里，如果我错了，我不知道，请教育我。

Tell me what Wordle is, somebody.

有人告诉我 Wordle 是什么吗？

Put it in the comments and tell me if I should play it or not.

把它放在评论里，告诉我是否应该玩。

Here's the deal.

事情是这样的。

When acetylcholine is released from nucleus basalis, the neurons are there in the base of the brain, but they extend axons, which are like little wires, elsewhere in the brain.

当乙酰胆碱从基底核释放时，神经元位于大脑底部，但它们会在大脑其他地方延伸轴突，就像小电线一样。

And when acetylcholine is released, it tends to be released at particular locations in the brain that are associated with whatever activity we happen to be doing.

当乙酰胆碱释放时，它往往会在大脑中与我们正在进行的任何活动相关的特定位置释放。

So if I'm doing Wordle, here I'm talking about it as if I've ever done it, doing a crossword puzzle or Wordle, well, the neurons that were involved in trying to figure out the solution to that Wordle or crossword puzzle are active.

所以，如果我在玩 Wordle，我在这里谈论它就好像我曾经做过一样，做填字游戏或填字游戏，那么，参与尝试找出填字游戏或填字游戏解决方案的神经元是活跃的。

And then acetylcholine is released from the little wires, the little endings of these cells in nucleus basalis, and all of a sudden, those neural circuits get a boost.

然后乙酰胆碱从基底核中这些细胞的小末端释放出来，突然间，这些神经回路得到了增强。

They become more active, and believe it or not, our ability to perform that crossword puzzle, or at least focus on that Wordle or crossword puzzle, gets enhanced.

他们变得更加活跃，不管你相信与否，我们执行填字游戏的能力，或者至少专注于 Wordle 或填字游戏的能力得到了增强。

It literally increases our attention for that and not anything else is enhanced.

它确实增加了我们对此的关注，但其他任何东西都没有得到增强。

So it's literally like a neurochemical attentional spotlight.

所以它实际上就像一个神经化学注意力聚光灯。

Nicotine increases acetylcholine, and thereby focus and concentration and mental performance, not by changing the neural circuits that are activated per se, but rather by making more acetylcholine available at those release sites.

尼古丁会增加乙酰胆碱，从而提高注意力和精神表现，不是通过改变本身激活的神经回路，而是通过在这些释放位点提供更多的乙酰胆碱。

So it's as if the spotlighter got more intense.

所以聚光灯似乎变得更加强烈。

The highlighter is more intense than it would be otherwise.

荧光笔比其他情况更强烈。

And I should also mention because of the so-called pharmacokinetics, the time course in which nicotine has its effects, which are pretty short-lived, talk about those in a moment, this enhancement in cognitive performance and attention is going to be very transient, probably on the order of about 30, maybe 45 minutes.

我还应该提到，因为所谓的药代动力学，尼古丁发挥作用的时间过程是相当短暂的，一会儿就谈这些，认知能力和注意力的这种增强将是非常短暂的，可能约为 30 分钟，也许 45 分钟。

The half-life of nicotine, depending on how it's ingested and whether or not you have food in the gut and what else is in the bloodstream, et cetera, it's going to be anywhere from one to two hours.

尼古丁的半衰期取决于它的摄入方式、肠道中是否有食物以及血液中是否还有其他物质等，它的半衰期约为一到两个小时。

But typically, the effects of nicotine will come on in about two to 15 minutes, as I mentioned before, and then will last anywhere from about 30 to 45 minutes.

但正如我之前提到的，通常尼古丁的作用会在大约 2 到 15 分钟内显现，然后持续大约 30 到 45 分钟。

This is why in the old days, and still to some extent in certain areas of the world, but less so in the United States and certainly in Europe as well, we don't see quite as many people smoking cigarettes for reasons we can discuss later.

这就是为什么在过去，在世界某些地区，在某种程度上，我们没有看到那么多人吸烟，但在美国和欧洲则较少，原因我们稍后会讨论。

But you would see these chain smokers who are trying to maintain constant levels of nicotine in their brain and bloodstream.

但你会看到这些连续吸烟者试图维持大脑和血液中尼古丁的恒定水平。

Now, perhaps they didn't know that Nicotine has this one to two-hour half-life, but they could sense no doubt the cognitive and the physical effects of nicotine, including this cognitive enhancement effect and highlighting of neural circuits effect.

现在，也许他们不知道尼古丁有这么一到两个小时的半衰期，但他们无疑可以感受到尼古丁对认知和身体的影响，包括这种认知增强作用和突出神经回路作用。

And they would notice they would smoke a cigarette, and then for the next five to 45 minutes, have heightened focus, and then it would start to drop off, so then they smoke another cigarette.

他们会注意到自己会吸一支烟，然后在接下来的 5 到 45 分钟内，注意力高度集中，然后注意力会开始下降，所以然后他们会再吸一支烟。

So in other words, they're trying to maintain a constant level of nicotine for whatever activities they need to perform.

换句话说，他们试图在需要进行的任何活动中保持恒定的尼古丁水平。

Obviously, chain smoking because of the terrible effects of smoking.

显然，连续吸烟是因为吸烟的可怕影响。

I'll talk about those terrible effects, but I'm sure you've heard of them before.

我将谈论这些可怕的影响，但我相信您以前听说过它们。

Cancer, depletion of just about every organ and body tissue to the point that it can actually be measured how many years of your life you're peeling off in terms of lifespan and health span by smoking.

癌症，几乎每一个器官和身体组织都被耗尽，以至于可以实际测量你的寿命和健康寿命因吸烟而减少了多少年。

Well, the terrible effects of smoking are indisputable, but the positive effects of nicotine on this circuitry are part of the reason why people would chain smoke in the first place rather than get one big peak of concentration and focus and then just let it disappear after 45 minutes.

吸烟的可怕影响是无可争议的，但尼古丁对这一回路的积极影响是人们一开始会连续吸烟而不是集中注意力并在 45 分钟后让它消失的部分原因。

Okay.

好的。

So what we have is a scenario where dopamine is going up in the mesolimbic pathway.

所以我们看到的情况是多巴胺在中脑边缘通路中上升。

That's why smoking or ingesting nicotine in any other way feels good and makes us feel motivated.

这就是为什么吸烟或以任何其他方式摄入尼古丁感觉良好并让我们感到有动力。

And then the increase in acetylcholine, especially from nucleus basalis in the front of the brain, is the reason why it can increase our ability to focus on particular types of endeavors, particular mental work that we're doing, or maybe even particular physical work.

然后乙酰胆碱的增加，尤其是来自大脑前部基底核的乙酰胆碱的增加，是它可以提高我们专注于特定类型的努力、我们正在做的特定脑力工作、甚至特定体力工作的能力的原因。

Although, I should mention anytime I'm pairing the words nicotine and physical work, it's obvious that because of the ways that smoking impairs lung function, those two things really run counter to one another.

虽然，每当我将尼古丁和体力劳动这两个词配对时，我都应该提到，但很明显，由于吸烟损害肺功能的方式，这两件事确实是相互矛盾的。

In other words, if you are thinking about ingesting nicotine through smoking or vaping in order to improve physical performance, that's a terrible idea.

换句话说，如果您正在考虑通过吸烟或电子烟摄入尼古丁来提高身体表现，那是一个糟糕的主意。

The logic isn't there, and the health detriments are certainly there.

逻辑不存在，但健康危害肯定存在。

The third neurochemical pathway that's strongly activated when nicotine is brought into the central nervous system, into the brain, is epinephrine or in particular norepinephrine, which is related to epinephrine.

当尼古丁进入中枢神经系统、进入大脑时，第三种神经化学途径会被强烈激活，那就是肾上腺素，特别是去甲肾上腺素，它与肾上腺素有关。

Now, earlier I said epinephrine is the same as adrenaline.

现在，我之前说过肾上腺素与肾上腺素相同。

That's still true.

这仍然是事实。

Norepinephrine is closely related to epinephrine, and for today's discussion, we're going to use them interchangeably.

去甲肾上腺素与肾上腺素密切相关，在今天的讨论中，我们将互换使用它们。

Although I realize as I say that, that the medical students and some biology students are probably going to have a minor seizure when I lump norepinephrine and epinephrine.

尽管我意识到，当我将去甲肾上腺素和肾上腺素混合在一起时，医学生和一些生物系的学生可能会出现轻微的癫痫发作。

I don't do that to be too much of a lumper.

我这样做并不是为了显得太过笨拙。

In science, we talk about lumpers and splitters.

在科学中，我们谈论集总器和分离器。

Lumpers are people that like to oversimplify a little bit.

笨蛋是那些喜欢过于简单化的人。

Splitters are people that really like to detail.

分裂者是真正喜欢细节的人。

You'll see a lot of splitters on social media from time to time.

你时不时会在社交媒体上看到很多分裂者。

They'll say, "Wait, you didn't mention the alpha two beta six receptor subunit." Okay, look, I get it, and I am all for having splitters in the room, but for sake of today's discussion and for ease of digestibility of some of this, just want to point out that norepinephrine, epinephrine, and adrenaline I'm going to treat as a common pool of similar, in fact, very similar molecules that all have the same net effect, at least in the context of this discussion, and that's to increase levels of alertness, energy, and arousal.

他们会说，“等等，你没有提到α2β6受体亚基。”好吧，听着，我明白了，我完全赞成在房间里放分流器，但为了今天的讨论，也为了便于理解其中的一些内容，我只想指出，我将把去甲肾上腺素、肾上腺素和肾上腺素视为相似的、事实上非常相似的分子的共同池，它们都具有相同的净效应，至少在本次讨论的背景下是这样，那就是提高警觉性、能量和唤醒水平。

And the way that nicotine accomplishes those increases in alertness and arousal and energy within the brain is by triggering the release of norepinephrine from a little cluster of neurons in the back of the brain called locus coeruleus.

尼古丁实现大脑内警觉性、唤醒力和能量增加的方式是通过触发大脑后部称为蓝斑的一小群神经元释放去甲肾上腺素。

Tiny cluster of neurons that offers up, or I should say has, because they're always there from birth, has these little wires, these axons, that extend many, many places in the brain.

微小的神经元簇提供了，或者我应该说已经提供了，因为它们从出生起就一直存在，有这些小电线，这些轴突，延伸到大脑中很多很多地方。

Not every place, but virtually every place, and can sprinkler the brain with norepinephrine, essentially serve as a wake-up signal, elevating levels of energy.

不是每个地方，但几乎每个地方，都可以向大脑喷洒去甲肾上腺素，本质上是作为唤醒信号，提高能量水平。

And when that combines with the acetylcholine from nucleus basalis, which causes attentional spotlighting, increases in concentration and focus, and with the feel-good properties of dopamine and the motivating properties of dopamine released from the mesolimbic reward pathway, now you can start to get a picture of why nicotine is such a powerful molecule.

当它与来自基底核的乙酰胆碱结合起来时，它会引起注意力集中，增加注意力和注意力，再加上多巴胺的感觉良好特性和中脑边缘奖励通路释放的多巴胺的激励特性，现在您可以开始了解为什么尼古丁是一种如此强大的分子。

It's making people feel motivated and good, it's making people feel focused, and it makes people feel alert when they would otherwise feel a little bit sleepy.

它使人们感到有动力和良好，使人们感到专注，并且使人们在原本感到有点困倦时感到警觉。

So this is a really powerful compound.

所以这是一种非常强大的化合物。

In fact, going back to our earlier discussion about focus and some tools for focus, and I encourage you, if you're interested, to please check out the episode on focus.

事实上，回到我们之前关于专注和一些专注工具的讨论，如果您有兴趣，我鼓励您查看有关专注的剧集。

There are a number of different tools and protocols there to increase focus.

有许多不同的工具和协议可以提高关注度。

But here we're talking about one molecule, nicotine, found in plants like tomatoes and potatoes and the tobacco plant, and it can be synthesized in a laboratory and ingested through a patch or a gum or even a pill or a toothpick dipped in nicotine.

但这里我们谈论的是一种分子，尼古丁，存在于西红柿、土豆和烟草等植物中，它可以在实验室中合成，并通过贴片或口香糖，甚至是药丸或浸有尼古丁的牙签摄入。

One molecule that can trigger activation of all the circuits for focus and motivation in one fell swoop.

一种分子可以一次性触发所有回路的激活，以提高注意力和动力。

That is remarkable.

这是非常了不起的。

That is absolutely remarkable.

这绝对是了不起的。

And here we haven't even touched on some of the psychological components of focus, right?

在这里我们甚至还没有触及专注力的一些心理成分，对吧？

Whether or not we're interested in something, whether or not we're excited about it or not.

无论我们是否对某件事感兴趣，无论我们是否对此感到兴奋。

This is a very, very powerful system.

这是一个非常非常强大的系统。

So powerful, in fact, that I think we can really place nicotine right up there at the top, right next to caffeine as the molecule that has fundamentally changed human evolution, human consciousness, and human experience.

事实上，如此强大，以至于我认为我们真的可以将尼古丁放在顶部，紧邻咖啡因，作为从根本上改变人类进化、人类意识和人类经验的分子。

Right?

正确的？

Even if you're somebody who's never ingested nicotine, this absolutely has to be true because you have these nicotinic receptors.

即使您是从未摄入过尼古丁的人，这也绝对是正确的，因为您有这些烟碱受体。

Which is to say that acetylcholine that's naturally released without any external trigger within your brain and body, or I should say without any trigger from nicotine in particular, is binding these nicotinic acetylcholine receptors and is creating these effects in your brain and body.

也就是说，在您的大脑和身体内没有任何外部触发的情况下自然释放的乙酰胆碱，或者我应该说没有任何尼古丁的触发，会结合这些烟碱乙酰胆碱受体，并在您的大脑和身体中产生这些影响。

It's just absolutely staggering.

这绝对是令人震惊的。

Now, earlier I mentioned the appetite-suppressing and indeed metabolism-increasing effects of nicotine.

现在，前面我提到了尼古丁的抑制食欲和促进新陈代谢的作用。

And while that's a fairly niche component of what nicotine does, it's an important one, but it's not the major reason why most people consume nicotine.

虽然这是尼古丁作用中相当小众的组成部分，但它是一个重要的组成部分，但它并不是大多数人消费尼古丁的主要原因。

I'd like to take a moment and talk about that now because we are in the brain, and we're talking about the effects of nicotine in the brain, and so it seems to me the appropriate time to talk about this.

我现在想花点时间谈谈这个问题，因为我们在大脑中，我们正在讨论尼古丁对大脑的影响，所以在我看来，现在是谈论这个问题的合适时机。

Now we can have this conversation about nicotine and appetite and metabolism in a very simple and straightforward way.

现在我们可以以非常简单直接的方式讨论尼古丁与食欲和新陈代谢。

If you'd like to learn more about the biology of metabolism and appetite and how those things are mediated by neural components, so not just stuff like your liver, et cetera, we have episodes on that, but really the neural components of hunger and appetite, I encourage you to check out our episode on hunger and appetite.

如果你想了解更多关于新陈代谢和食欲的生物学知识，以及这些东西是如何由神经成分介导的，那么不仅仅是像你的肝脏等东西，我们有关于这方面的剧集，但实际上是饥饿和食欲的神经成分，我鼓励你看看我们关于饥饿和食欲的剧集。

But in that episode, we had a discussion, and it's one that I'll just Briefly summarize now that you have a collection of neurons that sits right above the roof of your mouth or so called the hypothalamus.

但在那一集中，我们进行了一次讨论，现在我将简要总结一下，因为您的上颚或所谓的下丘脑正上方有一组神经元。

Hypo means below, and thalamus is right above it, hypothalamus.

Hypo 的意思是下面，丘脑就在它的上面，即下丘脑。

So the small collection of neurons in the hypothalamus do a number of different things related to sex behavior, aggression, mediating the temperature of your body, et cetera, but also appetite and suppressing appetite.

因此，下丘脑中的一小部分神经元会做许多与性行为、攻击性、调节身体温度等相关的不同事情，而且还涉及食欲和抑制食欲。

And within the hypothalamus, there's a compact collection of these little neurons which are referred to as the POMC, P-O-M-C neurons, and the name comes from the fact that they express certain peptides, and we won't get into that now.

在下丘脑内，有一个紧凑的小神经元集合，它们被称为 POMC、P-O-M-C 神经元，这个名字来源于它们表达某些肽的事实，我们现在不讨论这个。

But the POMC neurons have a very profound impact on whether or not you feel hungry or whether or not you do not feel hungry, whether or not your appetite is suppressed.

但 POMC 神经元对你是否感到饥饿、是否不感到饥饿、你的食欲是否受到抑制有着非常深远的影响。

It turns out that when nicotine gets into the bloodstream and then into the brain, some of that nicotine binds to nicotinic alpha four, beta two containing nicotinic receptors.

