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All You Need To Know About Nicotine

Everything important about nicotine is here. There is a lot more, but it's all good - such as the long list of benefits for certain medical conditions. The full details of the biomechanisms that a nutrient employs are interesting but not pertinent to this list of topics, which concerns nicotine's public image and its distortion for commercial purposes.

What you think you know about nicotine is almost certainly wrong.

Nicotine and dependence

  • It is virtually impossible to become dependent on pure nicotine [1] [2]
  • It is impossible to create nicotine dependence clinically [3] except by co-administration with tobacco
  • No person in the history of medical science has ever been reported as becoming dependent on nicotine as a result of the administration of pure nicotine to never-smokers in a clinical trial - and this would be very easy to demonstrate, if there were any factual basis for statements such as "nicotine is addictive"; indeed it is likely to have been a prime target for researchers in the past - and the fact it has not been achieved, ever, even once, despite the huge financial benefits that would accrue to the person achieving it, tells us that it is impossible [4]
  • Smokers commonly become addicted to smoking and dependent on nicotine, but persons who have never consumed tobacco cannot be made to become dependent on nicotine. This tells us that something apart from nicotine is creating the dependence, and since tobacco/smoke contains 9,600 compounds identified to date [5], there are plenty of candidates for this agent or agents
  • Nicotine by itself cannot create dependency (see for example the FDA NRT labelling consultation: "Nicotine appears to have no potential for abuse") - and with market experience of NRTs since 1984 they should know

Nicotine and harm

  • No government agency anywhere (such as the FDA or UK NICE) can supply any materials that prove nicotine is harmful to the normal person [6] [19]
  • Nicotine is not associated with cancer: it does not cause it, or promote it, or enable it in any way - see the definitive statements on this in NICE PH45; the FDA NRT labelling advice; qv References)
  • The UK NICE (in effect the UK government medical oversight body) have now licensed medical products that contain nicotine (called NRTs) for long-term use and multi-use; it is expected that the US FDA will follow [7]
  • Many doctors give incorrect advice about nicotine, and may even be guilty of professional negligence due to their belief in propaganda that is opposite to the facts [8]

Nicotine and toxicology

  • The old propaganda that "nicotine is highly toxic" has been utterly demolished [9]
  • It is regarded as almost impossible to die from ingestion of nicotine alone, because the dose required is so large; and because swallowing it induces a vomit reflex that expels it and an anaesthetic is required to prevent emesis (vomiting); and it is so rare to find any example of an adult dying from nicotine ingestion alone that the suggestion is that some other agent was also consumed as an anaesthetic or anti-emetic [10]
  • Using several different delivery routes for nicotine at the same time, and deliberately causing an overdose, is harmless [11]

Nicotine and blood pressure

  • Nicotine does not "raise the blood pressure" as the propaganda strongly asserts (except of course for a very short time), and in fact the opposite is true: long-term consumption actually reduces the blood pressure [12]

Nicotine in the diet

  • Nicotine is a normal part of the diet and everyone tests positive for it. In all of the large-scale clinical surveys where hundreds of subjects were tested, no person has ever tested negative for nicotine [13]
  • Nicotine is a normal ingredient in vegetables and everyone consumes it (13]
  • Nicotine is an active alkaloid [14] and an active part of the diet [15] - removing it has negative consequences for some [16], and supplementing it has benefits for some [17]
  • Its sister compound nicotinic acid, co-located in the same plants and with several benefits in common with nicotine, has been allocated vitamin status as Vitamin B3 (although the researchers had to invent a new name for it in order to get it accepted) [18]
  • You feed your baby nicotine in her mashed-up vegetables, and no corrupted medic has ever dared to claim this is a bad idea since nicotine is so closely associated with the B vitamin group that a nutritional deficiency would almost certainly be created if an attempt were made to try and artificially exclude any active ingredient such as nicotine [20]

Nicotine and disease prevention

Three closely related active compounds in this group are co-located in vegetables or created as metabolytes in humans, and are found in the normal human diet: nicotine, nicotinic acid, and nicotinamide. All three share certain effects in the human organism, and each has additional specific functions. It is reported that nicotinamide is a metabolyte of nicotine in the human organism, and nicotinic acid is a metabolyte of nicotine in certain organisms.

Nicotinic acid has been allocated vitamin status as vitamin B3 due to its easily-demonstrated function as a preventive agent for two important conditions: the skin disease pellagra, and certain psychiatric symptoms. A new name for it had to be invented in order to get it approved: 'niacin' (a selective contraction of nicotinic acid). It is likely that the other two compounds will achieve vitamin status within the B grouping, perhaps at some time in the future when the nicotine taboo is less prevalent.

