Use Herbs to Quit Smoking Naturally?

Lobelia, also known as "Indian Tobacco" is one of the more commonly used herbs to quit smoking.  This herb is the main ingredient in many commercial herbal quit smoking remedies such as NicRX, Finally Free, and NicoCure.  These products all provide an herbal combination in pill form that is designed to help reduce cravings and withdrawal symptoms.

If you're considering using herbs to quit smoking, but don't like pills, there is also an herbal patch that delivers the herbal treatment transdermally (through your skin).  It's called Zero Nicotine.

The active ingredient in lobelia is an alkaloid called lobeline, which affects the brain in ways similar to nicotine.  See  Mechanism of Action below for an in-depth explanation of how this can help you quit. 

Besides lobelia, herbal remedies formulated specifically for smoking cessation typically contain other herbal ingredients that are intended to work in conjunction with lobeline to help reduce stress, clear mucus and soothe mucus membranes, support lung health, and promote detoxification. 

Effectiveness

Unfortunately, there isn't a lot of direct evidence for the effectiveness of lobelia or other herbs to quit smoking, including the combination herbal formulations for quitting.  The gold standard for research - meta-analytic evidence -  is lacking for this method, primarily because there are not any studies that meet the very high standards for inclusion in meta-analysis.  This is unfortunately relatively common for non-drug-related aids, including herbs to quit smoking. 

However, there is clear evidence that lobelia's active ingredient, lobeline, has a  mechanism of action that is similar to the prescription drug  varenicline (Chantix), which has been shown to be moderately effective.  This provides some evidence that lobelia may be an effective way to quit.  (Interestingly, lobeline's mechanism of action is currently being researched with an eye towards helping people quit methamphetamines because of its effects on dopamine release, which is also a key factor in smoking cessation.) 

Mechanism of Action

OK, this is the technical part.  If you're not interested in a technical explanation of the mechanism of action, feel free to skip ahead to 'How to Use Herbs to Quit Smoking'.

Unlike other herbs to quit smoking, Lobelia impacts neurotransmitter activity in a way that is similar to nicotine.  The active ingredient, Lobeline, is a both a nicotine agonist and antagonist derived from an Indian plant “lobelia inflata.”  Here's what that means:

The brain has neurotransmitter receptor cells that have been labeled 'nicotinic' receptors because they are stimulated by nicotine.  Lobeline acts on these cells as an 'agonist,' which means that it binds to these cells and stimulates them in a similar way to nicotine.  (The effects are not as strong as nicotine, however.)  Because the drug is in effect 'parked' at the receptor sites on these cells, it also partially blocks nicotine from activating them, thereby reducing the effect of nicotine in the brain from smoking, and helping to reduce the 'reward' associated with smoking.

Interestingly, unlike nicotine, which is highly addictive, lobeline does NOT appear to be addictive.  This may be because of its structural differences from nicotine, and the different ways that it affects dopamine storage and release.  (Dopamine is another a neurotransmitter - one that is implicated in addictive patterns of behavior.) 

Rather than stimulating the release of dopamine in the normal way (from the presynaptic terminal), lobeline appears to induce the metabolism of dopamine intraneuronally as well as inhibit dopamine re-uptake.  The result of this is that rather than getting a 'dose' of rewarding dopamine immediately connected to the behavior of smoking (or of taking lobeline), the dopamine effect is more diffuse.  So you still get the pleasant dopamine effect, but because it is not strongly associated with the behavior, it does not induce addictive behaviors, and in fact partially blocks the addictive effect of nicotine intake.

Dwoskin LP, Crooks PA., (2002) A novel mechanism of action and potential use for lobeline as a treatment for psychostimulant abuse. Biochemical Pharmacology. Jan 15;63(2):89-98.

A Note About Addiction 

One of the reasons smoking is so psychologically addictive is because the method of delivery - smoke - has an immediate effect on your system.  In other words, you are 'rewarded' right after the behavior - not 5 minutes later, or half an hour later.  Psychological research shows that rewards or punishments that follow the action quickly have a much greater effect than rewards or punishments that are delayed.  So the act of lighting up is immediately rewarded, and it becomes a very strong behavior, making it very difficult to quit. 

Because lobeline partially mimics nicotine, but in a steady, all-the-time way, NOT as a response to lighting a cigarette, and also partially blocks the effects of real nicotine, the act of lighting up isn't as 'rewarding' as before, and the addiction itself is weakened. Both of these effects make it easier to quit smoking.

Do keep in mind that the 'reward' of nicotine in the brain is only one part of the physical and psychological addiction to nicotine and smoking more generally.  There are many other aspects of smoking dependence that should be addressed by psychological and behavioral techniques designed to help eliminate their effects.  See below for specific recommendations in that department.