事实证明，当尼古丁进入血液，然后进入大脑时，其中一些尼古丁会与含有烟碱受体的烟碱α4、β2结合。

Again, these subunits are receptors, but basically the nicotine binds to one of those parking spots, parks there, and as a consequence, these POMC, P-O-M-C neurons increase their electrical activity and appetite is suppressed.

同样，这些亚基是受体，但基本上尼古丁会与其中一个停车位结合，停在那里，因此，这些 POMC、P-O-M-C 神经元的电活动增加，食欲受到抑制。

And that's because the POMC neurons have outputs to various areas of the brain and body, controlling everything from how full we feel to whether or not our blood sugar goes up or down, which can impact our hunger, and believe it or not, whether or not we have a tendency to want to move the jaw of our mouth in order to chew food.

这是因为 POMC 神经元向大脑和身体的各个区域输出，控制着一切，从我们的饱腹感到血糖是否上升或下降，这会影响我们的饥饿感，不管你相信与否，无论我们是否倾向于移动下巴来咀嚼食物。

Yes, believe it or not, the neural circuitry associated with appetite and suppression of appetite actually dictates whether or not you prefer to, or I should say, are more biased or less biased to moving your mouth, that is chewing.

是的，不管你信不信，与食欲和抑制食欲相关的神经回路实际上决定了你是否更愿意，或者我应该说，更偏向或不偏向移动你的嘴，即咀嚼。

Which makes perfect sense when you hear it, right?

当你听到它时，这很有意义，对吧？

One way to suppress appetite is to sew the jaw shut neurally, or at least make it less likely to open your mouth and put food in it.

抑制食欲的一种方法是用神经缝合下颌，或者至少使其不太可能张开嘴并将食物放入其中。

Actually, that reminds me of a story.

其实，这让我想起一个故事。

I'll just interrupt myself to tell a brief story.

我会打断自己讲一个简短的故事。

That there's a famous Nobel laureate who won the Nobel Prize for something totally distant from appetite, but once turned to a friend of mine at a meeting and said, "You know, I discovered the biological mechanism for losing weight." And my friend said, "Well, of course, it's ingest fewer calories than you burn, right?

有一位著名的诺贝尔奖获得者，他因一些与食欲完全无关的东西而获得诺贝尔奖，但有一次在一次会议上对我的一个朋友说：“你知道，我发现了减肥的生物机制。”我的朋友说：“当然，它摄入的卡路里比燃烧的卡路里少，对吧？

Calories in, calories out, fundamental rule of thermodynamics and basically the fundamental rule of weight loss, weight gain, or weight maintenance."

卡路里输入、卡路里输出、热力学的基本规则以及减肥、体重增加或体重维持的基本规则。”

And he said, "No, it's actually the gene that controls whether or not you open your mouth." Now, he was making a very nerdy joke, so if you didn't register that as a joke, that's about as funny as neuroscience or biology jokes get.

他说：“不，实际上是基因控制着你是否张开嘴。”现在，他正在讲一个非常书呆子的笑话，所以如果你没有将其视为一个笑话，那它就像神经科学或生物学笑话一样有趣。

There are a couple funnier ones, but that one's kind of considered on the funnier side, so this is why we're not considered comedians.

有一些更有趣的，但那一个被认为是更有趣的，所以这就是为什么我们不被认为是喜剧演员。

But the point of the matter is that whether or not you crave or desire or impulsively want to put things in your mouth and chew it will actually dictate how many calories that you eat.

但问题的关键在于，无论你是否渴望、渴望或冲动地想把东西放进嘴里咀嚼，实际上都将决定你摄入了多少卡路里。

And so I find it remarkable and indeed important to know that these POMC neurons are actually inhibiting the opening and the movement of the mouth for chewing.

因此，我发现了解这些 POMC 神经元实际上抑制口腔的张开和咀嚼运动非常重要，而且确实很重要。

So when we smoke or when we ingest nicotine in any other way, you activate these POMC neurons, you suppress appetite, but in part, you do that by actually limiting the impulse to chew.

因此，当我们吸烟或以任何其他方式摄入尼古丁时，您会激活这些 POMC 神经元，抑制食欲，但在某种程度上，您实际上是通过限制咀嚼冲动来做到这一点的。

Incredible, at least to me.

难以置信，至少对我来说。

Now, in addition to limiting appetite by changing one's desire to ingest food and chew it, and actual craving of food by regulation of blood sugar, et cetera, there do seem to be some quite direct effects of nicotine on metabolism, and the effects on metabolism aren't enormous.

现在，除了通过改变摄入和咀嚼食物的欲望来限制食欲，以及通过调节血糖来限制对食物的实际渴望等之外，尼古丁似乎确实对新陈代谢有一些相当直接的影响，而且对新陈代谢的影响并不大。

These are increases in metabolism that are about 2% up to about 5%, but I want to emphasize that those are transient increases in metabolism.

这些是新陈代谢的增加，大约为 2% 到 5%，但我想强调的是，这些都是新陈代谢的短暂增加。

Nonetheless, people that quit smoking often find that their appetite goes up.

尽管如此，戒烟的人常常发现他们的食欲增加了。

They sometimes gain weight, they sometimes do not, depending on whether or not they offset that increase in appetite with increased physical exercise or with decreased food intake in other ways.

他们有时会增加体重，有时不会，这取决于他们是否通过增加体育锻炼或以其他方式减少食物摄入来抵消食欲的增加。

But there does seem to be this direct effect of ingesting nicotine on metabolism, which I find is interesting because if you look in the literature, one of the reasons why people are reluctant to quit ingesting nicotine, if, for instance, they want to quit using the delivery device to nicotine that's causing such problems for their health, like smoking or vaping, or whether or not they find themselves, quote, unquote, "addicted to or have the habit of ingesting nicotine," in part, that's likely due to be the dopamine effects, right?

但摄入尼古丁似乎确实对新陈代谢有这种直接影响，我发现这很有趣，因为如果你看一下文献，就会发现人们不愿意戒掉尼古丁的原因之一，例如，如果他们想戒掉使用尼古丁输送装置，因为尼古丁会给他们的健康带来问题，比如吸烟或吸电子烟，或者他们是否发现自己“对摄入尼古丁上瘾或有摄入尼古丁的习惯”，部分原因是多巴胺效应，对吗？

Because dopamine is highly reinforcing and rewarding.

因为多巴胺具有高度强化和回报作用。

It feels good, so people want to do more of it.

感觉很好，所以人们想做更多。

But it's also that for many people, and here the data really point to the fact that a lot of the younger female smokers or younger female vapers, or when I say that, of course, I mean younger females that vape, are doing that because they like the appetite-suppressing effects.

但对于很多人来说，这里的数据确实指出了一个事实，即许多年轻女性吸烟者或年轻女性电子烟使用者，或者当我这么说时，当然，我指的是年轻女性电子烟，这样做是因为她们喜欢抑制食欲的效果。

Which, of course, opens up an entire conversation about the sociology of body imagery, et cetera, a topic for a future podcast.

当然，这开启了关于身体意象社会学等的完整对话，这是未来播客的主题。

Okay, so nicotine has certain effects on the brain by virtue of the fact that nicotine binds these nicotinic acetylcholine receptors, and those receptors are found on some but not all neural circuits within the brain.

好的，尼古丁对大脑有一定的影响，因为尼古丁与这些烟碱乙酰胆碱受体结合，而这些受体存在于大脑内的一些但不是全部神经回路上。

And we talked about some of them already, mesolimbic, the POMC neurons, et cetera.

我们已经讨论了其中的一些，中脑边缘、POMC 神经元等等。

Now, when we ingest nicotine, it goes from the bloodstream to all the tissues and organs of the body.

现在，当我们摄入尼古丁时，它会从血液进入身体的所有组织和器官。

How does it do that?

它是如何做到的？

Right?

正确的？

Amazing.

惊人的。

It can pass to everything, the brain, the body.

它可以传递到一切，大脑，身体。

It does that because nicotine is fat-soluble.

这样做是因为尼古丁是脂溶性的。

And now anytime people hear the word fat, they tend to think about body fat, subcutaneous fat, or maybe they think about dietary fat.

现在，每当人们听到脂肪这个词时，他们往往会想到身体脂肪、皮下脂肪，或者可能会想到膳食脂肪。

What I mean by fat-soluble in the context of nicotine being fat-soluble is that the cells of your body have an outer layer, so-called outer membrane, and it's made up of lipid, of fat, very particular types of lipids, in fact.

在尼古丁脂溶性的背景下，我所说的脂溶性是指你身体的细胞有一个外层，即所谓的外膜，它是由脂质组成的，事实上，是非常特殊类型的脂质。

Nicotine has this remarkable ability to move through that fatty tissue.

尼古丁具有穿过脂肪组织的非凡能力。

Not all molecules have that ability, but nicotine does.

并非所有分子都具有这种能力，但尼古丁具有。

So it can move relatively freely through the brain and body and relatively freely from outside of cells, extracellular space, to intracellular space.

因此它可以相对自由地穿过大脑和身体，并且相对自由地从细胞外部、细胞外空间到细胞内空间。

So it can get into cells, it can do that with the brain, we talked about those effects, and it can do that within the body Now, anytime we're talking about the body, we could be talking about any number of things.

所以它可以进入细胞，它可以通过大脑做到这一点，我们讨论了这些影响，它可以在体内做到这一点现在，任何时候我们谈论身体，我们都可以谈论很多事情。

But today, I'm going to refer to the periphery and the body in more or less the same way.

但今天，我将以大致相同的方式提及外围和身体。

But keep in mind, in the back of your head, pun intended, you have your brain, your eyes, and the spinal cord, and those three things make up your central nervous system.

但请记住，在你的后脑勺，双关语，你有你的大脑、你的眼睛和脊髓，这三部分组成了你的中枢神经系统。

The peripheral nervous system and the periphery, which is the rest of your body, that contain your organs and so forth outside of the nervous system, things like your liver and your stomach, et cetera, that's what we're going to talk about now.

周围神经系统和外周，即你身体的其余部分，包含神经系统之外的器官等，比如你的肝脏和胃等，这就是我们现在要讨论的内容。

Because nicotine has profound effects on the organs of the body that are separate from, but that occur in parallel at the same time as the effects of nicotine on the brain.

因为尼古丁对身体器官的影响是独立的，但与尼古丁对大脑的影响同时发生。

So let's talk about what some of those effects are.

那么让我们来谈谈其中一些影响是什么。

When nicotine makes it into the bloodstream, again, within two to 15 minutes of ingesting it, depending on the delivery device, your heart rate will increase, blood pressure will increase, and the contractibility of the heart tissue will actually increase.

当尼古丁进入血液时，在摄入尼古丁后的 2 到 15 分钟内，您的心率会增加，血压会增加，心脏组织的收缩性实际上会增加，具体取决于输送装置。

So what that essentially speaks to is an increase in so-called sympathetic tone.

所以这本质上说明的是所谓的交感神经的增强。

And when I say that, I don't mean an increase in sympathy for others of the emotional sort.

当我这么说时，我并不是指在情感上增加对他人的同情。

What I mean is an increase in the sympathetic activity of the sympathetic arm of the autonomic nervous system, which is a real mouthful and mindful of ideas, but all you need to know is that it's a generalized system that increases levels of alertness and physical readiness.

我的意思是自主神经系统交感神经臂的交感活动增加，这是一个真正需要注意的想法，但你需要知道的是，它是一个通用系统，可以提高警觉性和身体准备程度。

So it makes you ready for action, makes you ready for thought.

所以它让你准备好行动，让你准备好思考。

It's balanced by a whole other system called the parasympathetic nervous system, which is basically the so-called rest and digest system, which is a system of neurons and organs, et cetera, that put your body and your brain into a state of not being able to think clearly, to digest, and to fall asleep.

它由另一个称为副交感神经系统的系统来平衡，副交感神经系统基本上就是所谓的休息和消化系统，它是一个由神经元和器官等组成的系统，使您的身体和大脑处于无法清晰思考、消化和入睡的状态。

Okay, so nicotine increases heart rate, blood pressure, and contractibility of the heart, so it's going to cause more blood flow in theory, although it also tends to constrict blood vessels in many locations in the body.

好吧，尼古丁会增加心率、血压和心脏收缩力，因此理论上它会导致更多的血流量，尽管它也会收缩身体许多部位的血管。

This explains the decrease in penile girth effect of nicotine, in particular nicotine ingested by smoking or vaping.

这解释了尼古丁，特别是通过吸烟或电子烟摄入的尼古丁，对阴茎周长的影响减少。

That's right, smoking and vaping reduces penis size and also will have damaging effects on the blood lining endothelial tissue.

没错，吸烟和电子烟会缩小阴茎尺寸，还会对血管内皮组织产生破坏性影响。

So over time, it actually is impairing blood's ability to get to the penis chronically as well as to other organs of the body.

因此，随着时间的推移，它实际上会损害血液长期到达阴茎以及身体其他器官的能力。

But when people ingest nicotine acutely, and let's say they do that by Nicorette patch or by toothpick dipped in nicotine, it will have some of these same effects, but when not smoking tobacco, when bringing nicotine into the bloodstream through other mechanisms, many, if not all, of the disruption of the endothelial cell function can be bypassed.

但是，当人们急剧摄入尼古丁时，假设他们通过尼古丁贴片或浸有尼古丁的牙签来摄入尼古丁，它会产生一些相同的效果，但当不吸烟时，当通过其他机制将尼古丁带入血液时，许多（如果不是全部）内皮细胞功能的破坏可以被绕过。

But the effects on penile girth, the effects on reducing blood flow to various tissues is still present during the effects of nicotine, which, as I mentioned, last about one to two hours.

但是，在尼古丁作用期间，对阴茎周长的影响、减少流向各种组织的血流量的影响仍然存在，正如我提到的，持续大约一到两个小时。

The half-life is about one to two hours, depending on a number of factors not interesting for today's discussion.

半衰期约为一到两个小时，具体取决于今天讨论的一些不感兴趣的因素。

So when nicotine gets into the bloodstream, it's making us more alert.

因此，当尼古丁进入血液时，它会让我们更加警觉。

It's preparing our body for readiness.

它正在让我们的身体做好准备。

The heart is pumping harder.

心脏跳动得更厉害。

Epinephrine, that is adrenaline, is released from the adrenal glands, which ride atop our kidneys.

肾上腺素，即肾上腺素，是从位于我们肾脏顶部的肾上腺释放的。

So everything is pointed toward creating more readiness to move, more readiness to think.

因此，一切都是为了让人们更愿意行动、更愿意思考。

And again, this is happening in parallel with all the effects of neurochemistry that are happening with the brain that we talked about a few minutes ago.

再说一遍，这与我们几分钟前讨论过的大脑中发生的所有神经化学效应同时发生。

Now, what's interesting about nicotine is that while it causes this global increase in readiness and alertness and attention and mood, et cetera, it also has the effect of somewhat relaxing skeletal muscle.

现在，尼古丁的有趣之处在于，虽然它会导致整体的准备度、警觉性、注意力和情绪等增加，但它也具有一定程度放松骨骼肌的作用。

Now, that might seem counterintuitive to those of you out there that already know what I'm about to tell the rest of you who didn't know it previously, that your muscles are able to contract because of the effects of acetylcholine released from neurons in your spinal cord that spit out acetylcholine onto the muscle and bind to what?

现在，对于那些已经知道我要告诉其他之前不知道的人的人来说，这似乎是违反直觉的，你们的肌肉之所以能够收缩，是因为脊髓神经元释放的乙酰胆碱的作用，这些神经元将乙酰胆碱吐到肌肉上并与什么结合？

Nicotinic acetylcholine receptors.

烟碱乙酰胆碱受体。

Put into plain English, nicotinic receptors are also the ways in which your muscles can get activated.

简而言之，烟碱受体也是激活肌肉的方式。

So therefore, why would it be that increasing nicotine would cause relaxation of the muscles?

那么，为什么增加尼古丁会导致肌肉松弛呢？

And that has to do with some of the neural circuits that are upstream of the muscles, and it has to do with a little bit of how the autonomic nervous system is arranged in terms of which receptors go where.

这与肌肉上游的一些神经回路有关，并且与自主神经系统如何安排哪些受体去哪里有关。

A topic and kind of rabbit hole of conversation far too deep for right now, at least in the context of this already somewhat detailed discussion of the effects of nicotine.

就目前而言，这个话题和某种兔子洞的对话太深入了，至少在已经对尼古丁的影响进行了一些详细讨论的背景下是如此。

But if we were to zoom out and just think about the effects of nicotine, we now have a very clear picture.

但如果我们缩小范围，只考虑尼古丁的影响，我们现在就有了一个非常清晰的画面。

Reward pathways are turned on, attention is turned on, alertness is turned on.

奖励途径被打开，注意力被打开，警觉性被打开。

You feel better than you felt a few minutes ago.

你感觉比几分钟前好多了。

Your blood pressure is up.

你的血压升高了。

Your heart rate is up.

你的心率上升了。

Your preparedness for thinking is elevated as well, and yet your body is somewhat relaxed.

