Thursday, October 6, 2011

Nicotine--not a cause of relapse to smoking

Many folks believe that if a smoker switches to a different source of nicotine, it is inevitable that he or she will start smoking again. But is that true? 

It's true that people who use the pharmaceutical nicotine products like the patch, gum, lozenges and prescription inhalers are likely to start smoking again. But nicotine isn't the cause of these relapses. It's the absence of nicotine. These products come with directions to stop using them after 12 weeks. This is not because GlaxoSmithKline knows of any danger involved in using the products longer. It's because that's how long the testing lasted to obtain FDA approval. In real life, when treatment stops, relapse begins.  

Smokers who switch to e-cigarettes (or some other smoke-free source of nicotine) are unlikely to take up smoking again. In the largest population survey of e-cigarette users published, Etter and Bullen noted that 77% of daily user don't smoke at all, and those who are (currently) continuing to smoke have cut their consumption from 25 cigarettes per day to 15. It took me 20 years to reduce from 50 cigarettes per day to 10, and it only took a few days with an e-cigarette to eliminate those last 10 cigarettes. That was 2-1/2 years ago!  The number of e-cigarette consumers reaching 1 year, 2 years, and even 3 years of smoke-free living is growing exponentially. 

Sweden has the lowest smoking rate in the European Union (14%) and the lowest lung cancer rate. But Sweden doesn't have the lowest rate of tobacco use. Many of those former smokers switched to snus, a type of spit-free moist snuff. Swedish smokers who switch to snus tend to stick with it, because they are not inundated with false information telling them that snus is just as harmful as smoking. The facts are that smokers who switch to snus eliminate the elements that cause lung disease because they no longer inhale smoke, and their rates of cancer and heart disease are no higher than ex-smokers who don't use any form of nicotine. 

In the U.S., smokeless tobacco products carry warning labels stating, "This product is not a safe alternative to cigarettes" which 85% of the populace thinks means that using the product is no safer than smoking. So in essence, our warning labels are saying "You might as well smoke." Thus, the biggest roadblock to reducing smoking prevalence may well be the false information disseminated by the tobacco control community. How ironic...and sad!