Nicotine is believed to be the active agent in smoking that prevents neurodegenerative disease, auto-immune / inflammatory disease, and some cognitive function disorders. In 1966, Harold Kahn, an epidemiologist working for the National Institutes of Health, uncovered a curious fact: non-smokers were about three times more likely to die of Parkinson’s disease as smokers. Subsequently, more than 40 clinical studies showed that smoking protects against Parkinson's. Maryka Quik, Director of Research at the Parkinson's Institute said, “A huge literature says that smoking protects against Parkinson’s."

One auto-immune disease is so strongly associated with non-smoking status that it is known as 'the non-smokers' disease' (ulcerative colitis). Dr Newhouse's research at Vanderbilt shows that nicotine therapies are beneficial in some cases for certain of these conditions, and for certain cognitive dysfunctions.

It therefore seems likely that dietary nicotine plays a role in protecting against some medical conditions, for some people - perhaps a certain genetic subset. For such people, just as nicotinic acid prevents the serious skin deformity pellagra for some, we may find that significant nicotine supplementation may help to prevent neurodegenerative and auto-immune conditions. There is significant investment in this line of inquiry, since Dr Newhouse - currently the leading expert on nicotine - has been granted a further $9m for investigative research, at Q3 2015.
 

Smoking can cause some diseases and prevent others
This direction of research seems very promising, and the implications might perhaps be considered: we know beyond doubt that smoking can both cause some diseases and protect against others. These are incontrovertible facts. As smoking protects against certain serious diseases (at least, up until the point where harm outweighs benefit) - then perhaps in the 21st century we should consider safer ways of mega supplementation of the beneficial agent or agents, which appear to include nicotine.

There is absolutely no need whatsoever to have to go to the pharmaceutical industry for dietary supplementation, these materials are all consumer products and always have been. We should think very carefully about legislative processes that create exclusive or preferred access to consumer products for the pharmaceutical industry; in what kind of world is this justifiable?

Nicotine propaganda

The nicotine taboo and all the propaganda surrounding nicotine has two substantial benefits:

  • It allows the pharmaceutical industry to claim ownership of nicotine, since it can be falsely described as a dangerous, alien, addictive drug - when it is none of those, as can be seen from the above. Pharma is keen to eliminate competition from vitamins, nutrients and herbal remedies, and vigorously employs legislation to either claim the product is a pharmaceutical, or remove competition or price it out of contention by introducing costly and unnecessary regulatory processes.
  • It allows the Public Health industry to add another topic to the reasons for their existence and the reasons why they need funding. It adds into the false evidence claims and the puritanical beliefs of the ideologists and religious fundamentalists who determine the agenda, and who are often unwittingly working for industry as against the public good.

Nicotine and vascularity

An interesting feature of the propaganda used against nicotine is that, in some cases, it ludicrously tries to use both sides of the argument. Vascularity is one example:

   "Nicotine promotes cancer because it increases blood flow and growth of new blood vessels, causing them to proliferate, thus enabling growth of tumours and promoting cancer."
- a common claim made by researchers who are close to funding sources that have an anti consumer nicotine agenda

And the next day you will read the exact opposite:

   "Nicotine must not be used before or after surgery because it restricts blood flow and growth of new blood vessels, thus hindering healing, and may result in failure of the treatment. Therefore we will not operate on smokers or vapers."
- sometimes heard from a hospital's admin department or a surgeon

You can have one or the other, but not both. Please make your mind up. The trouble with lying is that it becomes difficult to maintain consistency.

Citations

References for all the statements made here, and links to the citations, can be found on the References and the Quotations pages on this site. Some clarifications are given below, and the citations to support them are found elsewhere in these pages.



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Notes

[1] There are a small number of persons who can become dependent on almost anything. Therefore, perhaps one person in 100,000 or so given pure nicotine in an attractive format might become dependent - as they would, equally, on carrot juice. Quite rightly, we do not consider carrot juice to be addictive, even though there are apparently a couple of cases on record where this is reported. It might be able to create dependence in one or two persons in a million, but this is not really due to itself and more to do with the person involved. No person in their right mind would call carrot juice 'addictive' - but nevertheless it can provide that function in rare cases of persons with some sort of psychological and/or metabolic deficiency - just as nicotine or anything similar probably will [22].

[2] A note on terminology:
- Addiction in current usage is a dependence with significant risk of harm, which can be of any type: physical, social, economic or some other material negative for that person.
- Dependence in current usage is a harmless addiction: an addiction without any visible harmful consequences; and (although this is not relevant) that is probably much easier to conquer than some addictions.

The terms 'addictive' and 'addiction' are commonly used by the disingenuous to inflame the debate and introduce emotive reactions. It is clearly ridiculous to describe harmless normal dietary ingredients in the same terms as heroin.