你的思考准备度也提高了，但你的身体却有些放松。

That's a very interesting state of mind and body.

这是一种非常有趣的精神和身体状态。

Interesting because it's somewhat ideal for cognitive work.

有趣的是，它对于认知工作来说有点理想。

If you were going to sit down and work on a book, or you're going to sit down and try and figure out a hard math problem, or you're going to write a letter that's been really challenging for you to write, or maybe that you're really excited to write, but that you've been slow to get out the door for whatever reason.

如果你要坐下来写一本书，或者你要坐下来尝试解决一个困难的数学问题，或者你要写一封对你来说真的很有挑战性的信，或者你真的很兴奋写，但无论出于什么原因，你都迟迟不敢出门。

Here I'm talking about my own habits of procrastination.

这里我要说的是我自己的拖延习惯。

Well, that state of being very alert, but your body being relaxed, is almost, if not the optimal state for getting mental work done.

好吧，那种非常警觉但身体放松的状态，即使不是完成脑力工作的最佳状态，也几乎是最好的状态。

Because if you're feeling agitated in your body and you want to physically move your body, it's very hard to do cognitive work, at least the sorts of cognitive work that involve typing or writing or these sorts of things.

因为如果你感到身体烦躁并且想要移动身体，那么就很难进行认知工作，至少是涉及打字或写作或此类事情的认知工作。

It's also the exact opposite of the optimal state for physical performance, which is one of, yes, also alertness, yes, also motivation and elevated mood.

这也与身体表现的最佳状态完全相反，身体表现的最佳状态是，是的，也是警觉性、是的，也是动力和情绪高涨之一。

That's all wonderful stuff to have in mind, literally, when you are exercising or competing in sport or something of that sort.

当你在体育运动或类似活动中锻炼或参加比赛时，从字面上看，这些都是值得牢记的美好事物。

But under those conditions, you really also want to have a fast reaction time, a low latency for muscle activation, so that you can make coordinated muscle movements in the ways that you need to, which is, of course, what's required of physical endeavors.

但在这些条件下，你确实还希望有一个快速的反应时间，一个低的肌肉激活延迟，这样你就可以按照你需要的方式进行协调的肌肉运动，这当然是体力活动所需要的。

That tells us a few things.

这告诉我们一些事情。

First of all, it tells us that nicotine is going to be generally a bad idea for a pre-workout tool or for enhancing physical performance.

首先，它告诉我们，尼古丁对于锻炼前工具或增强身体表现来说通常不是一个好主意。

However, it's apt to be, and in fact is, an excellent tool for enhancing cognitive ability.

然而，它很可能并且事实上确实是增强认知能力的绝佳工具。

And of course, that triggers my mind to return to the anecdote about my Nobel Prize-winning colleague who ingests nicotine by way of nicotine-containing gum in order to increase levels of cognitive focus.

当然，这让我想起了我的诺贝尔奖获得者同事的轶事，他通过含尼古丁的口香糖摄入尼古丁，以提高认知焦点水平。

Certainly not for going out and playing sport.

当然不是为了出去运动。

In fact, despite the fact that he is very, very tall, he often points to himself in an appropriately funny way that despite being on the basketball team of his high school, he's probably the worst player that ever existed, and they only positioned him there because of his height, and I guess his head was designed to prevent balls from entering the basket.

事实上，尽管他非常非常高，但他经常以一种适当有趣的方式指出自己，尽管他是高中篮球队的成员，但他可能是有史以来最差的球员，他们只是因为他的身高而把他安置在那里，我猜他的头是为了防止球进入篮筐而设计的。

In any event, nicotine does seem to be very good at enhancing cognitive function, at least in the short term.

无论如何，尼古丁似乎确实非常擅长增强认知功能，至少在短期内如此。

Which is not to say that it isn't without its side effects, which we will talk about, and again, those are side effects that are independent of smoking or vaping or other forms of ingesting nicotine.

这并不是说它不是没有副作用，我们将讨论这一点，而且这些副作用与吸烟、电子烟或其他形式摄入尼古丁无关。

For instance, dipping or chewing tobacco is known to cause a 50-fold, yes, five zero, 50-fold increase in mouth cancers, things like leukoplakia, and just generally is terrible for your health.

例如，众所周知，吸食或咀嚼烟草会导致口腔癌、白斑等疾病的发病率增加 50 倍，是的，五零，50 倍，而且通常对您的健康有害。

I'm sorry to break it to you, but if you're dipping or you're using snuff or things of that sort, certainly I'm not going to tell people what to do, that's not my role in life, but you are dramatically increasing the probability of an oral cancer or of a mucosal lining cancer of some sort.

我很抱歉打扰你，但如果你在蘸药或使用鼻烟或类似的东西，我当然不会告诉人们该怎么做，这不是我在生活中的角色，但你会大大增加患口腔癌或某种粘膜癌的可能性。

So it's not just that smoking and vaping are bad for your health, these other forms of delivery for nicotine can be bad for your health as well.

因此，不仅吸烟和电子烟对您的健康有害，这些尼古丁的其他传递方式也可能对您的健康有害。

Now, whether or not ingesting nicotine by way of nicotine-containing gum or patch or toothpick or other method is dangerous for other reasons is a discussion that's important.

现在，通过含尼古丁的口香糖、贴片、牙签或其他方法摄入尼古丁是否因其他原因而危险，这是一个重要的讨论。

Right now it appears that provided the dosages are kept reasonable, we'll talk about what reasonable means a little later, and the frequency is kept relatively low, so not relying on these things constantly, there may in fact be some benefit to ingesting nicotine from time to time, provided that you are not still developing your brain.

现在看来，只要剂量保持合理，稍后我们再讲合理是什么意思，而且频率保持在相对较低的水平，所以不要一直依赖这些东西，事实上，时不时地摄入尼古丁可能会有一些好处，前提是你的大脑还没有处于发育阶段。

Now, in reality, neuroplasticity goes on throughout the lifetime.

事实上，神经可塑性会贯穿一生。

Your life is actually one long developmental arc.

你的一生实际上是一条漫长的发展弧线。

It's not like development occurs and then stops.

这并不是说发展发生然后就停止了。

But certainly for people before puberty, during puberty, and probably for the next 15 to 20 years after puberty, avoiding nicotine is probably a good idea.

但对于青春期之前、青春期期间以及青春期后 15 到 20 年的人来说，避免尼古丁可能是一个好主意。

Now, of course, development is your entire life.

当然，现在发展就是你的全部生活。

It's not like development starts and then ends, but certainly for people that are 25 years old or younger, ingesting nicotine as a way to enhance cognitive function is probably not the best idea, and certainly, please, for those of you that are 15 years old or younger, ingesting nicotine in any form, unless it's prescribed by your doctor for a very specific clinical reason, to me seems just like a terrible idea based on all the data that I've read.

这并不像发育开始然后结束，但对于 25 岁或以下的人来说，摄入尼古丁作为增强认知功能的一种方式可能不是最好的主意，当然，对于 15 岁或以下的人来说，摄入任何形式的尼古丁，除非医生出于非常具体的临床原因开出处方，根据我读过的所有数据，对我来说这似乎是一个糟糕的主意。

And the reason for that is it's going to create a scenario of nicotine dependence in order to achieve heightened levels of mood and alertness, et cetera.

原因是它将创造一种尼古丁依赖的场景，以达到更高的情绪和警觉性水平，等等。

And that's bad.

这很糟糕。

And what we're effectively talking about is an addiction for nicotine directly, not necessarily the delivery device method like smoking or vaping, although it could pull that in as an addictive or habit-forming behavior as well.

我们实际上讨论的是直接对尼古丁上瘾，不一定是像吸烟或电子烟这样的输送装置方法，尽管它也可能导致上瘾或形成习惯的行为。

But you want to let your neural circuits develop to the point where, again, unless there's a clinical need for a prescribed drug from a licensed physician or psychiatrist, et cetera, that you're not relying on chemical enhancement of these circuits.

但你想让你的神经回路发展到这样的程度，除非临床需要有执照的医生或精神病学家等开出处方药，否则你不依赖这些回路的化学增强。

For people who are 25 years or older, and again, that's not a strict cutoff, but roughly 25 years or older, but for those of you that are thinking about using nicotine to enhance cognitive function as adults and your brain development is slowing down, right, never ceases, but is slowing down or has slowed down to the point where we would say developmental plasticity is largely over and you're now operating in the context of adult neuroplasticity, well, in that case, there may be instances in which increasing acetylcholine, dopamine, et cetera, by way of nicotine ingestion might be a good idea, but certainly not by smoking, vaping, or by direct contact of tobacco to the mucosal lining tissue of the mouth or nose, so-called dipping or snuffing.

对于 25 岁或以上的人来说，这不是一个严格的界限，但大约是 25 岁或以上，但对于那些正在考虑使用尼古丁来增强成人认知功能的人来说，你的大脑发育正在减慢，对，永远不会停止，但正在减慢或已经减慢到我们可以说发育可塑性已基本结束的程度，而你现在正在成人神经可塑性的背景下进行操作，那么，在这种情况下，可能会出现以下情况：通过摄入尼古丁来增加乙酰胆碱、多巴胺等可能是一个好主意，但肯定不是通过吸烟、吸电子烟或将烟草直接接触口腔或鼻子的粘膜组织（所谓的浸渍或吸鼻）来增加。

For the last 20 minutes or so, we've been talking about the biology of nicotine specifically, how it impacts the brain, how it impacts the body, why it feels so good, why it can enhance focus.

在过去 20 分钟左右的时间里，我们一直在具体讨论尼古丁的生物学特性，它如何影响大脑，如何影响身体，为什么它感觉如此好，为什么它可以增强注意力。

And we've largely set aside smoking, vaping, dipping tobacco, and snuffing, and the negative effects that those all have on mental and physical health.

我们基本上已经忽略了吸烟、吸电子烟、吸烟草和吸鼻烟，以及所有这些对身心健康的负面影响。

Working down from the top of the head to the bottom of the feet, we can say that smoking, vaping, dipping, and snuffing negatively impact every organ and tissue system and cell of the body by virtue of the fact that they all damage the endothelial cells.

从头顶到脚底，我们可以说吸烟、吸电子烟、吸电子烟和吸鼻烟都会对身体的每个器官、组织系统和细胞产生负面影响，因为它们都会损害内皮细胞。

Again, the endothelial cells are the cells that make up the vasculature, which delivers blood and other nutrients to all the cells and organs and tissues of the body.

同样，内皮细胞是构成脉管系统的细胞，它将血液和其他营养物质输送到身体的所有细胞、器官和组织。

And those endothelial cells are strongly and negatively impacted by all of the practices that I just described.

这些内皮细胞受到我刚才描述的所有做法的强烈负面影响。

Now, the way that that happens varies a little bit from each one to the next.

现在，这种情况发生的方式因人而异。

For instance, it has been estimated that cigarettes contain anywhere from 4,000 to 7,000 toxins.

例如，据估计香烟含有 4,000 至 7,000 种毒素。

Now, the word toxins is a real buzzword these days.

如今，“毒素”这个词已经成为一个真正的流行词。

You hear about detoxes and toxins, but more specifically, we know that it contains carcinogens.

您听说过排毒和毒素，但更具体地说，我们知道它含有致癌物质。

These are cancer-promoting compounds.

这些是促进癌症的化合物。

For instance, we know that the tar in cigarettes, even low-tar cigarettes, as well as the ammonia within cigarettes, as well as the formaldehyde contained within cigarettes, as well as the carbon dioxide that's generated from smoking those cigarettes, are all carcinogens.

比如我们知道香烟中的焦油，甚至是低焦油香烟，还有香烟中的氨，还有香烟中含有的甲醛，以及吸食香烟时产生的二氧化碳，都是致癌物质。

Carbon dioxide also has the negative effect of depleting the amount of oxygen that's delivered to any and all of our tissues by way of the impact of carbon dioxide binding hemoglobin and preventing hemoglobin from delivering oxygen to the tissues of the body.

二氧化碳还具有负面影响，即通过影响二氧化碳结合血红蛋白并阻止血红蛋白将氧气输送到身体组织，从而耗尽输送到我们任何和所有组织的氧气量。

So while there may be 4,000 or 4,500 or 7,000 toxins, depending on which cigarette, which papers they happen to be rolled in, whether or not they're filtered or non-filtered, the type of tobacco, et cetera.

因此，虽然可能有 4,000 或 4,500 或 7,000 种毒素，但这取决于哪种香烟、卷在哪种纸中、是否经过过滤或未过滤、烟草的类型等等。

There are a tremendous number of toxins, and there are some very potent carcinogens within that long list of toxins.

毒素的数量非常多，而在这长长的毒素清单中，有一些非常强效的致癌物质。

Again, ammonia, tar, formaldehyde, and carbon dioxide being the most potent of those carcinogens.

同样，氨、焦油、甲醛和二氧化碳是这些致癌物质中最有效的。

Now, the fact that there are carcinogens in cigarettes sometimes leads cigarette smokers, and particularly the cigarette smokers that have the hardest time quitting or that enjoy their cigarettes the most, from saying, "Well, listen, everything is a carcinogen, or everything kills you." Well, certainly that's not a true statement.

现在，香烟中含有致癌物质这一事实有时会导致吸烟者，尤其是那些最难戒烟或最喜欢吸烟的吸烟者说：“好吧，听着，一切都是致癌物，否则一切都会杀死你。”嗯，这当然不是一个真实的说法。

And while there are other carcinogens in the environment, so environmental hazards like solvents, and even if you work in a laboratory, for instance, we use in the laboratory DNA intercalating dyes.

虽然环境中还存在其他致癌物质，例如溶剂等环境危害，但即使您在实验室工作，我们也会在实验室中使用 DNA 嵌入染料。

These are literally dyes that allow us to see the DNA structure of cells and see the proteins they make and see the RNAs they make.

这些染料实际上可以让我们看到细胞的 DNA 结构、它们产生的蛋白质以及它们产生的 RNA。

And it's very important to wear gloves when you work with those things because, as the name suggests, they intercalate.

当你处理这些东西时戴上手套非常重要，因为顾名思义，它们是嵌入的。

They actually get in between the strands of DNA and separate them.

它们实际上进入 DNA 链之间并将它们分开。

They are mutagens.

它们是诱变剂。

They mutate DNA.

它们使 DNA 发生突变。

They are often carcinogens as well.

它们通常也是致癌物质。

So we have them in our laboratory, but we take certain precautions to not have them negatively impact our health, safety protocols and so on.

因此，我们的实验室里有它们，但我们采取了一定的预防措施，以免它们对我们的健康、安全协议等产生负面影响。

We hear that there are carcinogens in car exhaust and bus exhaust and in all sorts of things, like pesticides, and that's all true.

我们听说汽车尾气、公共汽车尾气以及杀虫剂等各种物质中都含有致癌物质，这都是事实。

So in the argument of probabilities, one would say, well, if there are all these other carcinogens in the environment, why would you compound their carcinogenic effect by smoking or vaping or dipping or snuffing?

因此，在概率论中，人们会说，好吧，如果环境中存在所有这些其他致癌物质，为什么要通过吸烟、电子烟、浸泡或鼻吸来复合它们的致癌作用呢？

But that usually doesn't get people to quit smoking or doing those things because of the powerful reinforcing effects of nicotine itself.

但这通常不会让人们戒烟或戒烟，因为尼古丁本身具有强大的强化作用。

So again, nicotine is the reinforcing element by way of triggering that dopamine reinforcement pathway, the mesolimbic reward pathway.

同样，尼古丁是通过触发多巴胺强化途径（中脑边缘奖赏途径）的强化元素。

And of course, there are all the other additional effects of increased focus, such as increased ability to pay attention to work or to others that lead to other rewards, and so then it becomes a situation of compounding rewards.

当然，注意力的增加还有其他所有的额外影响，比如提高对工作或其他人的注意力的能力，从而带来其他奖励，所以这就变成了复合奖励的情况。

So it's not really about the cigarette, it's about the nicotine.

所以这并不是香烟的问题，而是尼古丁的问题。

And it's not really about the nicotine, it's about the dopamine that the nicotine evokes.

这实际上与尼古丁无关，而是与尼古丁引起的多巴胺有关。

And then it's not really about the dopamine that the nicotine evokes directly per se, but also about all the positive effects that that increased dopamine results in.

这并不是尼古丁本身直接引起的多巴胺，而是多巴胺增加所带来的所有积极影响。

So we can easily circle back to the negative effects of smoking, vaping, dipping, and snuffing and say the endothelial cells are disrupted.

因此，我们可以很容易地回到吸烟、电子烟、吸食和吸鼻烟的负面影响，并说内皮细胞受到了破坏。

The endothelial cells are involved in delivery of blood and other nutrients to every tissue of the body, and smoking, vaping, dipping, and snuffing contain carcinogens, which are cancer-promoting.

