Study may help explain why e-cigarettes satisfy smoker's cravings

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Bill Godshall

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While the authors/reporter didn't mention e-cigarettes, the following article on a new study may help explain why e-cigarettes satisfy the cravings of many smokers even though e-cigarettes deliver less nicotine (than cigarettes) to consumers, and even though some e-cigarettes contain/emit no nicotine.
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Smoking mind over smoking matter: Surprising new study shows cigarette cravings result from habit, not addiction
Smoking Mind Over Smoking Matter: Surprising New Study Shows Cigarette Cravings Result from Habit, Not Addiction - Science Daily
July 14, 2010

Nicotine patches and gum are common -- and often ineffective -- ways of fighting cigarette cravings, as most smokers have discovered. Now a new study from Tel Aviv University shows why they're ineffective, and may provide the basis for more successful psychologically-based smoking cessation programs.
In the new study published in the Journal of Abnormal Psychology, Dr. Reuven Dar of Tel Aviv University's Department of Psychology found that the intensity of cravings for cigarettes had more to do with the psychosocial element of smoking than with the physiological effects of nicotine as an addictive chemical.
"These findings might not be popular with advocates of the nicotine addiction theory, because they undermine the physiological role of nicotine and emphasize mind over matter when it comes to smoking," Dr. Dar says. He hopes this research will help clinicians and health authorities develop more successful smoking cessation programs than those utilizing expensive nicotine patches or gum.
Up in the air
Dr. Dar and his colleagues' conclusions are based on two landmark studies. In the most recent study, he and his colleagues monitored the smoking behavior and craving levels of in-flight attendants, both women and men, who worked at the Israeli airline El Al. Each participant was monitored during two flights -- a long flight of 10 to 13 hours in duration, from Tel Aviv to New York, for example; and a two-hop shorter trip from Israel to Europe and back, each leg lasting three to five hours. Using a questionnaire, he sampled craving levels of the attendants throughout the duration of their flights.
Dr. Dar and his colleagues found that the duration of the flight had no significant impact on craving levels, which were similar for short and long flights. Moreover, craving levels at the end of each short flight were much higher those at the end of the long flight, demonstrating that cravings increased in anticipation of the flight landing, whatever the flight's total duration. He concluded that the craving effect is produced by psychological cues rather than by the physiological effects of nicotine deprivation.
No smoking on the Sabbath
In an earlier 2005 study, Dr. Dar examined smokers who were religious Jews, forbidden by their religion to smoke on the Sabbath. He asked them about their smoking cravings on three separate days: the Sabbath, a regular weekday, and a weekday on which they'd been asked to abstain. Participants were interviewed at the end of each day about their craving levels during that day.
What Dr. Dar found is that cravings were very low on the morning of the Sabbath, when the smoker knew he would not be able to smoke for at least 10 hours. Craving levels gradually increased at the end of the Sabbath, when participants anticipated the first post-Sabbath cigarette. Craving levels on the weekday on which these people smoked as much as they wanted were just as high as on the day they abstained, showing that craving has little to do with nicotine deprivation.
Dr. Dar's studies conclude that nicotine is not addictive as physiological addictions are usually defined. While nicotine does have a physiological role in increasing cognitive abilities such as attention and memory, it's not an addictive substance like ......, which creates true systemic and biologically-based withdrawal symptoms in the body of the user, he says.
Dr. Dar believes that people who smoke do so for short-term benefits like oral gratification, sensory pleasure and social camaraderie. Once the habit is established, people continue to smoke in response to cues and in situations that become associated with smoking. Dr. Dar believes that understanding smoking as a habit, not an addiction, will facilitate treatment. Smoking cessation techniques should emphasize the psychological and behavioral aspects of the habit and not the biological aspects, he suggests.
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The citation for the study is:
The craving to smoke in flight attendants: Relations with smoking deprivation, anticipation of smoking, and actual smoking
J Abnorm Psychol. 2010 Feb;119(1):248-53.
Dar R, Rosen-Korakin N, Shapira O, Gottlieb Y, Frenk H.
http://psycnet.apa.org/index.cfm?fa=search.displayRecord&uid=2010-02209-018
 

kristin

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I have mixed feelings about this research.

