Nicotine 101: The Truth About What it is, and What it Does
"Though often thought of as a bad guy, nicotine itself is actually fairly safe. As with most substances, there is a lethal dose of nicotine, but the exact lethal dose is largely undetermined—in part because there are no realistic circumstances in which we would inadvertently encounter it."
"Once upon a time, the FDA did not approve long-term use of nicotine replacement therapies, urging people to completely quit all forms of nicotine within a maximum of 12 weeks.
More recently, the agency has walked back those recommendations after realizing that long-term nicotine use is rather benign, and if nicotine replacement therapies can mitigate the risk for relapse to smoking, then continuing to use nicotine as a replacement therapy is better than an abstinence-only approach."
"While the FDA has an eye to restrict vaping, a landmark study recently indicated that e-cigarettes are about twice as effective for smoking cessation as non-inhaled nicotine replacement therapies—a finding that chimes with the higher effectiveness of nicotine when it is inhaled.
"The health problems that are popularly associated with long-term nicotine use—including heart disease, various forms of cancer and stroke, to name a few—largely arise from smoking combustible cigarettes."
"When not accompanied by tar, carbon monoxide and the myriad chemicals associated with combustible tobacco, nicotine may exacerbate hypertension, but it is not responsible for the hardening of arteries, cancer or emphysema."
"So if nicotine does not cause cancer, heart disease or lung disease—but its use in isolation helps millions of people to avoid the combustible cigarettes that do cause these diseases, and indeed, as we’ll see, even has inherent benefits—then what’s the problem?"
So Is Nicotine Addictive?
"There is wide disagreement over whether nicotine per se is addictive. To begin, there are at least four separate, commonly referenced views of addiction:
"Neither the benefits nor the consequences of nicotine use need to be exaggerated for the good of public health. Perhaps the first step to understanding nicotine and, in turn, to ensuring that any necessary regulations do not exacerbate public health harms, is to simply have a normal, honest dialogue."
"Though often thought of as a bad guy, nicotine itself is actually fairly safe. As with most substances, there is a lethal dose of nicotine, but the exact lethal dose is largely undetermined—in part because there are no realistic circumstances in which we would inadvertently encounter it."
"Once upon a time, the FDA did not approve long-term use of nicotine replacement therapies, urging people to completely quit all forms of nicotine within a maximum of 12 weeks.
More recently, the agency has walked back those recommendations after realizing that long-term nicotine use is rather benign, and if nicotine replacement therapies can mitigate the risk for relapse to smoking, then continuing to use nicotine as a replacement therapy is better than an abstinence-only approach."
"While the FDA has an eye to restrict vaping, a landmark study recently indicated that e-cigarettes are about twice as effective for smoking cessation as non-inhaled nicotine replacement therapies—a finding that chimes with the higher effectiveness of nicotine when it is inhaled.
"The health problems that are popularly associated with long-term nicotine use—including heart disease, various forms of cancer and stroke, to name a few—largely arise from smoking combustible cigarettes."
"When not accompanied by tar, carbon monoxide and the myriad chemicals associated with combustible tobacco, nicotine may exacerbate hypertension, but it is not responsible for the hardening of arteries, cancer or emphysema."
"So if nicotine does not cause cancer, heart disease or lung disease—but its use in isolation helps millions of people to avoid the combustible cigarettes that do cause these diseases, and indeed, as we’ll see, even has inherent benefits—then what’s the problem?"
So Is Nicotine Addictive?
"There is wide disagreement over whether nicotine per se is addictive. To begin, there are at least four separate, commonly referenced views of addiction:
The psychiatric view: Addiction has aspects of an impulse control disorder (taking something for pleasure) and a compulsive disorder (taking something to relieve stress).
Psychodynamic view: Addiction is the result of developmental difficulties, emotional disturbances, structural factors, personality organization and a dysfunctional view of “self.”
Social psychology view: Addiction is the result of poor self-regulation.
Dependence view of addiction: Addiction is the result of an abnormal state where administration of a drug is required to maintain physiological equilibrium.
"Neither the benefits nor the consequences of nicotine use need to be exaggerated for the good of public health. Perhaps the first step to understanding nicotine and, in turn, to ensuring that any necessary regulations do not exacerbate public health harms, is to simply have a normal, honest dialogue."
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