内皮细胞参与将血液和其他营养物质输送到身体的每个组织，吸烟、吸电子烟、吸食和吸鼻烟都含有致癌物质，这些物质会促进癌症。

And because the epidemiological studies are out there, we can actually arrive at some very clear numbers as to how much life one will lose from ingesting nicotine by way of those four delivery devices, or I should say any one of those four delivery devices.

由于流行病学研究已经存在，我们实际上可以得出一些非常明确的数据，说明通过这四种输送装置（或者我应该说这四种输送装置中的任何一种）摄入尼古丁会损失多少生命。

Although I should also mention that many people who are vaping are also smoking cigarettes.

尽管我还应该提到，许多吸电子烟的人也在吸香烟。

This is becoming increasingly common.

这种情况正变得越来越普遍。

A lot of people are using vaping in one context and cigarettes in another, dipping in one context, vaping in another.

许多人在一种情况下吸电子烟，在另一种情况下吸香烟，在一种情况下吸，在另一种情况下吸。

But even for those that only smoke or only vape or only dip or only snuff, the negative effects are dramatic and calculable.

但即使对于那些只抽烟、只吸电子烟、只吸烟或只吸鼻烟的人来说，负面影响也是巨大且可以计算的。

So it is thought that for every pack of cigarettes consumed per day, so you could average that out if you're a two-a-day cigarette smoker or a pack-a-day cigarette smoker or two pack a day.

因此，人们认为，对于每天消耗的每包香烟，如果您是每天吸两包香烟的人或每天吸一包香烟的人或每天吸两包香烟的人，您可以将其平均化。

For every pack of cigarettes smoked per day, we can reliably estimate a 14-year reduction in lifespan.

每天吸一包香烟，我们可以可靠地估计寿命会减少 14 年。

So cigarettes are literally peeling years off your life.

所以香烟确实会缩短你的寿命。

Now because of the way that the brain works and the way that human beings anticipate the future and can be grounded both in the present and the future or the present and the past, that's just how the mind works, right?

现在，由于大脑的工作方式以及人类预测未来的方式，并且可以立足于现在和未来或现在和过去，这就是思维的工作方式，对吗？

That's why we can think about the future, but also realize where we are in time and space today.

这就是为什么我们可以思考未来，但也可以意识到我们今天在时间和空间上的位置。

Because of that, many people will say, "Well, I enjoy cigarettes," or, "I enjoy vaping, and so at least while I'm here, I'm enjoying it." And that's because the dopamine system is not very good at understanding opportunity cost.

正因为如此，很多人会说，“嗯，我喜欢香烟”，或者“我喜欢电子烟，所以至少当我在这里的时候，我很享受它。”这是因为多巴胺系统不太擅长理解机会成本。

That is what we would be doing in those 14 years and what we would be enjoying and the enrichment that we would get if we were to live into those 14 years.

这就是我们在这14年里要做的事情，如果我们活在这14年里，我们会享受什么，我们会得到什么丰富。

So at some level, the smoker or the vaper is being rational when they say, "Yeah, but I enjoy this, and so the years lost, I can't really register that," because it's hard to register what you don't have and what you've never had, right?

因此，在某种程度上，吸烟者或电子烟使用者在说“是的，但我喜欢这个，所以失去的岁月，我无法真正记录下来”时是理性的，因为很难记录你没有的东西和你从未拥有的东西，对吗？

On the other hand, we can also point to the statistic that there is this 50-fold increase in mouth cancers from dipping, and there are nasal cancers as well that are greatly increased by snuffing and from smoking.

另一方面，我们还可以指出一项统计数据，吸烟导致的口腔癌发病率增加了 50 倍，吸鼻烟和吸烟导致的鼻癌发病率也大大增加。

And now we know based on data from vaping, that the endothelial cell damage and the direct effects of damage to the lungs from tars, and even if people are vaping, which tends to have lower tars than do cigarettes, even for people that are vaping, greatly increased probability of stroke, of peripheral vascular disease.

现在，根据电子烟的数据，我们知道，内皮细胞损伤以及焦油对肺部损伤的直接影响，即使人们使用电子烟（其焦油含量往往比香烟低），也会大大增加中风和周围血管疾病的可能性。

So this is peripheral pain because remember, blood is delivering not just blood, but other nutrients, and it's clearing things out from tissues.

所以这是外周疼痛，因为请记住，血液不仅输送血液，还输送其他营养物质，并且清除组织中的物质。

So there's an accumulation of literally toxins and debris that cells generate all the time, which is healthy, but then it normally is cleared away by the endothelial cells and by other cell types of the immune system.

因此，细胞一直产生的毒素和碎片会不断积累，这是健康的，但通常会被内皮细胞和免疫系统的其他细胞类型清除。

That's all increased in people that engage in these nicotine delivery device behaviors.

对于使用尼古丁输送装置的人来说，这种情况有所增加。

Rates of heart attack, rates of stroke, rates of cognitive decline are all increased.

心脏病发作率、中风率、认知能力下降率均有所增加。

Now you might say cognitive decline, I thought that nicotine increases the likelihood that we can maintain healthy neuronal function and cognitive capacity.

现在你可能会说认知能力下降，我认为尼古丁增加了我们维持健康的神经元功能和认知能力的可能性。

It might even increase cognitive capacity in a potent way in the short term, and indeed it does.

它甚至可能在短期内有效地提高认知能力，而且确实如此。

However, cigarette smoking and vaping are now known to dramatically decrease cognitive function because one of the key things about the brain is that it is the most metabolically demanding organ, which means it consumes a lot of glucose, or even if you're ketogenic, you need ketones.

然而，现在已知吸烟和电子烟会显着降低认知功能，因为大脑的关键之一是它是代谢要求最高的器官，这意味着它会消耗大量的葡萄糖，或者即使你是生酮的，你也需要酮。

You need nutrients getting to the neurons and other cell types of the brain and nervous system in order for it to function properly.

您需要营养物质到达大脑和神经系统的神经元和其他细胞类型，才能使其正常运作。

And when you disrupt the vasculature through this endothelial cell dysfunction, you get things like interstitial, which just means in the spaces between dysfunction.

当你通过这种内皮细胞功能障碍破坏脉管系统时，你会得到像间质这样的东西，这意味着功能障碍之间的空间。

So it's not just beating up the endothelial cells themselves, but the spaces between the cells, it's being disrupted.

因此，它不仅破坏了内皮细胞本身，而且破坏了细胞之间的空间。

There's a lot of debris that accumulates there.

那里堆积了很多碎片。

And as a consequence, the brain just simply will not function as well.

结果，大脑就无法正常运作。

So you start getting short-term memory lapses, you start getting working memory lapses.

所以你开始出现短期记忆衰退，你开始出现工作记忆衰退。

Working memory is the sort of memory if someone tells you their seven-digit phone number, typically nowadays people just share their info, but seven-digit phone number or a sequence of numbers or an address and your inability to remember that.

工作记忆是指某人告诉您他们的七位电话号码的记忆，现在人们通常只是分享他们的信息，但是七位电话号码或一系列数字或地址而您无法记住它们。

So you're walking back to the kitchen sink and you can't remember what you were trying to remember just a short moment ago.

当你走回厨房水槽时，你却记不起刚才你想记住的事情了。

That's working memory.

这就是工作记忆。

Working memory suffers long-term memory, projective or interrogative memories into the future.

工作记忆会受到长期记忆、投射或疑问记忆的影响。

How can you remember things in the future that haven't occurred yet?

你怎么能记住未来还没有发生的事情呢？

Well, this is more of a memory for future plans or ideas and planning for things that are to come.

嗯，这更多的是对未来计划或想法的记忆，以及对即将发生的事情的计划。

So what we can very reliably say is that currently more than one billion, more than one billion people consume tobacco in order to get their nicotine, because that's really the reinforcing element within tobacco.

所以我们可以非常可靠地说，目前超过十亿人消费烟草是为了获取尼古丁，因为这确实是烟草中的增强元素。

More than one billion people consume tobacco in the form of cigarettes every day.

每天有超过十亿人以卷烟的形式消费烟草。

A growing number of people, more than half a billion people now are starting to vape.

越来越多的人，现在超过 5 亿人开始使用电子烟。

The estimates range from 200 million to 500 million, and there's a lot of debate about this because a lot of people are hybrid smokers and vapers, meaning they do one or both, depending on time of day and location, as I mentioned before.

估计范围从 2 亿到 5 亿不等，对此存在很多争论，因为很多人都是吸烟者和电子烟爱好者的混合体，这意味着他们会根据一天中的时间和地点选择其中一种或两种，正如我之前提到的。

But now you start to see how you can get to the number that billions of people are consuming tobacco because of course you also have your people that are dipping and your people that are snuffing, and as I mentioned before, you have people that are engaging in multiple of these behaviors.

但现在你开始了解如何才能获得数十亿人正在消费烟草的数字，因为当然也有人在吸食烟草，也有人在吸食烟草，正如我之前提到的，有人正在从事多种此类行为。

So billions of people on planet Earth, anywhere from one eighth to a quarter of human beings, incredible, right?

地球上有数十亿人，占人类的八分之一到四分之一，这令人难以置信，对吧？

Anywhere from one eighth to a quarter of human beings are consuming tobacco in one form or another in order to get their nicotine one way or another, and as a consequence, are peeling years off their life, dramatically increasing the probability of cancer, stroke, heart attack, peripheral neuropathies, brain dysfunction, meaning cognitive dysfunction, memory impairment, sexual dysfunction.

任何地方，都有八分之一到四分之一的人以某种形式消费烟草，以便以某种方式获取尼古丁，结果，他们的寿命缩短了，大大增加了患癌症、中风、心脏病、周围神经病、脑功能障碍（即认知功能障碍、记忆障碍、性功能障碍）的可能性。

There are a number of studies that have looked at increases in cortisol, and while minor, those increases do exist, decreases in growth hormone, and while minor, those decreases exist.

有许多研究考察了皮质醇的增加，虽然幅度较小，但确实存在这种增加，生长激素的减少，虽然幅度较小，但确实存在这种减少。

But even setting aside the negative impact on endocrine, on hormone factors, it's very, very clear that smoking, vaping, dipping, and snuffing are among the worst things that we can do for our health.

但即使撇开对内分泌和激素因素的负面影响，吸烟、吸电子烟、吸毒和吸鼻烟都是对我们的健康最糟糕的事情之一。

They are among the leading causes of preventable death and debilitating life conditions.

它们是可预防的死亡和使人衰弱的生活状况的主要原因之一。

Which may lead you to the question as to why in the world would people do this?

这可能会让您产生这样的问题：为什么人们会这样做？

Well, it turns out most of them don't want to.

好吧，事实证明他们中的大多数人都不愿意。

In the best surveys that one can find of if you could quit smoking, if you could quit vaping, would you?

在关于你是否可以戒烟的最佳调查中，如果你可以戒掉电子烟，你愿意吗？

What you find is that at least for cigarette smokers, 70%, 7-0, want to quit.

您发现，至少对于吸烟者来说，70%（7-0）想要戒烟。

They would love to quit, and yet they find that to be exceedingly difficult.

他们很想戒烟，但又发现这非常困难。

And the reason they find it to be exceedingly difficult is because of all the brain neurochemistry that we talked about before.

他们发现这非常困难的原因是因为我们之前讨论过的所有大脑神经化学。

The reason I spent close to 20 minutes talking about dopamine in the mesolimbic pathway, acetylcholine in the nucleus basalis, and epinephrine and the relaxation of muscles in the periphery, and the increase in readiness in the body and brain, is that all of those combine to make nicotine one of the most powerful and potent cognitive enhancers, and to some extent, physical enhancer, although as I mentioned before, the total number of physical exercise or physical sport-promoting effects of nicotine is very, very small, if not zero.

我花了近20分钟的时间谈论中脑边缘通路中的多巴胺、基底核中的乙酰胆碱、肾上腺素以及周围肌肉的放松，以及身体和大脑的准备度的增加，因为所有这些结合起来使尼古丁成为最强大和最有效的认知增强剂之一，并且在某种程度上，是身体增强剂，尽管正如我之前提到的，体育锻炼或体育运动促进作用的总数尼古丁含量即使不是零，也非常非常小。

There are certain conditions under which one might imagine using nicotine specifically for cognitive enhancement, where performance of complex motor skills would sort of outweigh the negative effects on the neuromuscular system, our ability to generate coordinated movements.

在某些情况下，人们可能会想象专门使用尼古丁来增强认知，在这种情况下，复杂运动技能的表现将超过对神经肌肉系统（我们产生协调运动的能力）的负面影响。

There's actually an excellent study looking at the effects of nicotine, not by smoking delivery, but by a different delivery mechanism, in which they looked at performance of hitters in baseball.

实际上，有一项出色的研究着眼于尼古丁的影响，不是通过吸烟传递，而是通过不同的传递机制，其中他们观察了棒球击球手的表现。

This experiment was kind of an interesting one, even though these were fairly skilled baseball players.

这个实验有点有趣，尽管这些都是相当熟练的棒球运动员。

What they had them do was hit a ball off a tee.

他们让他们做的就是从发球台上击球。

As I recall growing up, and admittedly I didn't play much baseball, but you start off on T-ball, and then you would go, I think it was to pitching machine, then they would use actual pitchers who'd throw the ball.

我记得在成长过程中，诚然我没打太多棒球，但你从T球开始，然后你会去，我认为这是投球机，然后他们会使用真正的投手来投球。

But in this case, it was a couple of different baseball-related tasks.

但在这种情况下，这是几个不同的与棒球相关的任务。

They'd have people hit the ball off a tee, but they had to direct that hit toward a ball atop another tee.

他们会让人们从一个发球台上击球，但他们必须将击球直接击向另一个发球台上的球。

So it's fairly precise targeting that's required in order to knock that ball off the other tee.

因此，为了将球从另一个发球台击落，需要相当精确的瞄准。

So this is an activity that involves not just motor output, but coordinated motor output, and not just coordinated motor output, but directed coordinated output that requires some, as we would say, top-down processing.

因此，这是一项不仅涉及电机输出，还涉及协调电机输出的活动，不仅涉及协调电机输出，还涉及定向协调输出，正如我们所说，需要一些自上而下的处理。

This isn't the kind of thing that can be done reflexively.

这不是那种条件反射就能完成的事情。

This is the kind of thing where the forebrain, the prefrontal cortex in particular, has to be heavily involved in order to suppress certain actions and then create other actions.

在这种情况下，前脑，特别是前额皮质，必须大量参与才能抑制某些行为，然后创造其他行为。

So the basic takeaway of the study is that nicotine delivered by way of nicotine gum, not by smoking, dipping, or snuffing, was able to increase cognitive performance and motor output.

因此，这项研究的基本结论是，通过尼古丁口香糖而不是通过吸烟、吸食或吸鼻来输送尼古丁，能够提高认知能力和运动输出。

So a rare circumstance where a Specific set of demands that involve both cognitive engagement and physical engagement showed a slight but significant improvement.

因此，在一种罕见的情况下，涉及认知参与和身体参与的一组特定要求显示出轻微但显着的改善。

But again, in most cases, nicotine is just simply not going to improve physical output if it's delivered through a smoked cigarette, through vaping, through dipping, or through snuffing.

但同样，在大多数情况下，如果尼古丁通过吸香烟、电子烟、浸渍或鼻吸来传递，它根本不会提高身体输出。

So if all these behaviors are terrible for essentially every aspect of our health, frankly, I mean, when you look at the literature, it's terrible for pregnant women, it's terrible for kids, it's terrible for older people, it's terrible for younger people.

因此，如果所有这些行为基本上对我们健康的各个方面都很糟糕，坦率地说，我的意思是，当你查看文献时，这对孕妇来说很糟糕，对孩子来说很糟糕，对老年人来说很糟糕，对年轻人来说也很糟糕。

I mean, you really cannot find a scenario in which smoking, vaping, dipping, or snuffing are good for us, and yet people like the effects on the brain, and they feel quite addicted to them.

我的意思是，你真的找不到吸烟、电子烟、吸食或吸鼻对我们有好处的情况，但人们却喜欢这些对大脑的影响，而且他们觉得对它们很上瘾。

Even if they say they're not, most of those people would be unwilling to give up their practice of nicotine delivery for more than a few hours.

即使他们说他们不是，大多数人也不愿意放弃尼古丁输送超过几个小时。

In fact, if you look at the effects of withdrawal, and we are going to talk about what withdrawal of nicotine looks like, what you find is that as soon as four hours after the last ingestion of nicotine by way of cigarette or vaping or dipping or snuffing, what people start to experience is some agitation, craving for nicotine, of course.

事实上，如果你看看戒断的影响，我们将讨论尼古丁戒断是什么样子，你会发现，在最后一次通过香烟、电子烟、浸渍或鼻吸方式摄入尼古丁后四个小时，人们开始经历一些焦躁，当然是对尼古丁的渴望。

And while craving is kind of a vague concept, it's actually a very specific biological mechanism.

