this post was submitted on 05 Oct 2023
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[–] Silentiea@lemm.ee 99 points 1 year ago (7 children)

It always confuses me to learn that when people want to ban smoking it somehow means ban "cigarettes" and not "nicotine"

[–] gmtom@lemmy.world 39 points 1 year ago* (last edited 1 year ago) (1 children)

Because smoking is WILDLY more harmful than vaping.

Yes vaping has SOME health risks, but it's like saying drinking tea and drinking four loko are just as bad because they both have caffeine

[–] morrowind@lemmy.ml 43 points 1 year ago (3 children)

Bro what tea are you drinking that has nicotine

[–] SomeRandomWords@lemmy.blahaj.zone 29 points 1 year ago (1 children)

I can only imagine they meant caffeine, another common drug that's heavily abused but a little more socially accepted

[–] Lemminary@lemmy.world 8 points 1 year ago (7 children)
[–] ComradePorkRoll@lemmy.ml 13 points 1 year ago (1 children)

How much did big coffee pay you to make this comment? I bet that link installs covfefe!

[–] Lemminary@lemmy.world 1 points 1 year ago

Wait, they pay for this? And I'm out here sharing medical info for free. Sign me up!

[–] SomeRandomWords@lemmy.blahaj.zone 2 points 1 year ago (1 children)

Yes, because not all drugs are bad for you.

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[–] askdocsthrowaway96@lemm.ee 7 points 1 year ago

Nicoteane 😉

[–] gmtom@lemmy.world 1 points 1 year ago

Lmao, ironically I made that comment before I had my morning tea.

[–] Cryophilia@lemmy.world 14 points 1 year ago

In the US it's the opposite, which is absolutely bizarro land. Want to ban vapes but not cigarettes.

[–] Chetzemoka@startrek.website 10 points 1 year ago (2 children)

Well, nicotine isn't the part of smoking that causes cancer

[–] Blum0108@lemmy.world 20 points 1 year ago (4 children)

But it's the part that is addictive and keeps you smoking.

[–] Plopp@lemmy.world 2 points 1 year ago (2 children)

If it's not too harmful - what's the problem with being addicted? I'm addicted to coffee and drink at least two cups per day, as do most people around here.

[–] Goo_bubbs@lemmings.world 5 points 1 year ago (5 children)

Nobody out there is just buying Nicotine gum for the flavor. The overwhelming majority are struggling with an addiction that may one day kill them.

Also, as a former smoker of over 20 years as well as a current coffee addict, I can tell you from personal experience that there is no comparison between the two. Some substances are simply more addictive than others. Nicotine is one of the worst on the planet.

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[–] abraxas@sh.itjust.works 1 points 1 year ago* (last edited 1 year ago) (2 children)

The problem with addiction is that it's safe to say that NOTHING is good if used to excess.

I used to be so hooked on caffeine I drank a 30-cup pot each day. It was giving me all kinds of issues, and I was only in my 20's. I'm still addicted, but I've learned to moderate. It took me years. And my 4th latte of the day is telling me that I'm not exactly great at it.

If I smoked/vaped Nicotine, I would have serious problems of taking too much all the time.

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[–] dudewitbow@lemmy.ml 2 points 1 year ago (1 children)

If addiction is a problem, should the general use of caffine be banned then? Thats why its kinda odd to specifically ban nicotine.

Choosing to ban specifically nicotine and not caffine is as silly as the idea that cigarettes should be legal but weed shouldnt.

[–] abraxas@sh.itjust.works 2 points 1 year ago

Probably, yes. Even the age restrictions are kinda silly.

I do think it's ok to ban sale of "prepared smokables" like cigarettes. The harm level is known to be severe. But if someone wants to buy their own tobacco+papers and roll their own cigarettes, that's on them.

Of course, I don't think it would be effective to ban cigarettes. Just ethically coherent.

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[–] Silentiea@lemm.ee 2 points 1 year ago (2 children)

The full effects of vaping are not well understood, and while they're almost certainly not as bad as cigarettes, they're also almost certainly still bad for you, and they are indeed still addictive for the same reasons as cigarettes because they still use nicotine.

Further, one main reason their risks remain as poorly understood as they do is that (again, because of the same active ingredient) people who vape often also use cigarettes. The two are closely linked, I don't think my confusion should be so easily dismissed as that.

[–] Chetzemoka@startrek.website 2 points 1 year ago (6 children)

Oh sorry, I was thinking nicotine supplements like gum and patches. In my mind, smoking and vaping are the same thing. "Don't inhale particulate matter of any kind" is an excellent rule of thumb for all humans in all situations

[–] Silentiea@lemm.ee 2 points 1 year ago

Exactly my point. It always throws me for a minute when I realize people are treating them so separately.

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[–] abraxas@sh.itjust.works 1 points 1 year ago* (last edited 1 year ago) (1 children)

The full effects of vaping are not well understood, and while they’re almost certainly not as bad as cigarettes, they’re also almost certainly still bad for you

That used to say that about artificial sweeteners. The question shouldn't be "is it bad for you" but "is it worse for you than 99 other things you do in a day". And vaping nicotine is "almost certainly bad for you" because of the nicotine, and nicotine is a known quantity - we know how bad it is and isn't. We don't have evidence that the mechanism of vaping is bad for you, and there's no "almost certainly" on that.

And the truth is, I have problems with people who lean on "poorly understood" for vaping. Evidence shows vaping as a mechanism (for THC as it were) going back over 2000 years to ancient Egypt. Widespread use of hookahs started in the 19th century and has tons mechanically in common with modern vaporization. There are some differences, but short of a few badly-designed vapes that let air reach the lungs while superheated, it looks a lot like people are saying "not well understood" because they cannot seem to "understand" bad things and they don't want to say good things. We have TONS of research precedent around room-temperature air with vaporized herbs in it.