[3] 'Clinically' means to demonstrate that a significant percentage of subjects in a CT or RCT (clinical trial or randomised CT such as a double-blind multi-group CT) comply with the stated condition, and that this result is repeatable.

Another term used for results that are well-demonstrated, of a significantly higher number than the minimum statistically-demonstrated number (which is around 2%, by general agreement), and have a known impact on health is 'clinically significant'. The minimum figure normally seen as clinically significant that is required to be well-demonstrated and repeatable by any other CT or RCT and regarding a material or activity that has a demonstrated impact on health is at least 3%.

Note therefore that the terms 'clinically demonstrated' and 'clinically significant' have two distinct and different meanings. One means it can be demonstrated in trials, the other that it is very well-demonstrated and affects health. Nicotine does not qualify under either meaning, since (a) dependence cannot be demonstrated (without potentiators / synergens), and (b) no harm from consumption can be shown, never mind be well-demonstrated.

[4] People like Benowitz and Fagerstrom have made careers from claiming that "nicotine is addictive", and providing work that purports to back this claim. What they haven't been able to do is show a single person who became dependent on nicotine without tobacco, since it is not possible to demonstrate this clinically [9].

If they had been able to do this, then they would have been able to name their price from pharma - the value would be incalculable, since at present the issue has to be lied about and obscured as much as possible.

[5] Rodgman, Perfetti 2013

[6] NICE (the official guidance body for all UK medical practitioners) officially advises doctors that nicotine is not associated with cancer, and that nicotine does not cause any clinically-significant disease - see NICE PH45. This advice is almost certainly based on the Swedish Snus data (a vast data resource including proof from confirmed national health statistics and huge epidemiologic resources, over multiple decades) and to a far lesser extent the NRT data (a much smaller data resource, though in some ways more focused, dating from 1984). No clinically-significant harm can be shown from chronic nicotine consumption [21], and the data resource is vast.

Note that nicotine is dependence-related after tobacco consumption, and therefore discussion of nicotine as being associated with dependence, and such dependence being ideally an avoidable condition, is absolutely correct - as long as it is understood implicitly that this can only occur after tobacco consumption. Often, this is not clear from the terminology employed, even though it is impossible to clinically demonstrate dependence created by pure nicotine administration with never-smokers / never-users of tobacco.

[7] This is believed to be the case because Benowitz and others assisted the application for long-term NRT licensing by pointing out that no evidence could be found from the vast Swedish Snus resources that chronic nicotine consumption is in any way associated with any measurable harm including cancer or any other disease, since the health outcomes for Swedish smokers who switch to Snus or who quit totally are the same.

No measurable harm could be demonstrated from NRT consumption either, and there is data going back to 1984 (though for some reason NICE stated in 2013 they only had 5 years' data).

The Snus data resource is much larger than the NRT data resource since the Swedish situation has been intensively studied for multiple decades; there are hundreds of clinical studies on Snus consumers; some studies had up to 98,000 subjects followed for decades; the epidemiologic resources are vast; and the national health statistics are of course unique. Beacuse two-thirds of Swedish tobacco consumers are snusers and only one-third are smokers, Sweden has the lowest smoking-related mortality rate of any developed country by a wide margin.

Sweden is the world leader in reducing smoking prevalence; the world leader in reducing smoking-related death; the world leader in reducing smoking-related disease; has the lowest male lung cancer and oral cancer rate in the EU; and is believed to be the only country that has reduced male smoking prevalence to below the female prevalence level (because more men than women are Snusers); was the first country to break 20% smoking prevalence barrier ordained by the EU; and will be the first country to break the 5% prevalence level agreed internationally as an insignificant value. The health outcomes for smokers who switch to Snus or who totally quit are the same. All at zero cost to the state and entirely by consumer choice.

This is why it is known as the Swedish Miracle, and why their stats have been used to demonstrate that use of medical nicotine will be harmless. To the limit allowed by the restricted size of the NRT data resource in comparison with the vast Snus data resources, medical nicotine use so far confirms this.

[8] Despite the above, and in direct contradiction to their official guidance, a survey of UK doctors in 2013 reported that 44% thought nicotine was associated with cancer, and even more thought that nicotine was a harmful agent in cigarette smoke. There is no evidence anywhere to support these beliefs (but a great deal of propaganda). This demonstrates that propaganda can be so powerful that it can lead to medical negligence, since doctors might give advice based on a false belief that nicotine causes some kind of harm. Advice (and especially treatment) given by a doctor based on an opinion directly opposite to the facts could be termed negligence, perhaps in some cases malpractice.