Now all the smoker-haters can say, "See, it's all in your head. You can quit any time."

They'll completely ignore that there ARE still some physiological needs/symptoms for some smokers. There is no "one size fits all" with smokers.

These researchers need to look into why e-cigarettes don't fill the need completely for approximately 25% of ecigarette users. Those users obviously need something more than the just the physiological relief from the nicotine and can't be written off as just a psychological trigger.
 

Bill Godshall

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kristin

The scientific evidence about nicotine dependence and why many/most smokers smoke more than a dozen cigarettes per day are vastly different issues than the propaganda issued by anti-tobacco extremists/prohibitionists.

While scientific evidence has long confirmed that there is no "one size fits all" with smokers (as 25% of cigarette smokers don't smoke daily, which is something that you won't hear from CDC, FDA, CTFK, ACS, AHA, ALA, ASH, etc.), this research similarly and further challenges the conventional view that cigarette smoking is entirely caused by nicotine addiction.

Similarly, it appears pretty clear that there also is no "one size fits all" about e-cigarette users, as some use no-nicotine products, and others supplement e-cigarettes with higher level e-liquid and/or other tobacco/nicotine products to satisfy their cravings and/or desires.
 

kristin

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I know Bill, but nicotine users can't win.

Either we're "addicts" and "slaves" to nicotine and should be using a pharmaceutical products to "beat" our addiction or it has nothing to do with nicotine and we're all just "pathetic" and "weak" because we won't "just quit" because it's "just a nasty habit."

I'm not blaming the researchers for what they found, just anticipating how the people who hate us will react to this study. The "you're just pathetic and weak" camp will take this to mean that they were right all along and it's all in our heads.
 

rothenbj

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I know Bill, but nicotine users can't win.

Either we're "addicts" and "slaves" to nicotine and should be using a pharmaceutical products to "beat" our addiction or it has nothing to do with nicotine and we're all just "pathetic" and "weak" because we won't "just quit" because it's "just a nasty habit."

I'm not blaming the researchers for what they found, just anticipating how the people who hate us will react to this study. The "you're just pathetic and weak" camp will take this to mean that they were right all along and it's all in our heads.

I'm so tired of worrying about what those "other people" think. I hear you loud and clear and at times I just walk away and at other times I try to put some logic to an argument and when I'm real weak, I just blow back at them.

I do feel that this study certainly has some merit and it does reflect on the three headed monster that is smoking. There is a large contingent of smokers that smoke because it has become a part of their life. They don't really need the nicotine, but sitting back, inhaling and exhaling smoke has become built into their every day activities. These get converted to E-cigarette users fairly easily if they are even a bit open minded about it. I've read their stories on here and got mad at myself because it wasn't working for me. No matter what level of nic I used in my PV, I still needed a few cigarettes to get me through the day.

I'm sure there are also quite a few that need that nic for their own physiology, much like some can't get through the day without a constant supply of caffeine. The one thing I've always doubted was that nicotine was what the antis claimed, one of the most addicting drugs ever to used. That has always seemed way overstated. I traveled all over the world before I retired. As they said in this article, the worst of the cravings came in anticipation of being able to smoke. I don't care if I was flying to Florida or flying to Australia, when it was getting close to arrival, the "need" kicked in strong.

Then as you stated and I'm one of them, there is that group that needs those other alkaloids that tobacco provides. A few pieces of snus and I stay level all day. I don't even need to vape and often don't. I still have a trigger if I sit at the bar, I like to vape there, but I've forgotten my PV and was comfortable without it- something that wouldn't have happened when I was smoking. I haven't tried to go without snus for any length of time. I just put one under my lip when I get that antsy feeling and I'm good to go.

At this point, I could probably do without anything if I went on an antidepressant (BP loves you on those things), but why? I don't see any reason to not use what is effective for me and is not a problem for those around me.
 

kristin

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The one thing I've always doubted was that nicotine was what the antis claimed, one of the most addicting drugs ever to used. That has always seemed way overstated.

Additionally, the implication of comparing nicotine to those other addictive drugs is that nicotine is AS BAD as those other drugs for the user.

Soapbox comments:

On the contrary, how many nicotine users lose their jobs because nicotine use renders them unfit to do their job or rob people and/or sell their bodies just to get a fix?

