Why nicotine is part of the solution to end smoking, according to experts
Metro Manila (CNN Philippines) — In 1976, Professor Michael Russell, a pioneer in the study of tobacco dependence, famously said, “People smoke for nicotine but die from the tar.”
It’s the thousands of chemicals contained in tobacco smoke that make tobacco use deadly.
“This toxic mix of chemicals—not nicotine—causes the serious health effects among those who use tobacco products, including fatal lung diseases, like chronic obstructive pulmonary disease (COPD) and cancer,” according to the US Food and Drug Administration (FDA), echoing Russell’s iconic words from almost half a century ago.
Collectively known as tar, these toxic substances (carbon monoxide, formaldehyde, ammonia, hydrogen cyanide, arsenic, DDT, etc.) are produced by the burning of dried tobacco leaf and are subsequently inhaled by the smoker.
Nicotine, while highly addictive, does not cause diseases associated with smoking. Similar to caffeine, it is a food-grade substance producing stimulant and sedative effects. It is also a main component prescribed by doctors to help patients quit smoking.
“It is the toxins in cigarette smoke…that cause smoking-related disease and death, not the nicotine,” according to a leaflet of nicotine replacement therapy (NRT) inhalator.
Unfortunately, there are a lot of misinformation and misconceptions about nicotine. More than 57% of respondents in the Health Information National Trends Survey (HINTS) of the US National Cancer Institute falsely agreed with the statement that “nicotine in cigarettes is the substance that causes most of the cancer caused by smoking” and even 80% of physicians falsely believe that nicotine causes cancer.
“Addiction is complex and not solved by a war on nicotine,” according to Consumer Choice Center.
The Washington DC-based consumer advocacy group believes that nicotine can’t be the only reason why so many people fail to quit smoking.
“If nicotine were the sole reason for smoking addiction, every smoker using a nicotine patch should be able to quit smoking right away,” the group pointed out. “Clearly, this is not the case. The smokers’ addiction is based on a combination of nicotine and other ingredients of tobacco smoke, together with conditioned behavior—the so-called ‘smoking ritual’ like the coffee break or the inhalation process.”
Tobacco control expert Professor David Sweanor, as regards to the impact of the smokeless oral tobacco product called “snus” in Sweden, said that nicotine can be delivered with minimal risks once smoke and harmful toxins are removed.
He describes the demonization of nicotine as similar to “trying to deal with cholera not by removing the fecal contamination but by attacking the drinking of water. Essentially, we just need to focus on getting the crap out of the delivery system.”
This is where tobacco harm reduction (THR) comes in. THR is a public health strategy that aims to provide safer alternatives to reduce the harm caused by smoking and to provide nicotine to people who cannot or do not want to quit smoking by themselves or with currently approved methods. Less harmful nicotine delivery devices such as e-cigarettes (vapes) and heated tobacco products are forms of THR.
Eighty-eight percent or nearly nine of 10 adult Filipino smokers would consider switching to smoke-free alternatives such as e-cigarettes and heated tobacco products, according to a survey commissioned by local consumer advocacy group Vapers PH. Conducted from Aug. 3 to 15, 2021, the survey involved 2,000 legal-age smokers (above 18) and vapers (above 21) nationwide.
Around 17 million (23.8%) Filipino adults are smokers, according to the latest Global Adult Tobacco Survey (GATS 2015). The global survey also revealed that the Philippines has a dismal 4% smoking quit rate, which reflects the ineffectiveness of currently approved smoking cessation strategies.