lauantai 27. helmikuuta 2016

Part 4: Personal thoughts on addiction and dependence

Continuing again on this topic, in the midst of translation projects. There's a lot to addiction and dependence, so I'm sure I won't run out of random thoughts to run out any time soon.

One argument (almost using scare quotes here) I keep constantly running into while working on the legislation in Finland and discourse surrounding it, is the assertion that vaping supposedly enables people to continue their addiction, or that "you're just switching one addiction for another". On their face, both claims are not just absurd based on the radical difference of health risks associated with each product, but I would assert that they are a result of very counter-productive thinking on the issue in combination with the claim that vaping would not help smokers to quit.

People seem to think that nicotine dependence and tobacco addiction are interchangeable phenomena, when in reality they are substantially different in terms of intensity. Cigarettes are designed to be as addictive as possible and are a result of highly sophisticated engineering and other scientific efforts, so there's no way a few components put together by mostly hobbyists could possibly achieve the same level of dependence. Even suggesting that undermines just how purposeful the cigarette really is.

So the reality is that when somebody switches to an electronic cigarette, they are not really continuing their addiction at all. Trading one addiction for another has slightly more merit, though even then they are barely even comparable.

The part that's counter-productive comes in when you consider the fact that most vapers tend to be the ones that are by far the most dependent, usually failing cessation attempts with various other forms of available products, nrt and such.

First, this obviously suggests that the effects nicotine, much slower speed of delivery or preventing the effects of nicotine alone is not enough to make them switch. Or to put it bluntly, the new product is not enjoyable enough, which appears to be one huge factor. The others being sensory experiences, social aspects and various other things nicotine alone cannot provide.

Second, addiction or dependence in itself cannot be considered a harm. It's just the pattern of behavior that results in harm if the product used is causing harm. However, that should not be a concern if the product is relatively safe and the person recognizes and accepts the risks, like say nicotine gum, snus or vaping.

Third, even IF we consider that the assertion would be true that vapers continue their dependence or switch one addiction to another, isn't that still a good thing? The fact that the new product might cause some harm, even if it's measurable and noticeable, is not exactly anything to be concerned about in comparison to the devastating effects smoking has. It's highly likely that past smoking has caused more harm than continued nicotine use will, especially if that use is preventing relapse.

Fourth, if it's the case that vaping could possibly cause the same level of addiction or dependence, wouldn't that suggest it's actually easy switching from smoking to vaping? I don't see a reason why ecigs could not help in cessation if that is true. The claim about not being effective at cessation usually comes in very close proximity to claims about continued or even increasing addiction, which seem to be quite mutually exclusive.

It does really seem to me that the discourse on vaping is riddled with insular one-liners about this and that problem that supposedly exists, asserted as facts.
Is nobody stopping to think about the big picture and actual health outcomes of real people?

Apparently the only thing that matters is personal sense of morality, that nicotine is some evil demon that possesses people and needs to be eradicated.
We've already had enough judgmental treatment, thanks. Sex, drugs, alcohol, nicotine, gambling, whatever else is next on the agenda.
Bullying, penalizing, patronizing and demonizing people just doesn't work.

Addiction is not a matter of morality, but a matter of helping them minimize risks in a way that does not infringe on their personal rights.

2 kommenttia:

  1. See my comment in Part 1.

    Much of the problem is that it's very clear many people involved in opposing vaping do not know very much about vaping and they know even less about nicotine, then there are those who just lie through their teeth for their agendas.

    In my opinion there are two groups opposing vaping. Firstly, the Front Group - those based in ideology who want to ban smoking (the end game) and who are not prepared to compromise with vaping, despite the enormous harm this would create. They banned Snus, despite it proven benefits, just because it's made by tobacco companies. I wonder how many people would have had their lives improved and extended if they hadn't?

    The second group also benefit from the highly lucrative smoking economy and want to keep it that way. They need people in public health to justify banning or severely restricting vaping because it will destroy their gravy train. They don't care one iota for the millions of people that vaping benefits and is yet to benefit, we are simply collateral damage. It's never been about health, it's only about the money. They are governments, universities and researchers, medical organisations, health charities, any organisation or council who is heavily invested in tobacco shares (including pensions) and pharmaceutical companies selling smoking cessation drugs and who benefit from smoking related diseases.

    Ecigarette Politics:

    1. Yeah, I read all the sites already :) The point of writing these is to illustrate my own thought processes and try to invoke some thoughts and questions in others :)
      I don't really believe it's just about the money, there are a lot of people who do honestly believe the things they are saying and even more than that, people who never looked deeper into these things and formed opinions on conventional wisdom.
      I think it's far more likely most ANTZ already hold these beliefs and gravitate towards the sort of jobs that sustain that sort of thinking. Sure paychecks play a part, but I really doubt that's the major incentive for the most part.