There are engative addictions and positive addictions. Negative addictions are where risks outweigh the benefits received and positive addictions are the opposite.

Nicotine addiction is a negative addiction when using smoking to obtain the nicotine - the health risks far outweigh the benefits. Same goes for those addictive drugs (even legal ones) they compare to nicotine to scare people.

However, remove the smoke and the risks are little to none, so the risks are far lower than the benefits with smokeless nicotine products, rendering it a positive addiction.
 

IVapus

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I've always had my doubts that smoking was solely or even primarily due to nicotine addiction though I admit I have no evidence nor have I ever run across any to substantiate this view. It's just a long held suspicion.
My cravings were always highest based on stress(more specifically, certain sources of stress), or habitual cues, rather than the elapsed time since my last cigarette. I smoked nearly a pack a day(more at one time), but as alluded to in the article, it was easier for me to go without for long periods when I knew ahead of time that I wouldn't be able to or would prefer not to smoke. In fact, I've on occasion gone on week long family vacations(I didn't smoke in the house or around my family) without smoking, only to pick up right where I left off when I returned. On the other hand, a good blow-up with my wife(one of my many cues) might have me heading to the nearest convenience store for a pack at midnight just so I can relax and go to sleep.

One of these days I'd love to see some double blind studies done with former smokers using e-cigs with no nicotine, and with varying levels of nicotine up to say 24mg/ml or more to see if there is any measurable difference in satisfaction level. Obviously, the juices would have to be blended in such a way that there was no discernible difference in flavor due to the difference in nicotine level. Of course this is implicitly based on the premise that all smokers are pretty much alike, which may not be true at all. Some sort or pre-selection criteria might be required, and studies like this might need to done on different classes or categories of smokers. I'm confident that one of these days, and possibly not too far off, we're going to figure this out.

Having said that, when I started on e-cigs nearly two months ago, I worried about starting with just the right gear, having just the right e-liquid flavors and nicotine level, and learning the correct maintenance regimen. In short, the same obsessive-compulsive concerns that I seem to share with the many other addictive personalities on this site. However, I can't say with any confidence that if a vendor were to goof up and give 6 or 12mg (or even 0) nicotine instead of the 24mg that I always order, that I would immediately be aware. On the other hand, if I came here and read posts from one or more forum members to the effect that they had learned that this same vendor had made an error with the nicotine level in their juice, I would immediately begin obsessing that the same error had been made with mine. In no time, I might convince myself that this juice is not as satisfying as others, or not as satisfying as the last time I ordered it, and that the reduced nicotine had to be the reason.

I'm not worried about where facts and good science will lead, but I think we need a lot more of it. As far as those inclined to misuse data to further their agenda, they can do that just as well with facts or a lack thereof, good science or bad science. If you're trying to counter misinformation however, I think good science and facts are indispensable.
 

westcoast2

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Interesting.

Here is my take on it, a slightly revamped version of a post over at UK Vapers a few days a go:

There seems to be (at least) three aspects to tobacco usage

1 Nicotine
2 Cognition
3 Behaviour

NRT was developed to combat 'Nictoine Addiction'. The thought behind it was to supply Nicotine at a dossage *below* what is thought to be addictive. This relates to blood plasma levels and the rate of delivery. (Note: of course this suggests that there is a threshold below which nicotine is not addictive)

As NRT was not as effective as it was believed it would be, recent efforts have concentrated on denormalization. The cognitive aspect of not seeing smokers, changing the perception of smoking etc. This has adverse consequences for the group being denorrmalized and, although they may not realise it, the group initating it.

The behaviourable aspect is catered for in some NRTs (e.g Nicotrol inhalator) though this area has been the least explored. Of interest are recent e-cig studies that show nicotine delivery levels are lower than thought both in concentration and speed. This is contrary to what one might expect. As a result some researchers have suggested that the behavioural aspects of smoking are catered for by the e-cig and this compensates, in some way, for the lower nicotine. An experiment using zero nic cigarettes showed a similar result.

The thing about e-cigs is that they address all three aspects along with other issues such as additives and combustion products.

I noted a while back that people using the e-cig were actualy cutting down on nicotine (after perhaps an inital increase) and that this was inconsistant with the notion that nicotine was highly addictive.