虽然渴望是一个模糊的概念，但它实际上是一种非常具体的生物机制。

It's the drop in dopamine that's starting to occur, so much so that there's a drop in dopamine below baseline.

多巴胺开始下降，下降幅度如此之大，以至于多巴胺下降到基线以下。

That is, the increase in dopamine that would normally be experienced from smoking, vaping, dipping, or snuffing is now not happening.

也就是说，通常因吸烟、吸电子烟、吸食或吸鼻而产生的多巴胺增加现在不会发生。

And in fact, the levels of dopamine are dropping below where they would've been even without performing that behavior.

事实上，即使不进行这种行为，多巴胺的水平也正在下降。

So that's what craving is, and withdrawal is an increased sense of that craving as well as a lot of negative stuff like stomach aches or nausea or irritability, and often collections of all of those.

这就是渴望，而戒断是指这种渴望的感觉增强，以及许多负面的东西，如胃痛、恶心或烦躁，而且通常是所有这些的集合。

So because these nicotine delivery approaches are so terrible for our health, and also because as many as 70% of people who smoke would like to quit but either feel they can't because they've tried and failed repeatedly often, or because it's just too scary, meaning the reinforcing properties are too strong and therefore they can't imagine living without them, or the withdrawal effects are too strong and they can't imagine living with those.

因为这些尼古丁输送方法对我们的健康非常不利，也因为多达 70% 的吸烟者想要戒烟，但要么觉得自己不能戒烟，因为他们经常尝试但失败，要么因为它太可怕了，这意味着增强特性太强，因此他们无法想象没有它们的生活，或者戒断效应太强，他们无法想象与这些尼古丁一起生活。

Well then, is there hope for quitting smoking, vaping, snuffing, or dipping?

那么，戒烟、戒电子烟、戒鼻烟或戒烟还有希望吗？

And the short answer, fortunately, is yes.

幸运的是，简短的答案是肯定的。

There are excellent ways to do that, and some of them are single event treatments, and we're going to talk about those shortly.

有很多很好的方法可以做到这一点，其中一些是单一事件处理，我们将很快讨论这些方法。

But before we do that, I want to highlight one very brief point, which is that nicotine is not the cause of cancer.

但在此之前，我想强调一个非常简短的观点，那就是尼古丁不是癌症的原因。

Nicotine is not the carcinogen.

尼古丁不是致癌物质。

It's the other things in tobacco or associated with the nicotine delivery device that are causing cancer, and I should mention the other negative impacts on our health, in particular by way of disrupted endothelial blood vessel function.

烟草中或与尼古丁输送装置相关的其他物质会导致癌症，我应该提到对我们健康的其他负面影响，特别是通过破坏内皮血管功能。

Now that leads us to this issue of vaping because as many of you know and probably are thinking as I've been delivering this information, people don't vape tobacco.

现在这让我们想到了电子烟的问题，因为正如我所提供的信息一样，你们中的许多人都知道并且可能正在思考，人们不吸电子烟。

The way that vaping pens are designed is that it includes some liquid, it involves heat, and it does not involve the burning off of tobacco.

电子烟笔的设计方式是它包含一些液体，涉及热量，并且不涉及烟草的燃烧。

In fact, there's a constant updating of the engineering of these vape pens so that they can be very low heat.

事实上，这些电子烟笔的工程设计不断更新，因此它们的热量非常低。

In some cases, they use even non-heating approaches to vaporize the nicotine and allow it to enter the bloodstream very quickly.

在某些情况下，他们甚至使用非加热方法来蒸发尼古丁并使其快速进入血液。

I must say, in a lot of ways, vaping resembles crack cocaine.

我必须说，在很多方面，电子烟类似于强效可卡因。

The reason why vaping and crack cocaine are so similar is the speed of entry of nicotine into the bloodstream.

电子烟和快克可卡因如此相似的原因在于尼古丁进入血液的速度。

This isn't an episode about cocaine, but I just want to very briefly touch on some of the delivery routes for cocaine because they parallel a lot of the delivery routes for nicotine, and we can learn a lot about drug pharmacokinetics and dopamine if we look at the parallels between cocaine and nicotine.

这不是关于可卡因的一集，但我只想非常简单地谈谈可卡因的一些传递途径，因为它们与尼古丁的许多传递途径相似，如果我们看看可卡因和尼古丁之间的相似之处，我们可以了解很多关于药物药代动力学和多巴胺的知识。

I'll preface this by saying cocaine is a terrible drug.

我先说可卡因是一种可怕的药物。

It is actually a Schedule 2 drug in the United States, which means that it has a very, very limited, yet still present medical application, mainly as an anesthetic in certain laboratory and hospital conditions.

它实际上是美国的附表 2 药物，这意味着它的医疗应用非常非常有限，但仍然存在，主要作为某些实验室和医院条件下的麻醉剂。

But aside from that, it's very clear that cocaine is one of the most debilitating drugs that humans can use because of the way that it impacts the dopamine system, and it basically creates a loop whereby the only thing that can really trigger dopamine release is cocaine.

但除此之外，很明显，可卡因是人类可以使用的最使人衰弱的药物之一，因为它会影响多巴胺系统，而且它基本上会形成一个循环，唯一真正能触发多巴胺释放的物质就是可卡因。

And as I've said before, the way that I define addiction is it's a progressive narrowing of the things that bring people pleasure.

正如我之前所说，我对成瘾的定义是，它是一种逐渐缩小给人们带来快乐的事物的范围。

Cocaine certainly falls into the category of addictive drugs, strongly addictive drugs, and in fact it has the additionally pernicious feature that after using cocaine for some period of time, the amount of dopamine that's released becomes progressively lower and lower and lower so that people can never get back to a state in which dopamine release is ever as great as it was the first time they did cocaine or prior to doing cocaine.

可卡因当然属于成瘾性药物，强烈成瘾性药物，事实上它还有一个更致命的特点，就是使用可卡因一段时间后，释放的多巴胺量会越来越低，以至于人们永远无法回到第一次使用可卡因或使用可卡因之前那样多巴胺释放的状态。

Now, with a long period of no cocaine use whatsoever and protecting the dopamine system in a number of different ways, people can often, not always, but often recover their dopamine system, if not completely, then near completely.

现在，由于长期不使用任何可卡因并以多种不同的方式保护多巴胺系统，人们通常可以（并非总是）恢复他们的多巴胺系统，即使不是完全恢复，也接近完全恢复。

So by all means, if you have a problem with cocaine, quit.

因此，如果您对可卡因有问题，请务必戒掉。

Find a way to quit.

寻找退出的方法。

Get treatment.

接受治疗。

Get over that one way or another.

以某种方式克服这个问题。

We have an episode with an expert guest, Dr. Anna Lembke, who's a physician and the chief of the Stanford School of Medicine Dual Diagnosis Addiction Clinic.

我们有一期节目邀请了一位专家嘉宾，安娜·伦布克博士，她是一名医生，也是斯坦福大学医学院双重诊断成瘾诊所的主任。

She's a world expert in dopamine and addictive substances and addictions of all kinds.

她是多巴胺、成瘾物质和各种成瘾方面的世界专家。

You can find that episode at hubermanlab.com.

您可以在 hubermanlab.com 上找到该剧集。

It's filled with information about how to get over different types of addictions, including cocaine addiction.

它充满了有关如何克服不同类型的成瘾（包括可卡因成瘾）的信息。

Also, check out her absolutely phenomenal and indeed important book, "Dopamine Nation," which touches on some of this as well.

另外，请查看她绝对非凡且确实重要的书“多巴胺国家”，其中也涉及其中的一些内容。

And in the show note captions for the episode where Dr. Lembke was my guest, you can also find some additional resources related to that.

在 Lembke 博士作为我的嘉宾的那一集的节目注释字幕中，您还可以找到一些与此相关的其他资源。

So cocaine is terrible.

所以可卡因是可怕的。

That needs to be acknowledged.

需要承认这一点。

It should be avoided, and you should find a way to quit it if you are currently using.

应该避免它，如果你正在使用它，你应该想办法退出它。

With that said, the delivery mechanism for cocaine strongly parallels the delivery mechanisms for nicotine.

话虽如此，可卡因的递送机制与尼古丁的递送机制非常相似。

That is, people will snort cocaine, which is a lot like snuffing or dipping.

也就是说，人们会吸食可卡因，这很像吸鼻或吸食。

That is when people snort cocaine, they're bringing cocaine into proximity or into contact really with the mucosal lining of the nasal passages, which then allows the psychoactive substances to permeate into the bloodstream.

也就是说，当人们吸食可卡因时，他们使可卡因接近或真正接触鼻道的粘膜内层，然后使精神活性物质渗透到血液中。

Very seldom do people eat it, although that does happen from time to time.

人们很少吃它，尽管这种情况时有发生。

People will inject it as so-called mainlining, which is a very rapid entry into the bloodstream because it's direct application to the bloodstream by way of injection.

人们将其作为所谓的主线注射，这是一种非常快速地进入血液的方法，因为它是通过注射的方式直接应用于血液。

And then there's crack cocaine, which is essentially like a vaporizing of the cocaine from a so-called cocaine rock that somewhat resembles vaping of nicotine.

然后是强效可卡因，它本质上就像从所谓的可卡因岩石中蒸发可卡因，有点类似于吸食尼古丁。

So while the vape pen involves a liquid that's sold, a cartridge that contains nicotine and often other flavors as well, flavorings, I should say, both crack cocaine and vaping cause very rapid increases in the relative substances that are psychoactive.

因此，虽然电子烟笔涉及一种出售的液体，但烟弹中含有尼古丁，通常还含有其他香料，我应该说，强效可卡因和电子烟都会导致精神活性相关物质的快速增加。

In the case of cocaine, that would be cocaine and the increase in dopamine in the brain and body, I should mention.

就可卡因而言，我应该提到的是可卡因和大脑和身体中多巴胺的增加。

And in the case of vaping, there's a very rapid increase in blood concentrations of nicotine, much faster than occur with cigarette smoking or other modes of nicotine delivery.

就电子烟而言，尼古丁的血液浓度会迅速增加，比吸烟或其他尼古丁输送方式快得多。

So that speed of onset turns out to be a critical parameter because the speed of onset of nicotine is going to also determine the speed of release of dopamine in the nucleus accumbens and ventral tegmental area, that mesolimbic reward pathway.

因此，尼古丁的起效速度被证明是一个关键参数，因为尼古丁的起效速度也将决定伏隔核和腹侧被盖区（中脑边缘奖赏通路）中多巴胺的释放速度。

And with the mesolimbic reward pathway, it's not just about the peak, meaning the maximal amount of dopamine that's released, but it's the time course, how steep the curve is, how quickly that dopamine increases that's going to determine how reinforcing, how habit-forming, and indeed how addictive a particular substance is.

对于中脑边缘奖励通路来说，它不仅仅与峰值有关，即释放的多巴胺的最大量，而且与时间进程有关，曲线有多陡，多巴胺增加的速度将决定特定物质的强化程度、习惯形成程度以及实际上的成瘾程度。

So one of the major important differences between vaping and cigarette smoking is that the onset of dopamine release from vaping is faster, and even a subtle increase in the rate at which dopamine increases in the mesolimbic reward pathway can make a given amount of nicotine much more habit-forming and addictive.

因此，电子烟和吸烟之间的一个重要区别是，电子烟释放多巴胺的速度更快，甚至中脑边缘奖赏通路中多巴胺增加速率的微妙增加也会使一定量的尼古丁更容易形成习惯和成瘾。

Now, this probably explains the fact that many, many more people, in particular young people age 25 and younger, are vaping at phenomenal rates now.

现在，这可能解释了这样一个事实：越来越多的人，特别是 25 岁及以下的年轻人，现在正在以惊人的速度吸电子烟。

People are starting to vape in just about everywhere.

人们开始在几乎所有地方吸电子烟。

You see this in restaurants.

你在餐馆里就能看到这一点。

You see it on the street.

你在街上就能看到它。

Indeed, you even see it in the classroom.

事实上，你甚至在教室里也能看到它。

This has actually become sort of sport of sorts.

这实际上已经成为一种运动。

It's certainly not something I encourage.

这当然不是我鼓励的事情。

In fact, when I learned about this from a college student, new college student, who's telling me that many college students are actually bringing vape pens into the classroom.

事实上，当我从一位大学生、新大学生那里了解到这一点时，他告诉我，许多大学生实际上正在将电子烟带进课堂。

I think this is also happening in high schools and even junior high schools.

我想这种情况在高中甚至初中也正在发生。

This is a really concerning practice.

这是一个非常令人担忧的做法。

And here I'm not trying to come across as the anti-vaping crusader, but I must say, given the negative effects on one's health in the long term, but also given these exceedingly powerful reward properties of nicotine entering the bloodstream quickly and dopamine being released very quickly from the mesolimbic reward pathway, what we're seeing out there makes total sense.

在这里，我并不是想给人留下反电子烟斗士的印象，但我必须说，考虑到从长远来看对人体健康的负面影响，而且考虑到尼古丁快速进入血液和多巴胺从中脑边缘奖励途径快速释放的这些极其强大的奖励特性，我们所看到的一切是完全有道理的。

Young people's brains are essentially getting wired to the expectation that dopamine is going to be increased dramatically and quickly under their control, except it's under their control only in a very narrow set of circumstances.

年轻人的大脑本质上已经建立了这样的预期：多巴胺将在他们的控制下急剧而迅速地增加，除非它只在非常有限的情况下受到他们的控制。

Recall the definition of addiction, a progressive narrowing of the things that bring you pleasure.

回想一下成瘾的定义，即逐渐缩小给你带来快乐的事物。

We can change that statement to also say a progressive narrowing and specific kinetics, that is specific time course, of the things that bring you pleasure.

我们可以改变这个说法，也说一个渐进的缩小和特定的动力学，即特定的时间过程，给你带来快乐的事情。

Now, that's a bit of a nerdier statement than a progressive narrowing of the things that bring you pleasure.

现在，与逐渐缩小给你带来快乐的事物相比，这是一个有点书呆子的说法。

But what we're going to see in the next few years, I believe, is an entire generation of young people for which a very large percentage of them are going to be seeking out a pattern or feeling because to the person taking it, they're not looking at their dopamine levels rising in their blood.

但我相信，在接下来的几年里，我们将看到整整一代年轻人，其中很大一部分人将寻找一种模式或感觉，因为对于服用它的人来说，他们不会看到血液中多巴胺水平的上升。

They're experiencing this as an increase in focus, an increase in alertness, an increase in mood and well-being that is very rapid, very dramatic, and that simply cannot be recreated by any other substance.

他们的体验是注意力的增强、警觉性的增强、情绪和幸福感的增强，这种增强是非常迅速、非常戏剧性的，这是任何其他物质都无法重现的。

And that's a very concerning scenario.

这是一个非常令人担忧的情况。

Concerning because that mesolimbic reward pathway is the only pathway, the only pathway by which you can achieve the rewarding properties of any kind of endeavor, not just vaping, of course.

之所以令人担忧，是因为中脑边缘奖励途径是唯一的途径，是您可以实现任何类型的努力（当然不仅仅是电子烟）的奖励特性的唯一途径。

It is the way in which people achieve satisfaction from reaching a relationship goal or an athletic goal or an educational goal, any kind of goal or sense of satisfaction.

它是人们通过实现关系目标、运动目标或教育目标、任何类型的目标或满足感而获得满足的方式。

And so it comes as no surprise that vaping is strongly associated with increased levels of depression, especially when vaping use drops off.

因此，电子烟与抑郁程度的增加密切相关也就不足为奇了，尤其是当电子烟使用量下降时。

Why would that be?

为什么会这样呢？

If people are getting so much more dopamine so much more quickly from vaping, shouldn't they be feeling better?

如果人们通过电子烟更快地获得更多的多巴胺，他们难道不会感觉更好吗？

Ah, that brings us back to the critical, and I should say defining feature of the dopamine reward pathway for motivation and well-being, which is that initially a given substance will cause, let's say, an eight out of 10, again, arbitrary units, but eight out of 10 increase in dopamine.

啊，这让我们回到了关键的问题，我应该说多巴胺奖励途径对于动机和幸福感的定义特征，即最初一种给定的物质会导致，比方说，十分之八的任意单位，但十分之八的多巴胺增加。

But with repeated use, what ends up happening is that even at similar or higher levels of ingestion, so not just one inhalation a minute, but maybe two inhalations a minute or an inhalation every 30 seconds, now it's level four out of 10 activation of dopamine, and then three, and then two, and eventually it drops below baseline.

但通过重复使用，最终发生的情况是，即使在相似或更高的摄入水平下，所以不仅仅是每分钟吸入一次，而是可能每分钟吸入两次或每 30 秒吸入一次，现在多巴胺激活的 10 次中达到第 4 级，然后是 3 级，然后是 2 级，最终降至基线以下。

Now, the whole system can be recovered by abstinence from nicotine consumption, but the dopamine system is applied to everything, all sense of well-being, all sense of motivation.

