EU "Dangers of nicotine"

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RoadToNever

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E-cigg opponent arguments often boil down to the dangers of nicotine. The extent of truth in that statement has nothing to do with the amounts a typical vaper consumes! We're not even remotely talking about consuming the amounts one would only give lab rats for experimental purposes.

We can take a look at the vast studies done on Snus, a smokefree tobacco alternative used in Sweden. You simply cant point to Snus leading to high blood pressure, cardiovascular disease and cancer. It's worth mentioning Swedish males have the lowest amount of lung cancer cases in the world. Sources: Snus - Wikipedia, the free encyclopedia

It's safe to say the argument doesn't hold up. Remember the burden of proof is on the one making the positive claim, and it's not justified by committing equivocation fallacies, only by providing the evidence, which currently doesn't justify the claim.

With this in mind one can certainly question the morality of making it impossible for a former or current smoker to use e-ciggs. The sucess rates of smoking cessation are very well known.
 
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RoadToNever

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The point of this post is that when you take a critical look at the arguments, taken into account that they come from concerns about public health, they end up looking very silly indeed. Could you imagine how the opponents would look on the TV news if they had their claims refuted with ease and their hypocrisy revealed?

Let's keep pointing out how the claims are unjustified.
 
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rolygate

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Nicotine in terms of a consumer product (as against industrial or agricultural poisoning issues) is about as harmful as coffee. However, nicotine is of course a normal and natural part of the diet, and everyone tests positive for it. In contrast to coffee, alcohol and so on, nicotine is therefore a far more natural part of our daily lives.

As you say, the Snus data from Sweden reveals that ad lib consumption of nicotine over many decades has no identifiable effect on health.

Carl Phillips says, "Nicotine has about the same implication for health as coffee and fries". On average it would appear that nicotine consumption has no statistically-measurable significance for health; persons with a genetic predisposition to vascular disease (a family history of early death from stroke, AAA etc) will be in a different position, are not average, and will know of their increased risk.

It is also worth noting that there is no science base for statements such as, "Nicotine is addictive", since there has never been a trial of nicotine consumption by nicotine-naive persons. (We know that animal nicotine models do not transfer to humans.) All citations given for 'nicotine addiction' lead to studies on smoking addiction, that is to say, consumption of a material with 5,300 known ingredients to date. If someone claims that dependence on a material containing at least 5,300 compounds equals dependence on one of those compounds, without any evidence to support it, then anything they say on any subject can probably be discounted.
 

Berylanna

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It is also worth noting that there is no science base for statements such as, "Nicotine is addictive", since there has never been a trial of nicotine consumption by nicotine-naive persons. (We know that animal nicotine models do not transfer to humans.) All citations given for 'nicotine addiction' lead to studies on smoking addiction, that is to say, consumption of a material with 5,300 known ingredients to date. If someone claims that dependence on a material containing at least 5,300 compounds equals dependence on one of those compounds, without any evidence to support it, then anything they say on any subject can probably be discounted.

This is the best argument I've ever seen for NOT leaving WTA's out of our vaping fight. Either nicotine is addictive, in which case we need to defend availability of nic juice, or it might not be, in which case WTA access is critical. (truth, it IS for about 5-10% of us)

My feeling is that in 100 years we'll know that nicotine is a vitamin, but not even switching to vaping is going to give me another 40 years.

I do NOT believe we should fight against the idea that nicotine is addictive. If we say it is not, then they can say "so no impact on vapers if we ban it."
 

TTK

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I do NOT believe we should fight against the idea that nicotine is addictive. If we say it is not, then they can say "so no impact on vapers if we ban it."

Don't you think it is best to fight for whatever Science shows about this? You cannot choose to use Science on one item and not on another if it is 'good" Science.
 

RoadToNever

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I have some trouble with using the word "addictive". That might be giving away a red herring to the other side. It's a loaded word. You can be "addicted" to nicotine but it'll hardly ruin your life like alcohol or smack. Lets not arbitrarily accept a term that changes it's meaning depending on the context, as there's a risk of the proper context getting lost to the other sides advantage in a debate.
 
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Berylanna

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Don't you think it is best to fight for whatever Science shows about this? You cannot choose to use Science on one item and not on another if it is 'good" Science.

So exactly why DO we think we cannot live without nic juice or we'll go back to stinkies? Or do you mean that like alchohol, it might not be addictive to EVERYONE? (Alchohol is not addictive to ME, but it certainly is to some people.)

