Smokers and Vapers have enjoyed nicotine for years, but will it ever be as socially acceptable as say wine or beer?

Tobacco control has raged against smoking for decades and have succeeded in banning it almost everywhere. Now that smoking is being superseded by vaping, they have turned their attention to nicotine, despite the stated goal being moving the population away from combustible tobacco.

Should this smoke free world ever be achieved, and if cigarettes became obsolete, would nicotine become acceptable then?

What would it take for it to become acceptable?

During the USA E-cigarette summit, one of the UK’s leading players in helping e-cigarettes to be accepted by the UK establishment gave a presentation. Professor Ann McNeill, Professor of Tobacco Addiction Institute of Psychiatry, Psychology & Neuroscience, King’s College London, described who she called the main players in this vaping/nicotine/regulatory arena.

They are: Academics, Advocates, Governments, Health Professionals and Consumers.

We would argue that she has left out the Pharmaceutical lobby and the media.

For nicotine (plus vaping) to become acceptable there would need to be a consensus between them.

Could this ever be done?

Exploring this question of acceptability further, we are going to take another presentation from the summit, this time by Ray Niaura, Director of Science and Training at the Schroeder Institute and look at what he says about nicotine.

He asks several questions about the acceptability of Nicotine, one of which was, what would be the unintended consequences?

What would they be, should nicotine be accepted as a recreational substance?

  • Off the top of our heads we would chip in and say:
  • The Tobacco industry would have to adapt, (some are in the process).
  • Tobacco control would have to adapt, (they are not fairing so well).
  • Health would have to adapt, and this would include Pharmaceutical companies.
  • The Media would have to be on board as well, (basically do a 180).
  • Governments would have to adapt.
  • Again, some are faring better than others.

Many, many things would have to change, some people will lose money, but the bottom line is that the status quo would change.

Yet what are the objections to nicotine, above the ‘it’s in cigarettes and you are all heavily addicted,’ and are they valid?

Objection 1. Cancer

Smoking has been shown to give you cancer, but nicotine has yet to show itself as carcinogenic.  Ray Niaura even suggest that there is serious doubt regarding the belief that nicotine may promote the spread of cancer, “Epidemiological evidence in human populations does not support the basic science concern from laboratory studies that nicotine promotes some cancer pathway activation.”

Objection 2. Addiction

Nicotine is not the addictive drug that is the current paradigm, and, if there are addictive qualities to it, but they are far less harmful than smoking, then is this really an issue? Ray asks the question, “What does addiction mean if there is little to no harm?”

Many in Public Health in the UK have equated vaping with coffee. Coffee is widely accepted and many are ‘addicted’ to it in the very loose sense of the word. True addiction wrecks lives. We have yet to hear of a coffee addict going on the rampage to get their morning fix of joe.

If the goal is to remove the use of combustible tobacco because it is so harmful, must it be all or nothing? (As an interesting point, see this report in which PMI have been told by  a Danish firm that they violate human rights simply by advertising cigarettes,  and should stop selling them).

Objection 3. Nicotine and the effects on the brain, both adults and teens.

This is complicated for us lay people, so quoting directly from the presentation:

·         Exposure in utero, during critical periods of fetal development, may affect the function of certain neural systems in the long run.

·         Some brain development continues through adolescence. Findings in rodents that nicotine exposure during adolescence affects these developmental processes have raised concerns about adverse effects on adolescent neurodevelopment.

·         The functional implications of the experimental rodent models for humans are not currently clear.

·         Some human studies suggest that nicotine can produce cognitive and affective benefits.

·         Certain subgroups of individuals that are experiencing cognitive decrements (e.g., individuals diagnosed with ADHD, older adults with mild cognitive impairment) might be most sensitive to nicotine-related cognitive enhancement

Ray Niaura concludes his presentation with the following:

We need a re-examination of fundamental questions concerning nicotine:

• When nicotine is delivered to the body via means other than inhalation of combusted tobacco smoke, to what extent does it remain biologically harmful?

• When nicotine is decoupled from combustible tobacco, how worrisome is its degree of addiction liability, and what are its behavioral or social consequences to individuals and society?

• From a public health perspective, if nicotine can be used in substantially less harmful forms, would its widespread use have a positive or negative population impact on death and disease?

The evidence indicates that nicotine itself, while not completely benign, carries substantially lower risks than smoking.

Once again, as vapers we find ourselves in a double bind. We know, and the science backs us up that vaping is way less harmful than smoking. The evidence is mounting up and should be common knowledge by now. Yet it isn’t. The media are against us, as is Tobacco control.

So how can we ever get a consensus when there is such polarity?

For nicotine and vaping to become acceptable, we somehow must get consensus with the main players, and as we know, this is no simple task. But it is possible, and our hopes are with the new FDA boss. Because if he has the intelligence to let the science speak, then those against vaping will have to change, and a consensus will be reached.