现在，整个系统可以通过戒除尼古丁消耗来恢复，但多巴胺系统适用于一切，所有的幸福感，所有的动力感。

So during the period in which one is abstaining from nicotine and vaping in particular People do not feel good.

因此，在戒除尼古丁和电子烟的时期，人们的感觉尤其不好。

They feel miserable.

他们感觉很痛苦。

That's why it's called withdrawal.

这就是为什么它被称为撤回。

It's associated with a bunch of psychological and physiological symptoms that all lead back to trying to get to the same levels of dopamine release in the same patterns that were experienced when one initially started vaping.

它与一系列心理和生理症状有关，所有这些症状都会导致人们试图以与最初开始吸电子烟时所经历的相同模式达到相同水平的多巴胺释放。

So I'm not trying to paint a dark picture here, but frankly, the picture is very dark.

所以我并不是想在这里描绘一幅黑暗的画面，但坦率地说，画面非常黑暗。

I'm very concerned about a practice of ingesting something that powerfully modulates the dopamine system with the sorts of kinetics that one sees from ingestion of crack cocaine in young people that has all these other negative health effects that in the short term is very powerfully rewarding, increased focus, wellbeing, et cetera, but that over a very brief period of time, leads to a state in which the entire dopamine reward system is impaired and can become permanently impaired unless one intervenes in a very deliberate way.

我非常担心摄入某种东西的做法，这种物质可以通过年轻人摄入强效可卡因的动力学来强有力地调节多巴胺系统，这种做法会对健康产生所有其他负面影响，在短期内会产生非常强大的回报，例如增加注意力、幸福感等，但在很短的时间内，会导致整个多巴胺奖励系统受到损害，并且可能会永久受损，除非有人干预刻意的方式。

So people are directly controlling the rate of dopamine and the frequency of dopamine release by the duration and frequency of inhalations off the vape pen.

因此，人们通过电子烟吸入的持续时间和频率来直接控制多巴胺的速率和多巴胺释放的频率。

And that's an incredible thing because what it does is it sets up the mesolimbic reward pathway for an expectation that dopamine will be delivered on that schedule.

这是一件令人难以置信的事情，因为它的作用是建立中脑边缘奖励通路，以期望多巴胺将按该时间表输送。

So that's one of the things that makes vaping, in particular, so hard to quit.

这就是电子烟很难戒掉的原因之一。

Vaping is actually harder to quit than cigarette smoking for most people.

对于大多数人来说，戒掉电子烟实际上比戒烟更难。

Now, does that mean that cigarette smoking is fairly easy to quit for most people?

现在，这是否意味着对于大多数人来说戒烟相当容易？

No. 70% of people who smoke cigarettes report that they would like to quit if they thought they could.

70% 的吸烟者表示，如果他们认为可以的话，他们愿意戒烟。

The success rate of quitting smoking when people try to go just cold turkey, just quit with no assistance whatsoever, they might tell their family and friends, "Hey, I'm quitting, that's it," is exceedingly low.

当人们试图在没有任何帮助的情况下戒烟时，他们可能会告诉家人和朋友，“嘿，我要戒烟了，就这样了”，戒烟的成功率是非常低的。

It's 5%.

是5%。

So 5% of the people that say, "That's it.

所以 5% 的人说：“就是这样。

I'm not smoking again despite cancer diagnosis.

尽管诊断出癌症，我不再吸烟了。

I'm not smoking again despite the fear of the negative health effects.

尽管担心对健康造成负面影响，但我不再吸烟了。

I'm not going to ever smoke again despite the financial cost, the health cost." I could list off a huge number of things that it does that are negative, but you already know these or you've heard them.

尽管要付出经济代价和健康代价，我不会再吸烟了。”我可以列出大量它所做的负面事情，但你已经知道这些或者你已经听说过它们。

It makes your skin worse.

它会让你的皮肤变得更糟。

As I mentioned, it lowers libido, it disrupts hormones, it disrupts vascular function, brain function.

正如我提到的，它会降低性欲，扰乱荷尔蒙，扰乱血管功能和大脑功能。

It does all these terrible things, and yet most people who try and quit simply can't.

它会造成所有这些可怕的事情，但大多数尝试戒烟的人却做不到。

And of the 5% that succeed in quitting, a full 65% of them relapse within a year.

在 5% 成功戒烟的人中，整整 65% 的人会在一年内复发。

So that's a very depressing picture, but it's not to say that people cannot quit, and in fact, they can.

所以这是一个非常令人沮丧的画面，但这并不是说人们不能戒烟，事实上，他们可以。

There are a couple of methods that have been shown to help people quit.

有几种方法已被证明可以帮助人们戒烟。

Some are behavioral, and some are pharmacologic.

有些是行为方面的，有些是药理学方面的。

I just want to touch on the behavioral ones first because it turns out that there's a quite powerful method for quitting nicotine ingestion by way of cigarette smoking, which also carries over to vaping.

我只想先谈谈行为方面的问题，因为事实证明，有一种非常有效的方法可以通过吸烟来戒除尼古丁的摄入，这种方法也适用于电子烟。

This is beautiful work that's been done by my colleague, in fact, close collaborator, although I was not involved in the research that I'm about to describe, at Stanford, and his name is Dr.

这是我的同事（事实上，亲密的合作者）完成的出色工作，尽管我没有参与我将要描述的斯坦福大学研究，他的名字是 Dr.

David Spiegel.

大卫·斯皮格尔.

He is our associate chair of psychiatry.

他是我们的精神病学副主任。

He's been a guest on the Huberman Lab podcast, and he is a world expert, if not the world expert in the clinical applications of hypnosis.

他是胡伯曼实验室播客的嘉宾，在催眠临床应用方面，即使不是世界专家，他也是世界专家。

Now, when I say hypnosis, a lot of people think stage hypnosis, which is the hypnotist trying to get people to do certain things and say certain things, not necessarily against their will, because they actually have to agree, but the hypnotist is dictating what the person thinks, says, and does.

现在，当我说催眠时，很多人会想到阶段催眠，即催眠师试图让人们做某些事情、说某些事情，不一定违背他们的意愿，因为他们实际上必须同意，但催眠师正在决定人们想什么、说什么、做什么。

Clinical hypnosis is vastly different from that.

临床催眠与此有很大不同。

Clinical hypnosis is where the person, the patient, actually directs their own brain changes toward a specific emotional or behavioral goal.

临床催眠是指患者实际引导自己的大脑变化以实现特定的情感或行为目标。

Work from Dr. David Spiegel's laboratory done in 1993, but that now has been repeated many, many times and has carried over into some more modern studies, and I will provide links to those studies in the show note caption so that you can access them.

David Spiegel 博士的实验室于 1993 年完成了这项工作，但现在已经重复了很多很多次，并已延续到一些更现代的研究中，我将在节目说明标题中提供这些研究的链接，以便您可以访问它们。

Those studies have shown that using a specific form of hypnosis, people can achieve complete and total cessation of cigarette smoking, and there's no reason to believe this doesn't also carry over to vaping through one single hypnosis session.

这些研究表明，使用特定形式的催眠，人们可以完全戒烟，并且没有理由相信这不会通过一次催眠疗程而延续到电子烟上。

And the success rates are incredibly high when one considers that normally it would be only a 5% success rate.

考虑到通常只有 5% 的成功率，成功率高得令人难以置信。

The success rate with this particular hypnosis developed at Stanford School of Medicine by Dr. David Spiegel is 23% of people who do this hypnosis one time succeed in quitting smoking.

斯坦福大学医学院 David Spiegel 博士开发的这种特殊催眠术的成功率是，接受过这种催眠术一次的人中有 23% 成功戒烟。

Now, in the old days, which actually wasn't that long ago, before the advent of smartphones and before the internet took off to the extent that it has now, this was done by having someone come into the clinic, and Dr. Spiegel himself or one of his colleagues would take somebody through the hypnosis.

现在，在过去，实际上并不是很久以前，在智能手机出现之前，在互联网发展到现在的程度之前，这是通过让人进入诊所来完成的，斯皮格尔博士本人或他的一位同事会带领某人进行催眠。

Nowadays, you can access this hypnosis.

如今，你可以进入这种催眠状态。

There's a wonderful app that was developed by Dr. David Spiegel and others.

David Spiegel 博士和其他人开发了一款很棒的应用程序。

It's called Reveri, R-E-V-E-R-I.

它的名字叫《Reveri》，R-E-V-E-R-I。

I've talked about this app a few times on the podcast before because there are hypnosis scripts within the app for enhancing sleep, for improving ability to fall asleep if you wake up in the middle of the night, for focus, and a number of other behavioral and emotional changes.

我之前在播客上曾多次讨论过这个应用程序，因为该应用程序中有催眠脚本，可以增强睡眠、提高半夜醒来时的入睡能力、集中注意力以及许多其他行为和情绪变化。

There's also a function in the Reveri app for smoking cessation, which exactly parallels the sort of in-laboratory and in-clinic approaches that Dr. Spiegel would use were you to show up at his clinic or in his laboratory.

Reveri 应用程序中还有一个用于戒烟的功能，这与 Spiegel 博士在您出现在他的诊所或实验室时使用的实验室和诊所内方法完全相同。

And since that's not possible for the large number of people out there, if you or somebody else is trying to quit smoking or vaping or dipping or snuffing for that matter, I strongly encourage you to check out the Reveri app.

由于这对于很多人来说是不可能的，因此如果您或其他人正在尝试戒烟、戒电子烟、戒烟或吸鼻烟，我强烈建议您查看 Reveri 应用程序。

You can find it easily by going to reveri.com.

您可以访问 reveri.com 轻松找到它。

It's available in various formats.

它有多种格式。

Some of it is available free, some of it is behind a paywall.

其中一些是免费的，一些是付费的。

But given the tremendously negative impact of smoking, vaping, dipping, and snuffing, the hypnosis for smoking cessation that Reveri has seems, at least to me, as a very powerful and worthwhile resource.

但考虑到吸烟、电子烟、吸食和吸鼻带来的巨大负面影响，至少对我来说，Reveri 的戒烟催眠术似乎是一种非常强大且有价值的资源。

So please check that out if you're somebody who's trying to quit ingesting nicotine by any of the four methods that I just described.

因此，如果您正在尝试通过我刚才描述的四种方法中的任何一种戒烟，请检查一下。

Now, of course, there are other methods that people have used to successfully quit smoking or vaping or other forms of nicotine delivery.

当然，现在人们已经使用其他方法来成功戒烟或戒电子烟或其他形式的尼古丁输送。

And there's actually an excellent review on this topic.

事实上，关于这个主题有一篇很棒的评论。

So before diving into a few of the specifics about some of the pharmacology of using nicotine itself to quit smoking or nicotine itself to quit vaping, or the use of various things, even SSRIs, antidepressants, to quit smoking or vaping, I just want to point you to a review article that if you'd like to get a complete survey of all the options that are available, there's an excellent review on this.

因此，在深入探讨使用尼古丁本身戒烟或尼古丁本身戒烟的药理学细节，或者使用各种药物（甚至是 SSRIs、抗抑郁药）来戒烟或电子烟之前，我只想向您推荐一篇评论文章，如果您想对所有可用选项进行完整的调查，那么这里有一篇很棒的评论。

It was published just a couple of years ago in 2020.

它于几年前的 2020 年出版。

The title of the article is Pharmacologic Approach to Smoking Cessation: An Updated Review for Daily Clinical Practice.

文章的标题是戒烟的药理学方法：日常临床实践的更新评论。

And even though this is mainly focused on smoking cessation, it carries over quite nicely to vaping.

尽管这主要针对戒烟，但它也很好地适用于电子烟。

And it details a number of statistics, the fact that every year 700,000 or more people die because of smoking-related diseases.

其中详细列出了多项统计数据，每年有 70 万人或更多的人死于与吸烟有关的疾病。

So there again, you have the negative health effects that younger people are smoking, that women are smoking more nowadays, and that even though you see less smoking typically in the US and Canada and even in Northern Europe, some places, there's still many, many people are smoking who would like to quit.

因此，年轻人吸烟对健康产生了负面影响，现在女性吸烟越来越多，尽管在美国和加拿大，甚至在北欧的一些地方，吸烟率通常有所下降，但仍然有很多很多人在吸烟并想戒烟。

But that 75% of people, at least according to this review earlier, I said 70%, but estimates are as high as 75% of people who try to quit smoking relapse within the first week.

但是那75%的人，至少根据之前的评论，我说的是70%，但估计高达75%的尝试戒烟的人会在第一周内复发。

The first week, they just go right back to it.

第一周，他们就直接回去了。

That's how powerfully reinforcing the nicotine is.

这就是尼古丁的增强作用。

Remember, it's the nicotine in the cigarette that's powerfully reinforcing, but it's also the oral habit, the motor habit.

请记住，香烟中的尼古丁具有强大的增强作用，但口腔习惯和运动习惯也具有强大的增强作用。

There is this thing about density of sensory receptors in the lips.

这与嘴唇中感觉感受器的密度有关。

People like bringing things to their lips, food, cigarettes, other lips in some cases, et cetera.

人们喜欢把东西送到嘴边，比如食物、香烟，在某些情况下还喜欢用其他嘴唇等等。

There is a reinforcement pathway related to that for sort of obvious adaptive reasons.

由于某种明显的适应性原因，存在与此相关的强化途径。

And as a consequence, there is a reinforcement both from the behavior and from the dopamine released from the nicotine itself, and as I mentioned earlier, from the positive reinforcement that comes from increased focus.

结果，行为和尼古丁本身释放的多巴胺都产生了强化，正如我之前提到的，注意力集中带来的积极强化。

So the money that you make through work or your attentional ability or the fact that you're alert and people feel you present, all of that funnels back into positive reinforcement, behavioral reinforcement, and then what we would call addiction.

因此，你通过工作赚到的钱，或者你的注意力能力，或者你的警觉性以及人们感觉你在场的事实，所有这些都会回流到积极强化、行为强化，然后就是我们所说的成瘾。

So this review covers all of that and then steps beautifully through nicotine replacement therapy and various compounds, several of which I'm going to talk about now, which have been shown to increase that number that we talked about earlier of only 5% of people who try to quit with no other support, pharmacologic or hypnosis or otherwise, just say, "That's it.

因此，这篇评论涵盖了所有这些，然后完美地介绍了尼古丁替代疗法和各种化合物，其中我现在要讨论其中的几种化合物，它们已被证明可以增加我们之前讨论过的人数，只有 5% 的人在没有其他支持、药物或催眠或其他方式的情况下尝试戒烟，只需说，“就是这样。

I'm not going to smoke again," or, "I'm not going to vape again." Only 5% of people succeed in doing that, and even among those, many end up relapsing later.

我不会再抽烟了，”或者，“我不会再吸电子烟了。”只有 5% 的人能够成功做到这一点，即使在这些人中，许多人最终还是旧病复发。

There are a couple pharmacologic approaches.

有几种药理学方法。

One of the main ones that's received a lot of attention in recent years is bupropion, sometimes referred to by its commercial name, Wellbutrin.

近年来受到广泛关注的主要药物之一是安非他酮，有时以其商业名称维布特林 (Wellbutrin) 来提及。

Now, bupropion is a compound that increases the release of dopamine and to a lesser extent, epinephrine and some other neurochemicals as well.

现在，安非他酮是一种可以增加多巴胺释放的化合物，并在较小程度上增加肾上腺素和其他一些神经化学物质的释放。

It's used for the treatment of depression and for smoking cessation.

它用于治疗抑郁症和戒烟。

Now, I want to point out again, I'm not a psychiatrist, so I'm not telling you to take bupropion, AKA Wellbutrin, but I'm going to give you a little bit of the contour of what's typically done in terms of bupropion administration to help people get relief from some of the withdrawal symptoms of trying to quit smoking or vaping or other forms of nicotine ingestion.

现在，我想再次指出，我不是精神病学家，所以我不会告诉你服用安非他酮，又名维布特林，但我将向你介绍一些安非他酮给药的典型做法，以帮助人们缓解试图戒烟、电子烟或其他形式尼古丁摄入的一些戒断症状。

Typically, bupropion is taken in 300 milligram per day doses divided into two dosages of 150 milligrams each, or sometimes there's a slow-release formula.

通常，安非他酮每天服用 300 毫克，分为两剂，每剂 150 毫克，有时也有缓释配方。

The dosages will vary from person to person.

剂量因人而异。

Want to really emphasize that there is an increased seizure risk with bupropion.

想要真正强调的是，安非他酮会增加癫痫发作的风险。

It only occurs in a small fraction of the population, but nonetheless, is a real concern for those members of the population.

它只发生在一小部分人口中，但仍然是这些人口中真正关心的问题。

So for those of you with seizure risk, whether you know it or not, that's going to be a valid concern in terms of potential side effects.