I suspect that there is more than one definition of "addictive" and the science would have something different to say depending on which definition we are using.

I have some trouble with using the word "addictive". That might be giving away a red herring to the other side. It's a loaded word. You can be "addicted" to nicotine but it'll hardly ruin your life like alcohol or smack. Lets not arbitrarily accept a term that changes it's meaning depending on the context, as there's a risk of the proper context getting lost to the other sides advantage in a debate.

Yes, Kristin points out that it is addictive LIKE CAFFEINE, not like ....... It is not intoxicating, users self-titrate (find their level and successfully control their dose intuitively), it does not ruin lives unless the only way we know to get it is via smoke inhalation. She had another phrase to use instead, but it sounded almost as bad to me.

I did find an article that defines addiction closer to your definition, it says caffeine is not addictive because it does not cause negative behaviors and appears to not affect the reward centers of the brain like ......, ......., and nicotine. This is an interesting view. I'd like to know what they call it if some of us need it enough to commit slowicide for it. http:// www. ncpa. org/sub/dpd/index.php Article_ID=13971

WebMD says caffeine causes "mild physical dependence."

Someone pointed out that if tea had originally been smoked instead of drank, people would think caffeine was a killer addiction, and would probably now be going crazy trying to ban tea even when steeped for drinking. We'd have ACTZ (Anti-Caffeine-and-Tea-Zealots) instead of ANTZ.

Good thing, I don't think I could pronounce ACTZ.
 

RoadToNever

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Maybe it's not the term after all. I just don't think it's our job to deal with addiction/dependency explicitly. I'm not saying we should deny or duck it either. IMO the main focus should be that the opponents havent met their burden of proof, and the studies relevant to their claims point to a different conclusion. We shouldn't make it look like we are fighting to keep our precious nicotine. It would be very hard to win anyone over to our side on arguments alone, but we can certainly point out the questionable tactics of our opponents, and it's easy to do so. A public health issue that affect tens of milions certainly deserves to be treated in an fair and correct way, so trust is key.
 
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rolygate

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I do NOT believe we should fight against the idea that nicotine is addictive. If we say it is not, then they can say "so no impact on vapers if we ban it."

Nicotine can of course create dependence, though perhaps not in all individuals. Current medical opinion (among experts in the field of dependency and addiction, not ANTZ) is that it first needs to be supplied in tobacco smoke, or in repeated large doses. In this way, it is similar to other dietary ingredients, which if supplied repeatedly in very large doses can also result in dependence in some individuals.

It would be interesting to see a study carried out with nicotine-naive subjects introduced to ecigs with nicotine, and see what the results are. Presumably some would become mildly dependent on nicotine, though probably far less than with cigarettes. The issue is fairly clear-cut for me: if denied coffee, my cravings are about ten times stronger than if denied nicotine. This is after using an ecig for three and a half years, even though I still use 36mg strength. Most days I don't pick up my ecig till lunchtime.

Apparently there will never be any clinical studies of nicotine in humans (at least, in the West) as a study of this type will not pass ethics committees (in order to be valid, the subjects would have to be never-smokers / never-users of nicotine). Until the day such studies are carried out, there is no scientific basis for any statement such as "Nicotine is addictive" or "Nicotine is dependence-forming". A statement like "Nicotine is highly addictive" is simply rubbish - absolutely without any foundation whatsoever. "Smoking is dependence-forming, on average, and as a result may create nicotine dependency" is somewhat more accurate.

The issue in any case is the right of others to stop someone taking dietary supplements in whatever form they choose. No one has that right.
 

RoadToNever

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The issue in any case is the right of others to stop someone taking dietary supplements in whatever form they choose. No one has that right.

It becomes downright ridiculous when someone is claiming this dietary supplement is dangerous based on these studies which happen to include 5300 other chemicals which we don't take under account.
 

rolygate

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It is true that many dietary ingredients are dangerous when consumed in very large quantities - there have apparently been deaths from vitamin A and vitamin D over-consumption. My favourite story in this line is the one about the arctic explorers who shot a polar bear, and ate its liver along with the other meat. One is supposed to have died from vitamin poisoning.

I don't think we can argue about the danger of some of these materials; but on the other hand, no one has suggested licensing iron pills or vitamin D pills, despite the fact that overdose can make you very ill or even kill you. People have the absolute right to take those supplements, and if they want to take them in the form of pills, or tonic liquid, or powder spread on their food, or whatever - then that is their right. The dangers are minimal.