If I were going to imbibe nicotine (or CBD or THC for that matter), I would probably prefer to vape it. I think the stigma against vaping needs to step aside for the vaccine research considering using vapes as an alternative to needle injection.

[–] Silentiea@lemm.ee 1 points 1 year ago (1 children)

Hookah is pretty bad for you too, my friend. From Wikipedia, emphasis mine:

The major health risks of smoking tobacco, cannabis, opium and other drugs through a hookah include exposure to toxic chemicals, carcinogens and heavy metals that are not filtered out by the water,[3][8][9][10][11] alongside those related to the transmission of infectious diseases and pathogenic bacteria when hookahs are shared.[3][9][12][13] Hookah and waterpipe use is a global public health concern, with high rates of use in the populations of the Middle East and North Africa as well as in young people in the United States, Europe, Central Asia, and South Asia.[3][8][9][10][11]

If the best you can say is "it's pretty much a mini hookah, don't worry", then I'm going back to the best you can say for it is that it's poorly understood. Vaping doesn't burn anything, unlike a hookah, but the vaporized oils still contain toxins and novel toxins not in the smoke from cigarettes or hookah. The health consequences of that are not well understood, but are probably not as bad as cigarette smoking. That's the best we've got.

[–] abraxas@sh.itjust.works 1 points 1 year ago* (last edited 1 year ago)

I didn't say it wasn't. I said we have a lot more context than people want to pretend about vaping in general.

And I'm not trying to say "it's a mini hookah", nor am I trying to say you should vape.

Vaping doesn’t burn anything, unlike a hookah, but the vaporized oils still contain toxins and novel toxins not in the smoke from cigarettes or hookah

If they contain toxins, we probably know quite a bit about those toxins right now. But what about pure vaporized solids? In the CBD and Cannabis community, dry herb vaporizing is the hot new thing specifically because 99% of complaints about vaping being unhealthy are irrelevant. All they do is get the herbs hot without burning it, run it through cooling, and inhale it. I laugh, but I used to do that with lavender with an aromatic herb heating unit.

The health consequences of that are not well understood, but are probably not as bad as cigarette smoking. That’s the best we’ve got.

Despite your incredulity, you really haven't shown that. The consequences are not perfectly understood, but we understand enough to start making educated opinions about vaping. Even your points about hookahs work towards that, with the worst cons being that you still get Carbon Monoxide and the intensity of Nicotine is high. The problem is that we don't want to tell people that the educated opinion is "probably better for you than that glazed donut"

[–] uis@lemmy.world 6 points 1 year ago* (last edited 1 year ago) (9 children)

Because probably it was defined as burning, not usage of nicotine

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[–] vidarh@lemmy.stad.social 2 points 1 year ago (2 children)

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.

[–] affiliate@lemmy.world 16 points 1 year ago* (last edited 1 year ago) (1 children)

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.

this is from a 2015 article i found on the NIH library:

Nicotine poses several health hazards. There is an increased risk of cardiovascular, respiratory, gastrointestinal disorders. There is decreased immune response and it also poses ill impacts on the reproductive health. It affects the cell proliferation, oxidative stress, apoptosis, DNA mutation by various mechanisms which leads to cancer. It also affects the tumor proliferation and metastasis and causes resistance to chemo and radio therapeutic agents. The use of nicotine needs regulation. The sale of nicotine should be under supervision of trained medical personnel.

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

[–] vidarh@lemmy.stad.social 2 points 1 year ago* (last edited 1 year ago) (9 children)

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:

Thus, the induced activation of nAChRs in lung and other tissues by nicotine can promote carcinogenesis by causing DNA mutations[26] Through its tumor promoter effects, it acts synergistically with other carcinogens from automobile exhausts or wood burning and potentially shorten the induction period of cancers[43] [Table 2].

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.

[–] affiliate@lemmy.world 3 points 1 year ago* (last edited 1 year ago) (1 children)

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.

they do focus on vaping, that does not mean they are irrelevant to the question of nicotine. from the cdc link:

Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s.

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:

Nicotine is highly addictive and can affect the developing brain, potentially harming teens and young adults.

from johns hopkins:

Nicotine is the primary agent in regular cigarettes and e-cigarettes, and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is a toxic substance. It raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack.

Both e-cigarettes and regular cigarettes contain nicotine, which research suggests may be as addictive as heroin and cocaine.

to your second point

To the cancer links, again without looking at delivery methods, this is meaningless.

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:

And, getting hooked on nicotine often leads to using traditional tobacco products down the road.

this is only to say that the cancer bit is not irrelevant.

This makes sense. Don’t inhale lots of particulates combined with nicotine in other words.

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’ll note that the article also includes things in its conclusion that it has categorically not cites studies in support of.

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.)

That doesn’t mean nicotine is risk-free, but compared to other things we’re happy to ingest, I stand by my statement.

your statements were

Nicotine is one of the safest stimulants we know, up there with caffeine in terms of safety.

and

The addiction potential of nicotine alone is also far lower than people assume,

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.

[–] vidarh@lemmy.stad.social 2 points 1 year ago* (last edited 1 year ago)

they do focus on vaping, that does not mean they are irrelevant to the question of nicotine. from the cdc link:

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.

i disagree that ignoring delivery methods is “meaningless”. form the johns hopkins article:

And, getting hooked on nicotine often leads to using traditional tobacco products down the road.

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.

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.

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.

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).

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.

the article did this by reviewing “90 relevant articles” from PubMed and Medline, then discussing what those articles found

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.

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.

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’m not trying to say nicotine is extremely dangerous, but rather that its danger is underestimated.

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.

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[–] JWBananas@startrek.website 4 points 1 year ago (1 children)

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

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.

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