因此，对于那些有癫痫风险的人来说，无论您是否知道，这都将是潜在副作用的合理担忧。

The other thing about bupropion is that it has to be used with caution in patients that have liver disease or renal disease that can impact the amount that anyone can take, meaning sometimes people have to take a much lower dose if they have renal disease or liver disease, and sometimes they can't take it at all.

关于安非他酮的另一件事是，患有肝病或肾病的患者必须谨慎使用它，这会影响任何人可以服用的剂量，这意味着有时如果患有肾病或肝病，人们必须服用低得多的剂量，有时根本不能服用。

Sometimes if people are taking benzodiazepines for whatever reason or other sedatives, there are contraindications there.

有时，如果人们出于某种原因服用苯二氮卓类药物或其他镇静剂，则存在禁忌症。

So bupropion isn't a kind of one-size-fits-all or magic bullet for quitting smoking.

因此，安非他酮并不是一种万能的戒烟灵丹妙药。

Nonetheless, for people that can take it safely, and again, this is a prescription drug, a board-certified psychiatrist or other physician is going to have to prescribe it for you if it's appropriate for you.

尽管如此，对于可以安全服用的人来说，再次强调，这是一种处方药，如果适合您，则必须由经过委员会认证的精神科医生或其他医生为您开处方。

And it moves that number of 5% success rate to about what one sees with the clinical hypnosis to about 20% of people will successfully overcome their nicotine, or I should say their smoking or vaping addiction.

它将 5% 的成功率提高到临床催眠中大约 20% 的人将成功克服尼古丁，或者我应该说他们的吸烟或电子烟成瘾。

Now, it's important to ask why this would work, right?

现在，重要的是要问为什么这会起作用，对吧？

It's not as if bupropion is increasing nicotine per se.

安非他酮本身并不增加尼古丁含量。

What it's doing is it's tapping on that mesolimbic reward pathway, increasing dopamine, or at least allowing dopamine levels to stay substantially elevated enough that people don't experience some of the drop in dopamine that leads to the withdrawal symptoms, the lessening of mood, et cetera.

它的作用是利用中脑边缘奖励通路，增加多巴胺，或者至少让多巴胺水平保持足够高的水平，这样人们就不会经历多巴胺的下降，从而导致戒断症状、情绪下降等。

And it's no coincidence that bupropion is also an antidepressant.

安非他酮也是一种抗抑郁药，这并非巧合。

It's a common antidepressant for people that experience negative side effects with the so-called SSRIs, the selective serotonin reuptake inhibitors, that prevent them from taking those things like lessen libido or appetite or in some cases increased appetite or any number of other side effects that some people, not all, but some people experience with SSRIs.

对于那些因使用 SSRIs（选择性血清素再摄取抑制剂）而出现负面副作用的人来说，这是一种常见的抗抑郁药，这种药物会阻止他们服用诸如性欲降低或食欲下降或在某些情况下食欲增加或某些人（不是所有人）使用 SSRIs 时出现的任何其他副作用。

They'll be prescribed Wellbutrin, bupropion is the generic name, so Wellbutrin being the commercial name.

他们将被开出维布特林（Wellbutrin），安非他酮是通用名称，所以维布特林（Wellbutrin）是商业名称。

Again, bupropion is what they'll be prescribed instead with the caveats of seizure risk, renal disease, liver disease, et cetera.

同样，他们将使用安非他酮来代替，但需要注意癫痫风险、肾脏疾病、肝脏疾病等。

The outcomes with Wellbutrin for smoking cessation are pretty good.

使用维布特林戒烟的效果非常好。

If you think about an increase from 5% to 20%, that's pretty dramatic.

如果你考虑一下从 5% 到 20% 的增长，那是相当惊人的。

And yet, I also want to refer back to the incredible success of the clinical hypnosis approach.

然而，我还想回顾一下临床催眠方法所取得的令人难以置信的成功。

Again, you can find that at reveri.com.

同样，您可以在 reveri.com 上找到它。

The clinical hypnosis approach has a success rate of 23%, so it's very closely aligned with, if not exceeding, the success rate with bupropion.

临床催眠方法的成功率为 23%，因此它与安非他酮的成功率非常接近（如果不是超过的话）。

Of course, there are other pharmacologic approaches to quitting smoking or vaping.

当然，还有其他药理学方法可以戒烟或戒电子烟。

All of them generally circle back to increasing dopamine and/or norepinephrine in order to offset some of the withdrawal symptoms of smoking cessation or vaping cessation.

所有这些通常都会回到增加多巴胺和/或去甲肾上腺素，以抵消戒烟或戒烟的一些戒断症状。

A very common approach for people to try and quit smoking or vaping is to use nicotine itself to try and prevent people from seeking nicotine through a cigarette or a vape pen.

人们尝试戒烟或电子烟的一种非常常见的方法是使用尼古丁本身来尝试阻止人们通过香烟或电子烟笔寻求尼古丁。

What I mean by that is people using a nicotine patch or nicotine gum or other nicotine delivery device that is not cigarettes and not vaping in order to maintain levels of nicotine in their bloodstream, which of course means maintain levels of nicotine in their brain and body to the same extent that they would if they were smoking or vaping, maybe even gradually taking down the total amount of nicotine in their brain and body by reducing the number or size of nicotine gum pieces that they ingest each day, or keeping the patch on for a shorter amount of time, or getting a lower dose patch that releases less nicotine total or over time.

我的意思是，人们使用尼古丁贴片或尼古丁口香糖或其他非香烟和非电子烟的尼古丁输送装置来维持血液中的尼古丁水平，这当然意味着将他们的大脑和身体中的尼古丁水平维持在与吸烟或电子烟相同的程度，甚至可能通过减少每天摄入的尼古丁口香糖块的数量或大小来逐渐减少大脑和身体中的尼古丁总量，或保持贴片的时间较短，或使用较低剂量的贴片，以释放较少的尼古丁总量或随着时间的推移。

All of those approaches have been shown to be reasonably successful, I'll get to the numbers in a few minutes, but reasonably successful in allowing people to quit smoking or vaping.

所有这些方法都已被证明是相当成功的，我将在几分钟内得到这些数字，但在让人们戒烟或电子烟方面相当成功。

Again, most of the data is on cigarette smoking because vaping is a relatively new phenomenon, although quite troublingly, it's a very rapidly increasing behavior, especially in the young population.

同样，大部分数据都是关于吸烟的，因为电子烟是一种相对较新的现象，尽管相当令人不安，但它的增长速度非常快，尤其是在年轻人口中。

So that's why I'm kind of lumping these two things together, because I think very soon we are going to need an all-out campaign for how to counter vaping addiction.

所以这就是为什么我把这两件事混为一谈，因为我认为很快我们将需要一场全面的运动来对抗电子烟成瘾。

So what do we know about smoking cessation using nicotine itself?

那么我们对利用尼古丁本身戒烟了解多少呢？

Is the patch best?

补丁最好吗？

Is nicotine gum best?

尼古丁口香糖最好吗？

Turns out that a combination of approaches is best.

事实证明，多种方法的结合是最好的。

This was somewhat surprising, but it was very clear from the literature that I was able to find that using nicotine patches for some period of time and then switching to a gum and then perhaps switching to a nasal spray, that's going to be the most effective.

这有点令人惊讶，但从文献中可以清楚地看出，我能够发现使用尼古丁贴片一段时间，然后改用口香糖，然后也许改用鼻喷雾剂，这将是最有效的。

Then the question is how long to continue each of those and whether or not to overlap them.

接下来的问题是每一项要持续多长时间以及是否要重叠。

It seems as if doing one for about a week and then switching to another for about a week and then switching to another is one rational and reasonable approach that many people have used successfully.

似乎做一种方法大约一周，然后换另一种方法大约一周，然后再换另一种方法，这是许多人已经成功使用的一种理性合理的方法。

Why would that be?

为什么会这样呢？

Well, it all has to do with the different rates of absorption of nicotine into the bloodstream and then the downstream consequences of that on the dopamine, acetylcholine, epinephrine, and other systems of the brain and body.

嗯，这一切都与尼古丁吸收到血液中的不同速率以及随后对多巴胺、乙酰胆碱、肾上腺素以及大脑和身体的其他系统的下游影响有关。

And while there hasn't been an extremely detailed study of the exact kinetics of how the nasal sprays versus the transdermal patches versus the gums, et cetera, work, there's a logical structure to it that will immediately make sense to you.

虽然还没有对鼻喷雾剂、透皮贴剂、牙龈等如何发挥作用的确切动力学进行非常详细的研究，但它有一个逻辑结构，您会立即明白。

First of all, the transdermal patches provide a fairly steady state dopamine release across the day, and oftentimes people are wearing them at night as well.

首先，透皮贴剂在白天提供相当稳定的多巴胺释放，并且人们通常也在晚上佩戴它们。

This is relevant because if people are ingesting nicotine by way of smoking and vaping, hopefully they're not waking up in the middle of the night just to smoke or vape, or believe it or not, some people do that.

这是相关的，因为如果人们通过吸烟和电子烟摄入尼古丁，希望他们不会在半夜醒来只是为了吸烟或电子烟，无论你相信与否，有些人会这样做。

But of course, while people are asleep, they are not smoking or vaping.

当然，当人们睡觉时，他们不会吸烟或吸电子烟。

They always tell you don't fall asleep with a cigarette in your mouth, you'll burn the whole house down.

他们总是告诉你不要含着香烟入睡，否则你会烧毁整个房子。

But exceedingly rare to have people who are smoking in their sleep.

但很少有人在睡梦中吸烟。

So people wake up in the morning, and because the half-life of nicotine from smoking or vaping is very short, anywhere from one to two hours, they're essentially in a state of withdrawal at the point where they wake up in the morning.

因此，人们早上醒来，由于吸烟或电子烟产生的尼古丁的半衰期非常短，只有一到两个小时，所以他们在早上醒来时基本上处于戒断状态。

How can I say that?

我怎么能这么说呢？

Well, remember, withdrawal sets in about four hours after the last ingestion of nicotine by cigarette or by inhalation from the vape pen.

好吧，请记住，在最后一次通过香烟或通过电子烟吸入尼古丁摄入后大约四个小时，戒断就会开始。

So people are waking up in nicotine withdrawal and then immediately going into the behavior of ingesting nicotine or very soon after waking for most people.

因此，人们在尼古丁戒断中醒来，然后立即进入摄入尼古丁的行为，或者对于大多数人来说，醒来后很快就会采取摄入尼古丁的行为。

So nicotine patch is going to be very effective for a week or so.

因此，尼古丁贴片在一周左右的时间内非常有效。

Again, talk to your physician about the best approach for this.

再次，与您的医生讨论最佳方法。

But then switching to a nasal spray or switching to nicotine gum for about a week, which is going to change the kinetics of that nicotine absorption into the bloodstream and change the release of dopamine and other neurochemicals within the brain, that's going to keep the system intentionally off balance so that it never comes to expect one single pattern or amplitude of dopamine release.

但是，然后改用鼻喷雾剂或改用尼古丁口香糖大约一周，这将改变尼古丁吸收到血液中的动力学，并改变大脑内多巴胺和其他神经化学物质的释放，这将故意使系统失去平衡，这样它就永远不会期望多巴胺释放的单一模式或幅度。

And that is a very powerful way for a, let's just call it a quitting method to work, because as I've always said, the most powerful schedule of dopamine is going to be this random intermittent reward.

对于一个人来说，这是一种非常有效的方法，让我们称之为戒烟方法，因为正如我一直说的，最有效的多巴胺时间表将是这种随机的间歇性奖励。

This is what's used in the casinos in order to take your money, and generally they do.

这就是赌场用来骗你的钱的方法，而且通常他们都是这么做的。

On average, they take your money more than you take theirs, and they take more of it, not just more often, because they use this random intermittent schedule.

平均而言，他们拿走你的钱比你拿他们的钱多，而且他们拿走的钱更多，而不仅仅是更频繁，因为他们使用这种随机的间歇性时间表。

The random intermittent schedule is one in which you don't really know when the peaks in dopamine are going to arrive, and so there isn't this expectation and craving, and then all of a sudden when dopamine is released, it's extremely high.

随机间歇性时间表是一种你并不真正知道多巴胺峰值何时到达的时间表，因此没有这种期望和渴望，然后当多巴胺释放时突然变得非常高。

That's how they get you to continue playing even though basically you're losing money and your dopamine is dropping.

这就是他们如何让你继续玩，即使基本上你在赔钱，你的多巴胺也在下降。

They elevate it every once in a while.

他们每隔一段时间就会提升它。

Nicotine replacement can be used in a similar way, but in a benevolent way in order to help you get over smoking or vaping.

尼古丁替代品可以以类似的方式使用，但以仁慈的方式帮助您戒掉吸烟或电子烟的症状。

By keeping the total amounts of dopamine variable around the clock and by changing the amount of dopamine that's released, it seems to help people behaviorally and psychologically because they don't come to expect having a particular amount of dopamine in their brain and blood at any given time.

通过保持多巴胺总量全天候变化并改变释放的多巴胺量，这似乎对人们的行为和心理有所帮助，因为他们不会期望在任何特定时间大脑和血液中都会有特定数量的多巴胺。

And this is an important point because it brings us to this notion of homeostasis.

这是很重要的一点，因为它让我们了解了体内平衡的概念。

Homeostasis is this tendency for biological systems to try and reach equilibrium.

稳态是生物系统试图达到平衡的这种趋势。

What goes up, goes down, et cetera, and to some extent to the same degree.

上涨、下跌等等，并且在某种程度上是相同的程度。

So I'll talk about this right now in the context of nicotine use withdrawal, and then the period in which people no longer crave nicotine.

所以我现在将在尼古丁戒断的背景下讨论这个问题，然后是人们不再渴望尼古丁的时期。

So you can imagine that if we were to measure your heart rate, your blood pressure, and your overall levels of alertness and well-being and mood, let's just give that some value.

所以你可以想象，如果我们要测量你的心率、血压以及你的警觉性、幸福感和情绪的整体水平，我们就给它一些价值。

Let's say it runs from zero to 10.

假设它从 0 到 10。

Again, arbitrary units.

再次，任意单位。

Let's just take all those physiological measures and the subjective measure of your mood, and let's measure it four times an hour across the day, across the waking hours.

让我们采取所有这些生理测量和对你的情绪的主观测量，让我们在一天中醒着的时间里每小时测量四次。

What we would find is a line that would kind of squiggle a bit, maybe a nice text comes in that you really like.

我们会发现一条有点弯曲的线，也许是你真正喜欢的漂亮文字。

Maybe you get a not so good news and your kind of autonomic arousal is all over the place But on average, it's kind of a squiggly line where it increases in the morning because that's typically when body temperature and autonomic arousal increase, and then towards the afternoon, it's going to come sloping down, and then right before sleep, there'll be an increase again.

也许你收到了一个不太好的消息，你的自主神经兴奋程度随处可见。但平均而言，这是一条弯曲的线，早上它会增加，因为这通常是体温和自主神经兴奋度增加的时候，然后到了下午，它会逐渐下降，然后在睡觉前，它会再次增加。

If you've ever felt that, you kind of run around a lot before sleep, and then it goes down.

如果你曾经有过这样的感觉，你可能会在睡觉前跑来跑去，然后这种感觉就会下降。

That's kind of the typical contour of autonomic arousal, mood, et cetera, across the day.

这是全天自主神经唤醒、情绪等的典型轮廓。

Removing, of course, life events and things like psychiatric illness and depression and et cetera, that's the typical arc of that.

当然，除去生活事件以及精神疾病和抑郁症等，这就是典型的弧线。

Now let's superimpose on whatever that contour is for you, nicotine.

现在让我们叠加到适合你的轮廓上，尼古丁。

So get a little bolus, as we say, a little bit of nicotine from smoking a cigarette or from taking an inhalation on a vape pen.

因此，正如我们所说，通过吸烟或通过电子烟吸入一点尼古丁。

What ends up happening is there's an increase in blood pressure, increase in heart rate, increase in mood, increase in alertness, all the things we talked about earlier.

最终发生的事情是血压升高、心率加快、情绪增加、警觉性提高，所有这些都是我们之前讨论过的。

Over time, the body starts to adjust so that the baseline upon which that nicotine-induced increase in arousal would occur is actually reduced.

随着时间的推移，身体开始进行调整，从而使尼古丁引起的兴奋增加的基线实际上降低。

Why would that be?

为什么会这样呢？

Well, the body and the brain, your physiology seeks homeostasis.

嗯，身体和大脑，你的生理机能寻求体内平衡。

So if there's a big increase in all those things like blood pressure and mood, et cetera, typically, your baseline will drop a little bit to compensate for that over time, after a couple of days or even weeks of ingesting nicotine.

因此，如果血压和情绪等所有因素大幅增加，通常情况下，在摄入尼古丁几天甚至几周后，您的基线会稍微下降，以补偿随着时间的推移。

So let's say you wake up, you typically take an inhalation off your vape, or you have a cigarette around 9:00 or 10:00 a.m., and you do that daily.

