An important part of writing this is my personal story, the “deconversion” from the conventional wisdom surrounding nicotine use and nicotine products. The attitudes surrounding this extraordinary spread of electronic cigarettes and vaping are very varied and often are based on simple prejudices: the fact that smoking cigarettes is highly addictive and destructive and vaping is superficially similar.
That kind of thinking is hindering progress into avenues that could be used to gain major advances in public health, due to resistance towards tobacco harm reduction ideas and products as well as the demonization of nicotine itself, which almost certainly plays a part in the fact that most people still try to quit smoking using the least effective method. Going the so called “cold turkey” way, without any kind of help has proven to be a hugely limiting factor in reducing smoking as most of those attempts inevitably fail when smokers relapse. Personally, I would suggest trying any and all help available, especially counceling and peer support.
Quitting smoking is one of the biggest positive health impacts a person can achieve, no matter how you do it. So, please don’t fear nicotine, smokeless products, vaping or whatever else is available to get there. Preventing relapse is a goal that possibly should be the major focus of efforts intended to reduce tobacco related mortality and disease.
As for me, I tried multiple kinds of nicotine replacement therapy, reducing consumption and hated all of it. The options just weren’t appealing enough for me, personally. I started smoking when I was 14, the last ten years or so of my 17 year smoker career I wanted to quit. Until I picked up an electronic cigarette I didn’t think I was going to quit at all, even though I wanted to be able to do so.
What made me finally connect the dots was a double blind smoking cessation trial I took part in the summer of 2014. It included some lozenges that were sweetened, quite tasty and the idea was that you have one while you are smoking and the pill had a simple compound in it that would bind to specific parts of smoke and render them inert. What really happened was it actually made smoking more enjoyable, when the act was associated with candy essentially, one that even masked the taste of smoke and ash.
That lit a lightbulb for me: This is more or less what electronic cigarettes do, without the actual smoke too!
So I picked one up and ordered some liquids with nicotine, which were deemed to be medicinal so I was forced to get them from abroad. I did have some previous experiences with nicotine free that failed, but add the throat hit and suddenly my smoking habit was more or less gone. Dropped off from over a pack a day to one in the mornings, eventually just deciding I don’t really need that habit either
It was incredibly easy. Thinking back on that, it’s becoming increasingly clear that there’s more to smoking cessation than getting nicotine. Dependence is a very complex function that involves a lot of sensory and motor actions and experiences, not just the rewarding effects of the drug itself. Clearly, for me it was the habit itself, inhalation and various social aspects that I needed to retain.
These simple realizations have started a chain-reaction for me, and since then I have learned incredible amounts about nicotine and dependence. Including a lot of myths, prejudices and counter-productive thinking. I think a lot of the credit should go to Carl V Phillips for these permanent changes in my brain, reading his work has been a huge eye-opener. Though I'm sure he'd be likely to disagree with a lot of my thoughts :) I'm a layman after all, not really qualified to analyze the science at a precise level.
It really does feel like a deconversion of sorts, going from “wait, if this is true these other things I used to believe don’t make much sense” to “If these things don’t make sense, there must be other explanations” and ultimately “Things are really not as simple as people think and things could be much better if perceptions were accurate”. A sort of continuum of thinking that is apparent in quite a lot of other areas of inquiry. Conventional wisdom and common sense are just not very useful when we need to think about specifics of complex phenomena.
Hence, why I’m writing this.
I truly, honestly believe that instead of pretending behaviour can be eliminated by prohibition, we would be better off not trying to bend to the morals of those trying to tell us things we should not do, but rather think of ways we can choose to do things that offer us benefits in a way that’s as safe and as enjoyable as we can make it, while also minimizing risks to human life and health without infringing on fundamental rights.
Harm reduction is an essential part of human evolution and success as a species.
We have done this with so many things already, why not nicotine?