Nicotine's potential for dependence
.....From an article by American Council on Science and Health Dr. Murray Laugesen Public Health Medicine Specialist QSO, MBChB, FNZCPHM, FRCS (Edin)
I have a lot of respect for Laugesen as he was the first scientist to research ecigs and to advocate for them. However he is one of the old guard when it comes to subjects like nicotine and ST, and some of the stuff he's written recently about them is baloney - both out of date and deliberately obfuscatory regarding certain risks or lack of risks.
His recent paper on 'Nicotine and Health' for the ACSH (who also deserve respect for their honesty) is riddled with outdated information and concepts that can probably be described as errors.
There is no evidence of any potential for nicotine to create dependence outside of exposure to tobacco smoke. On the other hand, there are about half a dozen clinical trials of pure nicotine administered to never-smokers, in some cases with high doses for 6 months, and none reported any withdrawal symptoms or continued use. So what evidence there is (which is regarded as anecdotal simply because the purpose of these trials was to measure benefit, lack of benefit, or side effects, for treatment with pure nicotine of assorted medical conditions such as cognitive dysfunction, but not dependence potential) appears to show that nicotine not only has no clinically-significant potential for dependence (i.e. a 3% effect or greater) but no measurable potential at all.
There are one or two caveats though: inhaled nicotine was not measured, and there is a possibility that results may be different with inhalation. Until this is tested, therefore, it is not possible to state definitively that "nicotine has no potential for dependence" - just that there is no evidence for it. Note carefully that
all studies that do report dependence are of smoking or smokers or ex-smokers; such trials are invalid because the subjects have already been exposed to the addictive cocktail of chemicals in tobacco smoke.
Nicotine is just one of the multiple candidates for the chemical dependence sector of addiction to smoking. It appears to need MAOIs and/or WTAs and/or pyrolytic compounds (and maybe freebasing as well), delivered along with the nicotine in order to create a synergistic effect, before the brain chemistry is permanently (or semi-permanently) changed to create dependence on nicotine by itself. There is absolutely no evidence that pure nicotine as contained in ecigs has any potential for dependence. Because an accurate modern definition of addiction is, "Compulsion to continue the habit despite negative consequences", as noted in one of the previous posts, the term cannot be applied to nicotine in any case - because no negative consequences can be demonstrated for long-term nicotine consumption. Even the ultra-conservative British medical establishment recognise this: see NICE PH45. Indeed, the vast mountain of Snus data from Sweden is used for long-term licensing applications for NRTs, since no reliably measurable harm can be shown, and because the NRT data resource is tiny by comparison (the lack of any clearly demonstrable harm in the Snus data is both proven by the national health stats and the massive volume of research data: hundreds of clinical studies over three decades). For a breakdown of this data / meta-analyses, see PN Lee, Lee and Hamlin, and Foulds et al 2003.
Hazards of ST (smokeless tobacco)
People in the tobacco control industry deliberately obscure the facts about ST in order to be able to claim that "all tobacco is very bad for you". For a full explanation of the real or imagined risks, please read the work of Rodu, Phillips and Foulds, who are independent of the TCI.
When examining the evidence for elevation of risk due to ST consumption, there are several essential facts to take into account:
1. Consumption of Snus in Sweden is
proven (not estimated) to have extremely low risk. This cannot be applied to other places or other eras (although there may be exceptions.
2. Consumption of Asian tobacco-containing oral products is proven to have significant risk.
3. Modern US oral tobacco products have low risks, and the level of risk is unrelated to that for historic products, which are known to have had significant risk. Modern products are not just safer, they are far safer.
Male smoking prevalence in Sweden will be just 5% in 2016 as prevalence falls by 1% per year and is currently about 7% or 8%. All types of smoking-related disease, including all cancers and not just lung cancer, are falling at the same rate as the reduction in smoking (and the rise in Snus consumption). Sweden has the lowest rate of male lung cancer and oral cancer in the EU. Sweden has the lowest rate of smoking-related mortality of any developed country by a wide margin.
"As smoking rates in Sweden fell significantly, and Snus consumption rose significantly, the oral cancer rate fell dramatically."
- Prof Rodu, the authority on the oral pathology of tobacco consumption.
"The principal risks for oropharyngeal cancers [
mouth cancer] are smoking, drinking and HPV."
- Rodu
"Elevation of risk for cancer from Snus consumption is too low to be reliably identified."
- Rodu
It is common to lump together all types of oral tobacco in all countries in all eras in order to come up with the most toxic statistics possible. Such an approach is disinformation (deliberately misinforming for the purposes of an agenda, and in total a lie). There is no comparison between modern and historic products. There is no comparison between Swedish and Asian products. Combining the results for all these products and eras and regions is simply lying for an agenda (as in the IARC report on ST).
Keep in mind that ex-smokers get cancer 20 years later, and Swedish Snus consumers who never smoked have an unmeasurably low incidence of any cancer. They do get cancer - but in such low numbers that it is impossible to reliably identify the effect statistically. ST and even Snus consumption is not safe because nothing is, even coffee and tea consumption would have a negative effect if you could measure it. It only has to be safer than smoking to make it worthwhile switching; and when it is so much safer that the elevation of risk isn't reliably measurable then obviously there are great benefits.
Long-term health impact of vaping
We don't know the long-term impact of vaping but it looks as if it will be in the Snus class. Some say better, some say worse. As a personal opinion it looks as if there will be a three orders of magnitude reduction in risk compared with smoking as the mean figure (1,000 times), with individuals able to adjust that risk up or down as they wish, since vaping is an extremely flexible system. That is to say, if you vape 3ml of unflavored or minimum-flavor base a day, then you might possibly take your risk reduction compared to smoking down to four orders of magnitude (10,000 times less); but if you vape 10ml of heavily-flavoured refill liquid in a 30-watt RBA a day then you could go way up the risk scale to perhaps only 2 or even 1 order of magnitude reduction. A 3-order reduction or 1,000 equals a reduction from 100,000 deaths a year to only 100. (Please note this is a personal opinion and may be incorrect.)
Fog flavoring
You can buy lemon flavor to add to disco fog, and we used to add it back in the 70's when I was in sound and light engineering. Doubt if it's changed.
- all citations can be found on the References page of ecigarette-politics.com -
toast