假设您醒来后，通常会吸一口电子烟，或者在上午 9:00 或 10:00 左右抽烟，并且您每天都会这样做。

You get used to a certain level of mood and alertness and well-being for that time of day.

您会习惯一天中那个时间的一定程度的情绪、警觉性和幸福感。

And then if you smoke again in the afternoon, let's say, you also get accustomed to a certain level of mood and alertness and well-being for that time of day.

然后，如果您在下午再次吸烟，那么您也会习惯一天中那个时间的一定程度的情绪、警觉性和幸福感。

Again, it'll vary depending on life events, but your system sort of gets used to it, and your baseline will drop to compensate for those peaks so that the peaks aren't quite as high as they were when you first started using nicotine.

同样，它会根据生活事件而变化，但你的系统会适应它，你的基线会下降以补偿这些峰值，这样峰值就不会像你第一次开始使用尼古丁时那么高。

Now you decide to quit.

现在你决定退出。

So now what we're talking about is transitioning from the consumption to what we're going to call the withdrawal phase.

所以现在我们谈论的是从消费阶段过渡到我们所说的退出阶段。

Now what happens is you say, "That's it.

现在发生的事情是你说：“就是这样。

I'm going cold turkey.

我要彻底戒掉。

I know there's only a 5% success rate, but I'm going to just go cold turkey." Or somebody will say, "No, I'm going to use the Reveri app," or somebody says, "No, I'm going to use bupropion or another method or nicotine patch or something of that sort."

我知道成功率只有 5%，但我打算彻底戒掉。”或者有人会说，“不，我要使用 Reveri 应用程序”，或者有人说，“不，我要使用安非他酮或其他方法或尼古丁贴片或类似的东西。”

Well, setting aside the nicotine patch or the nicotine delivery device and only focusing on approaches for getting through withdrawal that have no direct effects on nicotine, okay?

好吧，把尼古丁贴片或尼古丁输送装置放在一边，只关注对尼古丁没有直接影响的戒断方法，好吗？

So not using the nicotine patch, but say the hypnosis or bupropion, which can increase dopamine, but it doesn't increase nicotine directly.

所以不使用尼古丁贴片，而是说催眠药或者安非他酮，它可以增加多巴胺，但它不会直接增加尼古丁。

What happens?

会发生什么？

The day that you quit, that homeostatic mechanism in your brain and body that sets your level of mood and arousal, et cetera, does not know and hasn't adjusted to the fact that you're not bringing in nicotine.

在你戒烟的那天，你大脑和身体中决定你的情绪和兴奋程度等的稳态机制并不知道也没有适应你没有摄入尼古丁的事实。

You're not having that cigarette.

你没有抽那支烟。

You're not having that inhalation on the vape pen.

你不会在电子烟笔上吸气。

So what ends up happening is that baseline, which has been adjusted down to offset the increases in mood and alertness, et cetera, when you smoke or vape, is lower than it normally would be.

因此，最终发生的情况是，基线已被下调，以抵消吸烟或电子烟时情绪和警觉性等方面的增加，但基线低于正常水平。

So that 9:00 a.m.

所以上午 9:00

cigarette time or vape inhalation time no longer feels above baseline.

吸烟时间或电子烟吸入时间不再感觉高于基线。

It actually feels below baseline because what you're seeing is the lower amplitude of arousal that was there to offset the increase you were getting from vaping or smoking.

它实际上感觉低于基线，因为你看到的是较低的唤醒幅度，它抵消了你因电子烟或吸烟而增加的唤醒幅度。

And then in the afternoon, if normally you have a kind of phase of your afternoon you really enjoy, you go outside, you have a vape or a cigarette, you normally are feeling relaxed, or you go out at night and you like to vape, and you say, "Nope, I'm not going to do that anymore," you're going to feel much, much worse than you would have had you never started smoking or vaping.

然后到了下午，如果通常你有一个你真正喜欢的下午阶段，你出去，你抽了一支电子烟或一支香烟，你通常会感到放松，或者你晚上出去并且你喜欢电子烟，然后你说，“不，我不会再这样做了，”你会感觉比你从未开始吸烟或电子烟要糟糕得多。

Now, that's not much help to anyone who's already started smoking or vaping, but I say this because it's very important to understand that the reason why relapse rates are so high within the first week, 75% of people relapse within one week, and overall failure rates are 95%, is because people don't expect to feel even worse than they did prior to ever smoking or vaping.

现在，这对任何已经开始吸烟或电子烟的人来说并没有多大帮助，但我这么说是因为了解为什么第一周内复发率如此之高（75% 的人在一周内复发，总体失败率为 95%）的原因非常重要，因为人们预计不会比吸烟或电子烟之前感觉更糟糕。

So that first week is absolutely critical.

所以第一周绝对至关重要。

And the beauty of understanding this is that if you can get through that first week, either by sheer grit or by finding other methods to increase dopamine, healthy methods, I would hope, and certainly cold showers, ice baths have been shown to do that, by the way.

理解这一点的美妙之处在于，如果你能通过纯粹的毅力或通过寻找其他方法来增加多巴胺，健康的方法，我希望能度过第一周，顺便说一句，当然冷水淋浴、冰浴已被证明可以做到这一点。

This was described in Dr. Anna Lembke's book, "Dopamine Nation." Cold showers can increase dopamine, exercise, positive social interactions.

安娜·伦布克博士的著作《多巴胺国家》对此进行了描述。冷水淋浴可以增加多巴胺、锻炼和积极的社交互动。

It's very likely that people will need to use other healthy methods to offset that reduction in dopamine if ever they stand to get through that first week.

如果人们能够度过第一周，他们很可能需要使用其他健康的方法来抵消多巴胺的减少。

And again, if you can get through that first week, chances are quite a bit higher that you'll be able to maintain the cessation of smoking or vaping.

再说一遍，如果您能度过第一周，那么您能够维持戒烟或电子烟的机会就会大大增加。

And of course, hypnosis, things like bupropion can also assist in that.

当然，催眠、安非他酮之类的东西也可以起到帮助作用。

Bupropion by way of increasing dopamine pharmacologically, hypnosis through changes in neural circuitry that aren't completely understood but seem to involve a remapping of some of the so-called default networks and some of the networks that are involved in kind of understanding of your own internal state.

安非他酮通过药理学上增加多巴胺，通过神经回路的变化来催眠，这些变化尚未完全被理解，但似乎涉及到一些所谓的默认网络和一些参与理解你自己的内部状态的网络的重新映射。

This stuff gets a little bit complicated, and we're going to return to this in an upcoming episode of the Huberman Lab podcast.

这个东西有点复杂，我们将在即将播出的 Huberman 实验室播客中再次讨论这个问题。

But there are indeed legitimate changes in neural circuitry caused by clinical hypnosis that can at least partially explain why it is so effective in helping treat or allow people to stop smoking and vaping.

但临床催眠确实会引起神经回路发生合理的变化，这至少可以部分解释为什么它在帮助治疗或允许人们戒烟和电子烟方面如此有效。

So for those of you out there that either hear or are saying yourselves, "I just can't seem to quit smoking or vaping or dipping or snuffing," hopefully an understanding of how that homeostasis process works and the time course of nicotine, depending on the delivery device, hopefully understanding that will allow you to develop a protocol.

因此，对于那些听到或正在说自己“我似乎无法戒烟、戒电子烟、戒吸戒鼻烟”的人来说，希望了解体内平衡过程如何工作以及尼古丁的时间进程（取决于输送设备），希望了解这将使您能够制定方案。

Maybe it involves hypnosis.

也许这涉及到催眠。

Maybe it involves just understanding that the typical times in which you ingested nicotine through any of the different approaches of bringing it into your system are going to be particularly hard.

也许它只需要了解，通过任何不同的方法将尼古丁带入您的系统中，您摄入尼古丁的典型时间将会特别困难。

But I don't just mean particularly hard.

但我的意思不仅仅是特别困难。

I mean particularly hard, and you're going to need to do something specific to offset that decrease in Overall autonomic arousal and dopamine, et cetera.

我的意思是特别困难，你需要做一些特定的事情来抵消整体自主唤醒和多巴胺等的减少。

Hopefully, an understanding of that will allow you to get through that first week, and if you can make it past that first week, you stand a very good chance of never going back.

希望理解这一点能让你度过第一周，如果你能度过第一周，你就很有可能永远不会回头。

However, I did consult with Dr. David Spiegel in anticipation of this episode.

不过，我确实咨询了大卫·斯皮格尔博士（Dr. David Spiegel）对这一事件的预期。

Regardless of the method that you used to quit smoking or vaping, snuffing, or dipping, there's good evidence that a routine maybe once a month or even once a week hypnosis type approach to replenish or even enhance the neural circuits that are allowing you to stay away from nicotine is going to be a very good idea.

不管你用什么方法戒烟、吸电子烟、吸鼻烟或吸毒，有充分的证据表明，每月一次甚至每周一次的催眠式方法来补充甚至增强神经回路，让你远离尼古丁将是一个非常好的主意。

And given that it's a purely behavioral intervention, I can see no reason as to why people wouldn't want to do that.

鉴于这纯粹是行为干预，我看不出人们有什么理由不想这样做。

Go in and reinforce, tighten the bolts on that circuitry that are allowing you to not feel the impulse to smoke, not feel the impulse to vape.

进去加强，拧紧电路上的螺栓，让你感觉不到吸烟的冲动，感觉不到电子烟的冲动。

And just a very brief mention, there is a vast literature on the fact that when people have quit smoking or vaping or other form of consuming nicotine, that when they consume alcohol, there's a much higher probability of relapse.

简单提一下，有大量文献表明，当人们戒烟或戒掉电子烟或其他形式的尼古丁摄入时，当他们饮酒时，复发的可能性就会更高。

There are interactions between alcohol and nicotine that we'll cover in future episodes.

酒精和尼古丁之间存在相互作用，我们将在以后的剧集中介绍。

But for those of you that want to quit, I want to assure you, despite the fact that 95% of people fail, with the appropriate tools, and I like to think with an additional understanding of the underlying biology and psychology and what you can expect and when to really dig your heels and when to reinforce your system with more dopamine through any of the number of the different protocols and tools that we've offered here and that you can find elsewhere in other episodes of the Huberman Lab podcast, I have a high degree of confidence that you can quit smoking or vaping, dipping, or snuffing.

但对于那些想要戒烟的人，我想向你们保证，尽管事实上 95% 的人使用适当的工具都会失败，而且我喜欢通过对潜在的生物学和心理学的额外了解以及您可以期待什么、何时真正坚持到底以及何时通过我们在这里提供的任何数量的不同协议和工具用更多的多巴胺来强化您的系统，并且您可以在 Huberman 实验室播客的其他剧集中找到这些，我非常有信心您可以戒烟、戒烟、戒烟或戒鼻烟。

So today, typical of frankly all episodes of the Huberman Lab podcast, we've covered a lot about the biology of a particular system.

因此，今天，坦率地说，休伯曼实验室播客的所有剧集都是典型的，我们已经介绍了很多有关特定系统的生物学的内容。

We talked about the biology of nicotine in particular.

我们特别讨论了尼古丁的生物学。

We talked about vaping and smoking, dipping, and snuffing, and the negative health consequences associated with those.

我们讨论了电子烟和吸烟、吸食和吸鼻，以及与这些相关的负面健康后果。

I want to reemphasize that nicotine is not what causes cancer.

我想再次强调尼古丁并不是导致癌症的原因。

It is the delivery device that causes cancer and the other negative health effects.

它是导致癌症和其他负面健康影响的输送装置。

That is not to say that people should be ingesting nicotine through any different methods simply to get a cognitive boost.

这并不是说人们应该通过任何不同的方法摄入尼古丁只是为了提高认知能力。

There are certain circumstances where that might be appropriate, for the occasional work bout, certainly not for physical exercise given what we talked about earlier.

在某些情况下，这可能适合偶尔的工作，但鉴于我们之前讨论过的，当然不适合体育锻炼。

But of course, there are more and more approaches to increasing not just nicotine, but acetylcholine generally in order to achieve cognitive enhancement or physical enhancement, or I should say physical performance enhancement.

当然，现在有越来越多的方法不仅可以增加尼古丁，还可以增加乙酰胆碱，以实现认知增强或身体增强，或者我应该说身体表现增强。

Some of those we talked about earlier, such as alpha-GPC.

我们之前讨论过其中一些，例如 alpha-GPC。

In any event, nicotine, it should now be clear, is an immensely powerful substance.

无论如何，现在应该清楚，尼古丁是一种非常强大的物质。

One of the most commonly ingested substances on the face of the earth, and has been for a very long time.

地球表面最常被摄入的物质之一，并且已经存在很长时间了。

And now that you understand the underlying biology and the way in which this changes your psychology and physiology, that should come as no surprise.

现在您已经了解了潜在的生物学原理以及它如何改变您的心理和生理学，这应该不足为奇。

If you're learning from and are enjoying this podcast, please subscribe to our YouTube channel.

如果您正在学习并喜欢这个播客，请订阅我们的 YouTube 频道。

That's a terrific zero-cost way to support us.

这是支持我们的绝佳零成本方式。

In addition, please subscribe to the podcast on Apple and Spotify.

此外，请订阅 Apple 和 Spotify 上的播客。

And on both Apple and Spotify, you can leave us up to a five-star review.

在 Apple 和 Spotify 上，您都可以给我们五星级的评价。

If you have questions or comments or suggestions of topics you'd like us to cover or guests you'd like us to invite onto the Huberman Lab podcast, please put those in the comment section on YouTube.

如果您对希望我们报道的主题或希望我们邀请的嘉宾有疑问、意见或建议，请在 YouTube 上的评论部分留言。

We do read all the comments.

我们确实阅读了所有评论。

Please also check out the sponsors mentioned at the beginning of today's episode.

另请查看今天节目开头提到的赞助商。

That is the best way to support this podcast.

这是支持这个播客的最好方式。

During today's episode and on various previous episodes of the Huberman Lab podcast, we talk about supplements.

在今天的节目以及 Huberman Lab 播客的前几集中，我们讨论了补充剂。

While supplements aren't necessary for everybody, many people derive tremendous benefit from them for things like enhancing sleep, hormone function, focus, and so on.

虽然补充剂并不是每个人都需要的，但许多人从它们中获得了巨大的好处，例如增强睡眠、激素功能、注意力等等。

The Huberman Lab podcast has partnered with Momentous Supplements, spelled Momentous, O-U-S.

Huberman Lab 播客与 Momentous Supplements（拼写为 Momentous，O-U-S）合作。

You can find those supplements at livemomentous.com/huberman.

您可以在 livemomentous.com/huberman 找到这些补充剂。

If you haven't already subscribed to the Huberman Lab podcast Neural Network Newsletter, it's a monthly newsletter.

如果您还没有订阅 Huberman 实验室播客《神经网络通讯》，这是一份每月通讯。

We provide summaries of different podcasts, and we provide summaries of specific tools that you can use to enhance sleep, for instance, or enhance dopamine.

我们提供不同播客的摘要，还提供可用于增强睡眠或增强多巴胺等特定工具的摘要。

We talk about deliberate cold exposure, deliberate heat exposure.

我们谈论故意冷暴露、故意热暴露。

It's very easy to sign up for, and it's completely zero cost.

注册非常简单，而且完全零成本。

You go to hubermanlab.com, go to the menu, click on Newsletter, provide us your email.

您访问 hubermanlab.com，进入菜单，单击新闻通讯，向我们提供您的电子邮件。

We do not share it with anybody else.

我们不与其他任何人分享。

And you'll receive that monthly newsletter, and there you can also find PDFs of previous newsletters that you can immediate download without even having to sign up.

您将收到每月的时事通讯，在那里您还可以找到以前的时事通讯的 PDF 版本，您甚至无需注册即可立即下载。

If you're not already following us on social media, we are hubermanlab on Twitter, hubermanlab on Instagram, and hubermanlab on Facebook.

如果您还没有在社交媒体上关注我们，我们在 Twitter 上为 hubermanlab，在 Instagram 上为 hubermanlab，在 Facebook 上为 hubermanlab。

And at all of those locations, I describe science and science-related tools, some of which overlap with the content of the Huberman Lab podcast, much of which is distinct from the content covered on the Huberman Lab podcast.

在所有这些位置，我描述了科学和科学相关的工具，其中一些与胡伯曼实验室播客的内容重叠，其中大部分与胡伯曼实验室播客所涵盖的内容不同。

So once again, I'd like to thank you for joining me today for a discussion about the biology and psychological effects of nicotine, this incredibly powerful substance.

因此，我要再次感谢您今天与我一起讨论尼古丁这种极其强大的物质的生物学和心理影响。

And as always, thank you for your interest in science.

一如既往，感谢您对科学的兴趣。