The same thing applies to nicotine, and if people want to inhale it in small quantities as that works better for them, why not. There is no problem to fix here: people aren't dropping like flies due to nicotine OD. The problem is the same as, or less than, that for vitamin A pills.

The issue with the 5,300 compounds in cigarette smoke is one of dependence-forming ability. There haven't been any trials of nicotine in humans (that is to say, of pure nicotine supplementation in never-smokers), so it is not possible to say that "nicotine is dependence-forming", because there is zero evidence for it. We know that it appears to be so, in smokers or ex-smokers, but that is a different issue. There is also some evidence that even things like vitamin A (and/or its precursors) can be dependence-forming if delivered repeatedly in large quantities.

I also suffer from the same problem with chocolate doughnuts. So it isn't an isolated issue that only involves esoteric chemicals: it involves many things, and dietary ingredients are no exception.
 

Oliver

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Just briefly, on the addictive properties of nicotine, and whether administration in isolation would create dependency...

Obviously there are many facets to addiction. It's often stated that speed of delivery is central, hence injecting or smoking illegal drugs are indicators of a more advanced addiction than vaporising or snorting them. The same is true of nicotine with respect to smoking. E-cigarettes are less clear regarding speed of delivery; they're somewhere between gum and cigarettes, from my reading. But the fact that they are successful in providing all the cues which help vapors move away from smoking (throat-hit, visual stimulation from vapor, hand-to-mouth etc) must give us pause - the very same aspects might be key in creating the addictive behavior to begin with.

The reason that human addictive behaviors cannot be read out from animal models is due to the complexity of associative learning in man as opposed to, say, rats. A good example of this is the (relative) lack of morphine addicts whose addiction was triggered by long-term hospital treatment. Of course, they do exist, but not in the numbers that would be assumed on the basis of a pure physiological mechanism. Indeed, those treated with morphine do have to go through managed withdrawal, but very few report later cravings or drug seeking behavior. In other words, then, there is a dissociation between withdrawal and drug-seeking behavior.

It's the craving (and thus drug-seeking) aspect rather than the withdrawal that is so insidious for most drugs, but for a minority of smokers it seems that the withdrawal itself never fully resolves, or perhaps takes too long to resolve. There may be pre-existing mood issues that are responsible, or the age of onset of smoking might be an issue or, simply, there may be a genetic aspect (diathesis) which does not present in any other way than a high likelihood of nicotine dependence, and any of the aforementioned might also be responsible for speed of onset of the addictive process.

Indeed, the above unanswered questions are why, even if we were able to countenance research into nicotine-naive individuals response to nicotine, we'd struggle to get samples large enough to delineate the full story.

Personally, I'm not sure we'll ever get the answers to much of this. Instead, addiction studies will become a descriptive science in which patterns of behavior are modeled. The sad thing about not being able to have solid theory about the addictive process is that we cannot predict with much confidence what, in this case, e-cigarettes represent in terms of addictive potential. And if long-term use of nicotine is truly similar to caffiene in its health implications (which I believe it is), we'll probably not see much research funded into it - after all, Etter at the ENVI workshop stated that a large number of people are addicted to the gum but this is never spoken of as an area of a public health problem, because, well, it isn't a public health problem!
 

Hotwire

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did find an article that defines addiction closer to your definition, it says caffeine is not addictive because it does not cause negative behaviors and appears to not affect the reward centers of the brain like

Bwha ha ha ha ha!

I'd love to see the look on their face if they saw the difference between me having had my morning coffee and me walking out of the house without having had two cups of coffee first. The poor kids in my classes (I'm a teacher) would recoil in horror at me!

I'm bipolar though and like with tobacco I think it's the MAOI's not the nicotine.

Though now I'm vaping instead of smoking I'm addicted to vaping for sure. It's that or cigs, I'll not give it up.

Only on 6mg juice though but do like the stimulating effect and believe I am getting hooked on that, though I'll tell you something about bipolar - we'll self medicate with SOMETHING anyway and this is the one thing I've found that has negligible effects on my health, sometimes gives me an acidic stomach but not that bad.
 

Berylanna

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Bwha ha ha ha ha!

I'd love to see the look on their face if they saw the difference between me having had my morning coffee and me walking out of the house without having had two cups of coffee first. The poor kids in my classes (I'm a teacher) would recoil in horror at me!

I'm bipolar though and like with tobacco I think it's the MAOI's not the nicotine.

Though now I'm vaping instead of smoking I'm addicted to vaping for sure. It's that or cigs, I'll not give it up.

