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this post was submitted on 05 Oct 2023
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Nicotine is one of the safest stimulants we know, up there with caffeine in terms of safety. There's little meaningful reason to ban nicotine. You're more likely to harm yourself with any number of other things we readily allow.
The addiction potential of nicotine alone is also far lower than people assume, because smoking is highly addictive both due to the rituals and the other substances involved. I tried to get used to nicotine via patches years back to use as a safe stimulant, and not only did I not get addicted, I couldn't get used to it (and I was not willing to get myself used to smoking, given the harm that involves). That's not to say you can't develop addictions to patches or vapes etc. too, but much more easily when it's as a substitution for smoking than "from scratch".
Restrictions on delivery methods that are harmful or not well enough understood, and combining nicotine with other substances that make the addiction and harm potential greater, sure.
this is from a 2015 article i found on the NIH library:
source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363846/
in case you think i might be cherry picking, here’s something from johns hopkins, and here’s a source from the cdc. here’s something recent from harvard for good measure.
edit: i should be clear that the other sources don’t say exactly the same things as the NIH one, but they do talk about how nicotine itself is very addictive, and they talk about some of the harm it can cause
The links from John Hopkins, the CDC and Harvard all focus on vaping, and so are irrelevant to the question of nicotine rather than the delivery methods.
The first link has nothing wrong in it. It's correct nicotine is toxic. So is caffeine - the LD50 of caffeine in humans is reasonably high, many grams. To the issue of ingestion, the issue is toxicity at doses people are likely to deal with.
To the cancer links, again without looking at delivery methods, this is meaningless. To let me quote one small part:
This makes sense. Don't inhale lots of particulates combined with nicotine in other words. There are also many other parts of the article that are useful. E.g. it's perfectly reasonable to accept that e.g. if you are on chemo you should stay off nicotine, and if you breastfeed you should stay off nicotine.
What the article does not show is that nicotine, as opposed to delivery methods like inhalation, is much worse than other drugs we're perfectly fine with.
I'll note that the article also includes things in its conclusion that it has categorically not cites studies in support of. E.g. it just assumes the addiction potential is proven (it is, but putting that in the conclusion of a paper without citing sources is really poor form, especially in a paper claiming to set out the issues with nicotine in isolation rather than smoking).
It also tried to drive up the scare factor by pointing out its toxicity at doses irrelevant for human consumption (e.g. as an insecticide; if wildly irrelevant doses should be considered, then we could write the same paper about how apples should be banned because they contain cyanide).
The "Materials and methods" section also goes on to say "Studies that evaluated tobacco use and smoking were excluded" but then goes on to make multiple arguments on the basis of harm caused by smoking (e.g. "Nicotine plays a role in the development of emphysema in smokers, by decreasing elastin in the lung parenchyma and increasing the alveolar volume") and cites a paper focused on smoking, in direct contradiction of the claim they made ("Endoh K, Leung FW. Effects of smoking and nicotine on the gastric mucosa: A review of clinical and experimental evidence. Gastroenterology. 1994;107:864–78.")
So, yes, if you make claims about how you're going to address nicotine rather than smoking, and then go on to address smoking and other means of inhalation intermingled with the rest, and if you leap to conclusions you've not cited works in support of, and if you throw out risks without linking them causally to nicotine, you can make nicotine look very bad.
They also end with subjective statements they've not even attempted to support properly. E.g. they've gone from "here is why it's dangerous" to "it should be restricted", but if that was valid logic, we should restrict sales of apples too, most cleaning agents, all caffeinated products, housepaint, paint thinners, and a host of other things, it's a specious argument and fitting that such a badly argued paper ends with it. That this passed peer review is an incredible indictment of the journal which published it.
That doesn't mean nicotine is risk-free, but compared to other things we're happy to ingest, I stand by my statement. But don't inhale it.
they do focus on vaping, that does not mean they are irrelevant to the question of nicotine. from the cdc link:
there are also sections of that page titled "Why Is Nicotine Unsafe for Kids, Teens, and Young Adults?" and "How Does Nicotine Addiction Affect Youth Mental Health?" that focus only on nicotine.
from the harvard article:
from johns hopkins:
to your second point
i agree that it would be better to focus only on nicotine. i disagree that ignoring delivery methods is "meaningless". form the johns hopkins article:
this is only to say that the cancer bit is not irrelevant.
the part you quoted says that nicotine acts as an accelerator for the development of cancers from other sources, including things like car exhaust. these carcinogens are widespread in the modern world, so accelerating the development of cancer associated with them is a bad thing. eg, car exhaust fumes are everywhere.
i agree, this is bad. the problem you brought up with the "materials and methods" section is also bad. i'm not trying to defend the article holistically, i'm even particularly attached to that source (which is why i included a few different ones). the only reason i picked that article was that it explains some of the harmful effects of nicotine, and then backs them with citations. the article did this by reviewing "90 relevant articles" from PubMed and Medline, then discussing what those articles found - and these are the parts of the article i was interested in. i probably wouldn't use this approach if i were writing an academic paper on the subject, but i think it's fine for arguing on the internet that nicotine isn't "one of the safest stimulants we know". (i also included a few different sources to counteract the limitations of this approach.)
your statements were
and
i think the second statement was thoroughly debunked by the sources i've included: they all say nicotine is highly addictive, and one of them says it's "as addictive as heroin and cocaine". i think the sources i've shared also discredit the idea that nicotine is "up there with caffeine in terms of safety". i'm not trying to say nicotine is extremely dangerous, but rather that its danger is underestimated.