How to Use Herbs to Quit Smoking

You could use lobelia all by itself buy purchasing it as an herb or a tincture, but because of the variability of unregulated supplements and the negative effects of overdose, this is a little risky.  Keep in mind that lobelia is also known as 'pukeweed,' and can have significant negative consequences if you don't regulate the dosage properly.  (See side effects).  If you are an herbalist or know one who is familiar with lobelia as a quit smoking aid, you may have more luck coming up with an effective lobelia concoction, including other herbs to quit smoking that act to help clear the lungs and support your quit attempt in other ways.

Otherwise, it may be worth using one of the herbal formulations that is designed specifically for quitting smoking.  Although they can be a little more expensive, they have the added advantage of a combination of herbal ingredients that are intended to work with the lobelia to support your quit attempt.   These pre-formulated herbal products are generally simple to use, and have clear instructions regarding dosage, including the maximum safe amount.  Formulations which include lobelia generally recommend that you begin the herbal treatment on your actual quit day.  Smoking while on the formulation increases the probability of side effects such as nausea. 

If you choose to use lobelia to help you quit, keep in mind that this is just ONE element of a successful quit smoking attempt.  You'll want to combine it with the best behavioral program for quitting you can find, to maximize your chances for success.  (See My Recommendations below for more on this.)   In the near future I plan to evaluate some of the more commonly available herbal products to determine which one(s) are likely to be the most beneficial.

Side Effects

It is important to realize that just because a product is called 'natural' or contains only natural ingredients such as herbs doesn't mean it is without risk.  Modern day prescription medicines are still commonly derived from medicinal herbs, and keep in mind that some herbs to quit smoking can also have relatively powerful effects.

Herbal supplements, including herbs to quit smoking, are not regulated as stringently by the FDA as prescription and over the counter medicines, but the FDA's Center for Food Safety and Applied Nutrition does keep track of adverse events associated with foods and supplements.  There have been cases of adverse reactions associated with lobelia.  According to this agency, the possible heath hazards range from breathing problems at low doses to sweating, rapid heartbeat, low blood pressure, and possibly coma and death at higher doses.  They also indicate that lobelia may be dangerous to pregnant women, children, and people with heart problems.  (Of course, to maintain proper perspective, remember that cigarette smoke is also especially dangerous to these groups.)

In any case, do keep in mind that even "all natural" herbal products should be treated with the same caution that you would use for any medicine, including following the label directions and checking in with your doctor if you have any special health concerns.

Pros and Cons of Using Herbs to Quit Smoking

What are the pros and cons of using Lobelia to quit smoking?

Pros

  • Various herbal formulations using lobelia are available without a prescription

  • Lobelia's basic mechanism of action as a nicotinic agonist and antagonist has been shown to be effective in the prescription medicine varenicline, which provides some evidence for the likely effectiveness of lobelia.

  • The herbal formulations are simple to use, generally requiring that you take a couple of pills 2-3 times a day.

  • Most herbal formulation using lobelia also include complementary herbs to help soothe withdrawal symptoms and promote cleansing.

Cons

  • There is not enough research on lobelia and long-term smoking cessation to meet the 'gold standard' for evidence of effectiveness - no studies with long-term outcome data are available to be included in meta-analysis.

  • Like many drugs, herbs, including lobelia, can have adverse effects for some people.  (See side effects, above.)

My Recommendations

I have to admit to a preference for more natural products and methods over prescription drugs, but often there is not enough high-quality research to draw strong conclusions about their effectiveness.  I'd like to see more evidence of effectiveness for lobelia and other herbs to quit smoking, but given the information that is available, I would say this is worth a try, particularly if you are inclined towards more natural alternative therapies rather than prescription drugs.  Based on the research and information that is available regarding the mechanism of action for lobelia, I believe that it's quite likely that it will help at least some people improve their chances of quitting successfully.

If you decide to try an herbal remedy, I strongly recommend that you combine it with a compatible behavioral program that will also help you eliminate the psychological dependence.  Lobelia or other herbs to quit smoking may help, but don't count on them to be a 'magic pill' that will 'make' you quit.  You still have to do the work of eliminating the psychological aspects of your habit. 

Increase your chances of success by supporting your quit attempt with the best behavioral/psychological program you can find. 



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The Psychology of “Natural”

Natural methods for quitting have the benefit of helping to eliminate the physical addiction to nicotine without necessarily risk side effects.  On the other hand, some are better than others at eliminating withdrawal symptoms.

 

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