So IMHO (and I note that Dr Siegel now agrees) tobacco usage is not all down to nicotine 'addiction'.

Just to add, this study may give too much weight to the psychosocial aspects due to the researchers involved.

I agree with Kristin's concerns. The 'nicotine is as addictive as xxxx' is designed to associate Nicotine with all the negative effects of other drugs. I beleive it was a surgeon general who first made this comparison.

Anti-smoking groups have exploited this comparision, though (IMHO) the real world nature of nicotine/tobacco use (as also noted by Kristin) does seem to be completely different. Some groups may well attempt to also exploite the psychosocial aspect though, it seems as with Aclochol, there are varying degrees and weights dependant on the individual.
 

D103

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I certainly share Kristin's concerns but I also recognize that the "anti's" are going to remain so no matter what facts are discovered or rumors disseminated or just plain fantasy/fiction promoted. IVapus, I really liked your post and in particular your last paragraph - that says it as well as can be said, in my opinion!! Similarly, the post from Drozd just the other day referencing a link to an article about the FDA and CDC's position - they are gradually learning and slowly "moving away from the science" (because, in my opinion they know they will lose that one) and now beginning to focus more on the "behavior" and how it "Looks like smoking". They are again trumpeting the Evils of Smoking and scaring people into thinking that allowing something which "looks like", "simulates", "mimics" smoking will only result in the "behavior" again becoming popular and socially acceptable and as a result we will all lose our kids to "THE TOBACCO EPIDEMIC."
 
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TropicalBob

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I refuse to accept the either/or position. Smoking addiction is due to both the psychological component AND the dependence/tolerance we smokers develop for a poisonous chemical called nicotine.

That said, I could not find satisfaction with an e-cigarette alone. No liquid level or component strength made any difference. Something was missing. But e-cigs miraculously satisifed, and still do, my need to see "smoke", bring hand to mouth, reach into my pocket, etc., acquired over 50 years of smoking 30 cigarettes a day.

For me, the "something missing" is nicely supplied by Swedish snus and Stonewall hard snuff/dissolvables. I now have it all. And in every waking moment, I'm using one or two or even more (nasal snuff is a great dessert product!).

It's not either/or. No choice is necessary, in fact. We must all determine the balance of physiological and psychological factors in our smoking habit/addiction. I'm a nicotine addict. I smoked for 50 years and got alertness, relaxation and joy from it. With a combination of smokefree products, I still get those benefits, with smoking up my lungs.
 

D103

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I agree with Bob, it is certainly a "combination of factors" and others have pointed this out as well. Everyones' particular "addiction" is somewhat different, thus requiring different types of interventions. All the more reason why a vast variety of products should remain available to people in order that persons be allowed to find what particular product or combination of products suits them best. Also this is all the more reason why "truthful information" about addiction and available solutions is so vital so that persons who try a particular product and/or method and it does not work for them don't end up prematurely feeling discouraged and "giving up" on harm reduction as a viable alternative.
 

rothenbj

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I agree with Bob, it is certainly a "combination of factors" and others have pointed this out as well. Everyones' particular "addiction" is somewhat different, thus requiring different types of interventions. All the more reason why a vast variety of products should remain available to people in order that persons be allowed to find what particular product or combination of products suits them best. Also this is all the more reason why "truthful information" about addiction and available solutions is so vital so that persons who try a particular product and/or method and it does not work for them don't end up prematurely feeling discouraged and "giving up" on harm reduction as a viable alternative.

+1 on that

I just had a young fellow ask about where to get a PV. I immediately sent him here and gave him a suggestion of a Joye 510 as being an inexpensive starting point. However, I gave him my history and what I needed and explained everyone is different.

Hopefully he'll follow up. I may even set him up. He just got out of the military and hasn't been able to hook up a job for four months. He got a call about an interview while we were playing poker and was so excited. He's a computer type so immediately took a liking to him.
 

Shotline

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After having tried to quit using the patch, etc., I came to the realization that it was probably not nicotine addiction that was causing me problems but rather it was everything else that came along with analogs, the habit, the ritual, the social aspects. That is why when I researched PV's I became so excited because it appeard at the time, and has since been proven by use, that PV's would give me everything I enjoyed about smoking without all the crap. I attribute this fact to the only reason I have been able to give up analogs.
 