Only on 6mg juice though but do like the stimulating effect and believe I am getting hooked on that, though I'll tell you something about bipolar - we'll self medicate with SOMETHING anyway and this is the one thing I've found that has negligible effects on my health, sometimes gives me an acidic stomach but not that bad.

Considering all the discoveries going on about nicotine and cognitive functioning, including Parkinson's and Alzheimers and ADD, I suspect that in 100 years they'll have classed nicotine as a vitamin. Maybe, unlike C, which apparently every animal except humans and chimpanzees make themselves, they'll find out that there's a gene where some humans make *something* that means they don't need nicotine and others fail to make it.

It's pretty rare to see a big expensive campaign against vitamins. Or insulin. Or anything else people need to function, PROVIDED the pharma companies found it before consumers did.
 

mechanus

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Just to put my two cents in on the term "addiction". There are two positions on the term, and they tend to get used interchangeably with impunity. As you can imagine, this is a very complex topic.

Addiction, in the form of chemical dependence, is a medical model term. In essence, it's any chemical substance that can cause withdrawal symptoms after use. "Use" here is defined not only in length of time, but also dosage frequency and, to be more encompassing, the dosage itself. We all know several chemical substances that can cause a physical dependence - not only in illegal substances, but also prescription medication and other substances. Dealing with addiction from this perspective usually includes weening, medication to ease withdrawal symptoms, and/or substitution of the addictive substance for a reduced harm medication as an intermediary strategy. In most cases, addiction therapy must also be accompanied by some kind of psychological therapy, which may (or may not) be modeled to the individual patient's needs. Typical forms of supporting therapy are one-to-one psychotherapy (pick your school of thought here), group therapy, or half-way homes/environments.

However (and while this is not my direct area of expertise it's something that I've worked with), addiction can also encompass psychological addiction. I want to be very clear on this point: a psychological addiction is in no way, shape, or form, imaginary. It is very real to the individual. There is a bit of cross-over from the medical model when we talk about how we *create* addiction. Any thing (and I do mean anything) can become addictive at a psychological level. This can be a simple behavior, a substance, or a very complex behavior that ties into many aspects and facets of an individual's life.

You'll have to excuse me on the simplification, but detailing the mechanics would take a lot more than what I can reference right now. When we do something pleasurable (eating is a basic example), our bodies create dopamine (among other neurotransmitters) and trigger receptors in our reward pathways. At a very simplified level, we begin to associate voluntary actions with, what we perceive consciously or subconsciously in some cases, pleasure (as a consequence of the elevated levels of dopamine). The amount depends on how valuable we perceive the behavior (or the substance) to be - the more pleasurable the behavior, the greater the reward - so to speak. So, while eating may create an X amount of dopamine in the brain, eating your favorite food (or a socially acceptable treat that you also enjoy - since social acceptance is part of the behavior feedback loop), will create >X amount of dopamine.

In more complex situations, the addiction may be created out of escape requirements, so it's no long the actual action that triggers the release of dopamine, if not the avoidance of situation. Arguably, from an evolutionary perspective in psychology, actions that help survival (through avoidance or escape) are more easily reinforced compared to elective actions (we may only be able to escape once).

However, these are not universal rules - each individual, consciously or subconsciously, assigns a value to the action (and the surrounding situation).

Now, our bodies adjust themselves to the new levels of dopamine we've created through the newly internalized action. When those levels of dopamine are not at what our body has adjusted itself to, we suffer from withdrawal symptoms. These can manifest themselves in several fashions, including (and probably the ones you can identify with immediately) anxiety, irritability, and other emotional responses. This can be extended to psychosomatic responses where you have physical symptoms (pain, allergies, outbreaks of rashes, are usually the most common).

There is still quite a bit of debate in the psychology practice of where to draw the line between the psychological approach to addictions and the medical model. By the time we've internalized that behavior and it's self-reinforcing through the dopamine feedback loop, it can be considered a medically defined addiction (basically, we're addicted to dopamine at a "higher-than-normal" - which is also based on individual tolerance - rate; we cut off that source of dopamine-triggering behavior(s), and we have withdrawal symptoms).

Typically, (and as per the DSM-IV-TR and now the DSM-V), an addiction is considered an "issue" (or a disease - though I personally dislike that term; addiction is a complex set of behaviors that contain symbology that cannot be ignored), once the behavior affects the quality of life of the individual (some will argue that we should include "and those around them"). If you talk to a medical doctor, you're going to get the medical treatment; if you go to a psychiatrist, you may be lucky and get a combination of a medical treatment and some psychological support; if you go to a psychologist, you will definitely get psychotherapy and you may get referred to a doctor for medical treatment, if the addiction requires it.

