Big news: smoking is bad for you.
Nicotine, however… well, the jury is hung on its positive side because it is so linked to smoking.
High doses kill, that is well known by just about everyone. Beyond that, the dangers seem more to do with delivery and dosage than anything else. Which brings us to the idea that not smoking and quitting nicotine no longer have to be the same thing. Electronic cigarettes have opened up a whole range of other options. Which has big pharma seeing red (financially) for not thinking of this sooner.
The FDA already approves of the use of “medical” cessation products, which have netted drug companies a tidy sum and created cessation programs that big tobacco could run to pay down their debt to society and still manage to make a profit from people not buying their products anymore. Now, all the major tobacco companies also make e-cigs, so their bases are getting covered nicely (1). This leaves the drug companies playing catch-up in a game they thought they could own.
Welcome to the new shade of gray – vapor gray. Even on a good day, quitting is often a losing battle. Smokers know this and often decide it just isn’t worth the battle. Enter the patch/gum/other step down device! Your hero in quitting. You may not be as sharp or alert anymore, but you won’t smoke. Probably. Just pop the gum and celebrate. Never mind that the success rate is only about 10%, twice the rate for placebo, but still, 90% failure is abysmal (2). When this was the only option, it was great. Now, however, not so much. Drug companies everywhere are leaving out these numbers when they tout success and health benefits (2).
So, to “quit tobacco” long term means using their products long term. Which brings us back to the fact that using a patch forever is not quitting. With big tobacco stepping in to the electronic cigarette game, standards are going to be established and production materials improved as each company tries to become the safest most effective product out there. All of this spells gloom and doom for big pharma, who will undoubtedly continue to publish “yes, but” studies and articles showing how dangerous anything they do not produce really is. The only fundamental difference is delivery method. Theirs are largely invisible, while e-cigs look like what they are called. They look less like quitting because their nicotine delivery system conjures images of tobacco use.
Somehow, quitting tobacco and nicotine have come to be used interchangeably when, in fact, this is not the case. The drug companies point to studies where their products are more effective than electronic cigarettes as nicotine cessation tools without adding that almost a third of the participating vapers were not using them for that purpose (3). But, wait, are we talking smoking or nicotine as the thing which must be quit? It seems that now the demon is nicotine and the definitions of quitting and smoking are being skewed to fit agendas and anti-smoking groups’ agendas (4). The FDA didn’t help by deciding to call e-cigs tobacco products because nicotine is derived from it (5). This has given pharma a lot of leverage, if it can successfully continue to distinguish its products from e-cigs based solely on delivery method.
Bottom line, how they are used is beside the point. You don’t have to be a (nicotine) quitter to quit smoking. So, go celebrate the healthier side of life.