Are Nicotine Replacement Therapies safe? Most nicotine is still derived from tobacco but there have been giant strides in synthetic nicotine that is completely free of tobacco.
A study in the Indian Journal of Clinical Practice (July 2020) underlined the fact that about 80 per cent of our doctors believed that nicotine causes cancer. Another USA based study also showed similar findings. Both fly in the face of facts.
Dear doctor friends, nicotine doesn’t cause cancer. You are simply (or simple?) victims of overzealous public health campaigns to conflate nicotine with tobacco.
Nicotine has long been a victim of Zohnerisms (“the use of a true fact to mis-lead a scientifically and mathematically ignorant public to a false conclusion” – James K. Glassman) and many of the dangers of tobacco are erroneously attributed tonicotine. Google “Zohnerism” and you will likely see the parallels between the dangers of DHMO (aka Water) and Nicotine. Nicotine is made out to be the stuff of nightmares and the root of all evil. Numerous webpages portray nicotine as a vile poison with innumerable dangers and more lethality than cyanide, while forgetting to put things in context. In the right (or wrong) circumstances, anything on earth is dangerous to life.
Yes, nicotine is habit-forming and has been long accepted as the primary reason why people are hooked to tobacco despite education about its many dangers. But notably, these dangers arise from the other compounds present including tobacco specific nitrosamines, tar and additives and not from Nicotine by itself. In a nutshell, one consumes tobacco for the nicotine but it’s the other stuff that kills.
So, if nicotine doesn’t kill and can be separated from tobacco the logical next step would be to delink nicotine from tobacco. Doesn’t take genius level IQ to see this approach saves lives.
This is the basis of Nicotine Replacement Therapies (NRTs) like gums, patches, lozenges, etc marketed by big pharma and endorsed by Tobacco Control Groups and even the WHO to provide a safer alternative and wean people off tobacco. Yet, these are not a runaway success at getting people to quit. This problem is especially pronounced when it comes to smoking behavioural cues, like hand-to-mouth action, throat-feel of vapour, rapid nicotine absorption, were missing and soon big pharma launched nicotine inhalers and sprays to address these shortcomings.
Are Nicotine Replacement Therapies safe?
Well, smokers do not fancy dying either and contrary to prevailing opinion, their brain cells haven’t all suffocated. An ex-smoker invented the first E-cigarette (Google “Hon Lik”) in 2003. The concept was straight from NRTs delink nicotine from tobacco and save lives. Soon, people were vaping all over – not just to quit, but to even continue using nicotine in a safer manner.
Most nicotine is still derived from tobacco but there have been giant strides in synthetic nicotine that is completely free of tobacco. And therein lies the threat to the status quo. Are we encouraging a nicotine use epidemic if we endorse nicotine as safer than tobacco? Well, so what? It is safer. So, why the moralizing? Did we ask this question about caffeine? Or alcohol? Or even automobiles? The choice then is between saving many lives by condoning nicotine use in a safer manner Or saving fewer lives by a rigid ‘tobacco cessation only’ approach.
I can’t say nicotine is completely safe it is indeed dangerous to kids and pregnant women but so are a myriad of other things from alcohol to strenuous workouts to even common medicines that cause birth defects or trigger severe immune responses and no one advocates the supply of nicotine to our kids or pregnant women. But they make convenient “people to save” as justification for a blanket ban. Imagine using this reasoning to ban coffee? Or cars?
This is a real blind-spot for tobacco control groups when it comes to nicotine pharma marketed NRTs are completely safe, while alternatives like vaping and nicotine pouches (Synthetic Nicotine incidentally) are more dangerous than tobacco? Does pharma nicotine (mainly derived from Tobacco) differ from nicotine manufactured by the tobacco industry?
If nicotine was deadly do you imagine for a moment that big pharma would risk a class-action lawsuit by marketing NRTs?
Ask this question of most people in Tobacco Control and you are labelled as a mouthpiece for the tobacco industry and subject to personal attacks and ‘rebuttals’ that jump from “saving our kids” to “you can’t trust Big Tobacco” and a lot of words that essentially mean we know best and everyone else has been fooled. The fundamental question remains unanswered.
The WHO and Tobacco Control have set very unambitious targets for tobacco cessation and congratulate each other on achieving these but the truth is in the details – while we trudge along saving a few, many others are dying. By the time we get to them, it may be too late. Allowing reduced risk nicotine alternatives could make a huge difference.
The author of this article is Dr. Kiran Melkote, Orthopaedic surgeon & member of AHRER – Association for Harm Reduction, Education and Research.