The problem here is that when people refer to addiction, they never qualify how the addiction was created, and therefore, it's impossible to determine which is the best course of action to "treat" it. Unfortunately, from a regulation/authoritarian perspective, we don't get a holistic approach - we will typically only get the medical model approach and ignore the other factors (or relegate them as secondary considerations, or worse, as a "one-size" fits all approach).

I have no idea on the actual chemical dependance factor of nicotine. I am not a chemist or a medical doctor - but I can (to a certain degree of confidence) guarantee you that the psychological addiction to the act of vaping/smoking exists. Is it something you need to seek help with? It will depend on how it affects your quality of life (and, to a further extent, your health (and the value you place on that as well)).

I just want to be clear, I'm not advocating that we all walk around with impunity on addictions - we're all addicted to something - may it be vaping (as a behavior), to the nicotine in it, to the social aspects of vaping (a complex social behavior); or, more "benign", to chocolate, or to coffee (or the caffeine in it), or to eating. The question becomes - is this behavior so extreme in nature that it is affecting my quality of life?
 

Berylanna

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I have no idea on the actual chemical dependance factor of nicotine. I am not a chemist or a medical doctor - but I can (to a certain degree of confidence) guarantee you that the psychological addiction to the act of vaping/smoking exists. Is it something you need to seek help with? It will depend on how it affects your quality of life (and, to a further extent, your health (and the value you place on that as well)).

I just want to be clear, I'm not advocating that we all walk around with impunity on addictions - we're all addicted to something - may it be vaping (as a behavior), to the nicotine in it, to the social aspects of vaping (a complex social behavior); or, more "benign", to chocolate, or to coffee (or the caffeine in it), or to eating. The question becomes - is this behavior so extreme in nature that it is affecting my quality of life?

Another question becomes, is it right for someone else to try to make it so that this behavior is affecting my quality of life because they don't approve of it?

Anything from nagging to making laws designed to make me uncomfortable as often as possible?

I think this depends on whether or not I'm harming others. As for making others uncomfortable, I can see having to balance my discomfort with someone else's UNLESS their discomfort is purely disapproval or uninformed fear.
 

Vocalek

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In 2007, the Royal College of Physicians issued a report, "Harm Reduction in Nicotine Addiction: Helping People Who Can't Quit."

It appears increasingly probable that some smokers may experience very long-term, perhaps lifelong, disruption of brain function, mood and/or cognitive ability following smoking cessation. Such individuals may require similarly long-term treatment support or nicotine maintenance, and this may account for the sustained use of nicotine medications by some ex-smokers, many of whom report that their use is to enable them to maintain [smoking] abstinence.
 

rolygate

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Most people are probably dependent on something, at some point in their lives. It's harmless, at least in terms of urban lifestyle choices. Addiction is probably best defined as having a dependency that is harmful in some way. At least then people are on the same page.

Describing nicotine as being 'strongly addictive' (or even 'fiercely addictive' as seen recently) is simply rubbish on numerous levels. There isn't even any evidence that nicotine is dependence-creating in never smokers. There is no clinical trial of nicotine consumption by never-smokers, so statements about any potential for dependence have no scientific basis. It is certainly problematic after smoking, for many people, but that is a different matter. It's a bit like saying "Vitamin B3 (nicotinic acid) is strongly addictive", after repeated smoking of a mixture of snow, bolivian marching powder, speed, and vitamin B3*. It might well be, but that is completely irrelevant.
* had to put it like this because of the word censor

E-Cigarette Terminology
[see 'dependence' and 'nicotine dependence']
 

Berylanna

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In 2007, the Royal College of Physicians issued a report, "Harm Reduction in Nicotine Addiction: Helping People Who Can't Quit."

It appears increasingly probable that some smokers may experience very long-term, perhaps lifelong, disruption of brain function, mood and/or cognitive ability following smoking cessation. Such individuals may require similarly long-term treatment support or nicotine maintenance, and this may account for the sustained use of nicotine medications by some ex-smokers, many of whom report that their use is to enable them to maintain [smoking] abstinence.

What if we needed it BEFORE WE STARTED? Is the difference between a vitamin and vs a bad drug simply whether or not it is patentable?

Everything but humans and chimpanzees can make Vitamin C. What if some humans cannot make Vitamin Nicotine or WTAs?
 
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