IVapus

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After having tried to quit using the patch, etc., I came to the realization that it was probably not nicotine addiction that was causing me problems but rather it was everything else that came along with analogs, the habit, the ritual, the social aspects. That is why when I researched PV's I became so excited because it appeard at the time, and has since been proven by use, that PV's would give me everything I enjoyed about smoking without all the crap. I attribute this fact to the only reason I have been able to give up analogs.

My suspicions ran along similar lines, and as soon as I stumbled across e-cigs, and this site, I intuitively knew they would work. I smoked on and off for over 25 years, about a pack a day(some periods more, some a little less). I quit cold turkey on 2 separate occasions, once for about a year, once for about 3 years as I recall. Just like when I started the first time, stress, depression, and an unfortunate penchant for self-destruction triggered me to start up all over again. The last time I tried to quit cold turkey I only lasted about 2-3 months, which I don't even count. The time before that I tried the patch and it was a total joke. I couldn't tell it was doing anything at all for me, and I continued to smoke at exactly the same pace while wearing it.

I do think nicotine is a factor, and a major one. The size of the role it plays may vary from person to person. But there's still a whole lot more to it than that I suspect. People tend to think that to say something is in the mind means it's not physical and therefore it should be easily overcome with will power, but I don't think that's true. Our brains are also governed by physical and chemical processes. It's not either/or. When those of us prone to addiction train our brains a certain way, we have a heck of a time overcoming, or retraining it, and the longer we go the harder it is. When I think back now, I can't begin to imagine how I could have managed to quit cold turkey for 3 years, but that was 15 years ago, and I'm sure it was a lot easier then. Even fairly recently, as I mentioned earlier, on occasion I would go a whole week without smoking while on holiday with my family. It may not have been easy or pleasant(for them or me), but I could do it. The fact that I knew I could smoke again when the week was up made it that much easier.

When cigarette smoking was banned on airplanes, I'm sure many smokers, like me, wondered how they would manage, but we did. I sometimes fly to the Far East or Southeast Asia on trips lasting 18 to 24 hours and it's becoming more and more common for airports not to have smoking areas indoors, and for you to have to go back beyond baggage, passport, and security checkpoints(which could mean as much as 1-2 hours) in order to get outdoors for a smoke. So it's not always easy to dope up on nicotine prior to boarding at your origin, or connecting flight. Yet somehow we [ex in my case] smokers managed. We knew we'd get there eventually and be able to light up. Boy was that first analog good after a 20+ hour trip.

If there is a point to this insipid wandering(sorry), it's that I suspect anyone can quit smoking if literally forced to, nicotine addiction and withdrawal notwithstanding. However, I think personalities such as mine will eventually have to find some vehicle, be it healthy, unhealthy, or neutral, to channel their addictive tendencies. The neat thing about vaping I think is that it's close enough to smoking that it requires very little retraining of our brains to switch from a clearly unhealthy outlet to a seemingly neutral one. Also, though it may not be as easy or as idiot-proof as smoking, it can also be more satisfying and rewarding with time.
 

Shotline

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I work in a jail and we have inmates that are here for months at a time and up to a year in some cases. They cannot smoke at all here and many of them keep talking about how they will have a cigarette as soon as they get out. I tell them, this is the best stop smoking program around, you haven't had a cigarette for 6 months, why have one now. Their response is almost always, "I like it."
 

IVapus

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I work in a jail and we have inmates that are here for months at a time and up to a year in some cases. They cannot smoke at all here and many of them keep talking about how they will have a cigarette as soon as they get out. I tell them, this is the best stop smoking program around, you haven't had a cigarette for 6 months, why have one now. Their response is almost always, "I like it."

And I'm sure many of them will do exactly as they say and start up again the second they get out, whether they've been off cigs and nicotine for a few months, or several years. They may not be able to feed their nicotine addiction in jail, but with their imagination and fantasies they can keep the psychological aspects of their addiction going strong indefinitely without the aid of cigarettes in the interim. Hell, I'm getting kind of excited right now thinking about how unbelievable the first analog would taste after a good long stretch in the big house, LOL.
 
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