We need to talk about cigarettes, nicotine, and being autistic

A more up to date take on this can be found here.

Nicotine addiction is rarely talked about when discussing addiction, but it is probably the most common addiction around.

I would estimate that at least half, if not most, of the autistic people I have interacted with have been smokers at some point in their lives. Nicotine addiction is a real issue, especially when you consider the health effects of smoking combined with the already shortened life expectancy of autistic people as a whole.

With that in mind, I’m sure that you can understand why I was so frustrated to read this sweeping statement, coming out of Yale University:

“Moreover, those with ASD are much less likely to smoke cigarettes than the general population because their health tends to be more closely monitored by others.”

It is claimed in this article that the statement is based on a review of literature. I suspect that, if accurate, it was not research that has accounted for the broad spectrum of autistic individuality.

The statement echoes the sentiment of many professionals in the world of autism, claiming that autistic people are less likely to be addicts than the general population.

This is problematic, and some research has even shown that autism and ADHD increase the risk of addiction. It also minimises the impact of addiction on the autistic community.

Perhaps more worrying is the context of the statement.

The article discusses the use of transdermal nicotine patches to reduce aggresive behaviour in autistic people.

It justifies it by saying that this method of delivery makes it non-addictive. However makes no mention of the risk of physical dependence. Just because someone isn’t forming a habit/compulsive need to use, doesn’t mean they won’t experience withdrawal upon cessation of the substance.

Using nicotine on autistic people seems unfair, and I guarantee that withdrawal is going to potentiate harmful behaviours (hey Yale, you ever been through withdrawal? Well, I have, and it ain’t a picnic).

Perhaps nicotine reduces aggression because of its relaxing effects? Here’s an idea, why not try improving the quality of life of autistics rather than medicating it away. Medication is important for many people, but administering a substance with the potential for physical dependence seems unethical, especially when that person may not be able to consent, is a risky path to walk.

Nicotine addiction is a real issue for the autistic community, and I think that Yale have really minimised the issue here. I would implore them to add to the limited pool of research on addiction in Autistics before making statements like the one I quoted above.

Many of us have experienced life changing impacts from the smoking that Yale claim we’re less likely to do.

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