To this and your subsequent points, these claims are not backed up by sources in the pages you linked to, and as we've seen from the other paper as well, there's good reason to be cautious about assuming their claims are separating the effects of nicotine from the effects of the delivery method, especially given every single source actually cited by the CDC article is about smoking. Neither the Johns Hopkins or Harvard article cites any sources on nicotine alone that I can see.
A claim that is not backed by sources, and has divorced this from delivery method. E.g. how many people starts with gum or a patch and goes on to tobacco? I can certainly see there being some transfer from vaping to tobacco, but that is very different from the blanket claim and illustrates the problem with these sources that fail to disambiguate and extrapolates very wide claim from sources that looks at specific modes of use.
Yes, inhaling nicotine is bad. That we can agree on, and the source supports the limited claim that if you get nicotine in a way that binds to cites in your lungs, that is bad. The sources do not provide evidence that this risk is present for other modes of use. Maybe it is, but they've not shown that.
But that article is the best of the sources you gave. The others cite nothing of relevance to the claim I made that I can see after going through their links.
But the problem is that not nearly all of those "90 relevant articles" are relevant to their claim, and so they start off by misrepresenting what they're about to do. They then fail to quantify their claim in any way that supports their conclusion. They back up some specific claims without quantifying them (e.g. I can back up the claim that apples can be lethal, but you'd need vast quantities to get enough cyanide from an apple to harm you, so a claim they can be lethal in isolation is meaningless) or unpacking whether they are risks from nicotine in general, or nicotine via a specific delivery method. This is an ongoing problem with research on this subject.
They have not provided an argument for how any of those "90 relevant articles" supports their conclusion.
The say that, but they don't back it up. Ironically, pointing to heroin is interesting, because the addiction potential of heroin has also been subject to a lot of fearmongering and notoriously exaggerated, and we've known this for nearly half a century -- a seminal study of addiction in Vietnam war vets found the vast majority of those with extensive heroin use in Vietnam just stopped cold turkey when they returned to the US and the vast majority didn't relapse, the opposite of what the authors assumed going into the study. A study that was commissioned as part of Nixons then-newly started politically motivated and racist War of Drugs with the intent of providing evidence of how bad it was.
(see https://www.mayooshin.com/heroin-vietnam-war-veterans-addiction which gives a reasonable account of Robins study, and gives full reference to the paper)
That's also not to say that heroin isn't dangerous or seriously addictive because it is. Nobody should use heroin. But it's also frequently used as a means of exaggerating by implication because peoples idea of the addiction potential of heroin is largely way out of whack with reality and heavily context-dependent. So when someone drags out a heroin comparison without heavy caveats, that's reason to assume there is a good chance they're full of bullshit.
In other words: It's perfectly possible that some ways of taking nicotine can be as addictive as heroin, but that doesn't tell us what most people think it does. E.g. UK hospitals sometimes use heroin (as diamorphine; its generic name) for post-op pain management because it's far better than many alternatives.
The sources you've given do not present any support for claims that nicotine considered separate from delivery methods is particularly risky. They do provide support for claims it's dangerous when smoked, and possibly dangerous when inhaled even via vaping, and the takeaway that you should generally avoid inhaling stuff other than clean air without good reason is good. The other claims about nicotine in general do not appear to be backed up at all.
I find the notion that the danger is underestimated hilarious when one of the claims used a comparison with heroin to fearmonger.
Your source, if anything, is evidence to me of the opposite.
I didn't read this novel but you're arguing nicotine isn't unhealthy and that makes you wrong
"I haven't read this, but let me misrepresent what the thing I didn't read says".
I have not argued it isn't unhealthy. I have argued it's one of the safer stimulants we have, unless you ingest it in a way that is dangerous (e.g. inhalation). That does not mean it's free of downsides, but neither are a whole lot of things we still decide it's fine to use.
Next time maybe try abstaining from replying to something you've not bothered to read.
You just confirmed what I said. "One of the safest"
And yeah you wrote way more shit than you should ever expect people to read. Maybe abstain from writing 10,000 words ever but especially if you're wrong
No, you made the false claim that I said it isn't unhealthy. "One of the safest" is not the same as "isn't unhealthy".
If you can't be bothered to read my ~600 words in reply to someone else and not directed at you, that is entirely your choice. Nobody is forcing you to. Neither are anyone forcing you to blatantly misrepresent what I've claimed, however.
You went and counted the words. That says more than I could
Your hyperbole was so idiotic that I took 10 seconds to pipe the contents to "wc" to highlight just how lazy you were before you misrepresented what you reply to, yes. That it was such a chore for you to read 600 words before making up a strawman to reply to does indeed say more than you did with words.
Get laid
Thank you. I will 😘
Well of course not. You weren't getting the dopamine rush of a large acute dose rushing from your lungs directly to your brain in a matter of seconds.
What the heck kind of hot take is this?
Regardless, the dangers – including ease of addiction – are well-known and are scientifically proven. Your anecdata of one does not change that.
So in other words, you're saying I didn't pick the right delivery method to get me addicted. Which was my point.
Missing the point: 1) a large part of the addiction for most people is down to delivery, not nicotine itself - something you yourself used as an argument against my anecdote above -, and most of the research focuses on that. 2) the remaining addiction potential of nicotine is real, and proven, but it's also nothing particularly special compared to other things we're fine with seeing the addiction to as ranging from a nuisance (e.g. caffeine) to a problem that doesn't justify prohibition (any more), like alcohol.
My point was not that it's impossible to get addicted to nicotine, but that confusing nicotine vs. nicotine via a given delivery method is not helpful.