[9] Prof Mayer showed that there is absolutely no evidence anywhere to support the propaganda that asserts nicotine is highly toxic, or that it is so toxic that a dose of just 60mg can kill an adult (qv References page). In contrast, he showed that:

a) Ingesting a dose of 1,500 mg is survivable.
b) The fatal dose by ingestion is so large it has never been accurately determined, but is several grammes; since most is expelled by the vomit reflex, either a huge dose is needed or a large amount would need to be provided in a form that can be absorbed instantly by the oral mucosa.
c) In practical terms, to die by nicotine ingestion needs concomitant anaesthesia or anti-emetics in order to stop the subject expelling the nicotine.
d) There may be no case on record where nicotine can be guaranteed to have been the sole cause of death of an adult by ingestion, since the dose required is so large and because anaesthesia in some form is normally found in cases of death.

[10] To die by nicotine poisoning would probably require a large amount of pure nicotine poured into the lungs, or onto the skin along with rinsing it off prevented and considerable time elapsing (perhaps hours). Otherwise, it requires anaesthesia or anti-emetics in some form to stop the subject simply vomiting oral nicotine out.

This applies to adults, but may well not apply to children. However, one 'child death from nicotine ingestion' when investigated lead to the discovery that death occurred from choking on the cartomiser (a small container) involved, not from nicotine poisoning. The media and the Public Health industry appear happy to conceal this fact.

[11] Prof Hajek tells us that concomitant use (multi-use) of, for example, NRTs, ecigs and tobacco are harmless: the person feels unwell and stops, just as they would if they had drunk too much coffee. To go on further would induce sickness that prevented any further consumption. Nicotine is quickly metabolised and eliminated from the body, so such effects are transient.

[12] The world's leading expert on the administration of nicotine to never-smokers, Dr Newhouse of Vanderbilt, states very clearly that chronic (= over a long period) nicotine consumption reduces the blood pressure [qv Quotations]. Acute (= for a short period / at the time) administration does raise the blood pressure since nicotine is a vasoconstrictor; but the propagandists who repeat this ad nauseam appear to be trying to convey the impression that this is a lasting effect when it is in fact purely transient, and the long-term effect is the opposite.

[13] There have been several large-scale clinical studies that investigated the presence of nicotine in the general population. None have ever found anyone who tested negative for nicotine, and one study was of 800 people. [qv References]

[14] Alkaloids are active substances that (usually) a plant creates and uses for some purpose. Alkaloids are produced by all classes of organisms including insects and animals, though most are indeed produced by plants including the edible and nutritional types we term vegetables. Not all alkaloids are active in the human organism although many do have effects. Often these are beneficial or useful for medicines [see Terminology page: alkaloids]. In general it is recognised that eating vegetables is a good thing. Many foodstuffs contain beneficial alkaloids: even chocolate contains one.

Alkaloids are not an uncommon ingredient in the diet, or some kind of unusually strong drug. They are a nomal part of the normal diet and therefore quintessential consumer products. It is not abnormal or risky or somehow unusual to drink tea, which normally contains five alkaloids that are all active in the human organism. Indeed, they are the reason we drink it. One of the alkaloids that tea normally contains is nicotine.

[15] Nicotine clearly has a role in preventing some diseases, as is increasingly becoming obvious in research projects (that may proceed with difficulty due to the taboo). Alzheimers, Parkinsons, and some auto-immune diseases are the first identifed. Its sister compound nicotinic acid has already been allocated the status of vitamin B3. They are found co-located in the same plants and share several of the same effects. Each has, in addition, some specific benefits - for example nicotinic acid prevents the skin disease Pellagra and some psychiatric symptoms; nicotine prevents onset of neurodegenerative diseases and at least one auto-immune disease. It also appears to mitigate some cognitive dysfunctions.

[16] Some auto-immune diseases are described as "non-smokers' diseases" because apparently a lack of sufficient nicotine (in the diet or in supplements) causes them to occur. Smokers get sufficient nicotine to prevent the condition being triggered. There is some genetic predisposition shown here: members of families with a history of Ulcerative Colitis for example (an auto-immune condition) have a much higher risk of presenting with the disease; but if such persons smoke, they will return to a near-normal risk for the disease. This is believed to be due at least in part to the nicotine supplementation.

[17] Members of families with a genetic predisposition to some auto-immune conditions are shown to benefit from dietary nicotine supplementation (e.g. if they smoke, they have less risk for the disease). Persons suffering from the disease are shown to derive benefit from nicotine therapy. Persons suffering from some types of cognitive impairment are shown to benefit from nicotine supplementation therapies.

A note on smoking and Parkinsons etc: smoking is shown to have a preventive effect for some diseases, but this may eventually be cancelled out by the harm caused. Therefore various time factors have to be used by researchers in order to qualify their statements on these issues. Nicotine helps to prevent onset of these conditions, but smoking may, eventually, cause sufficient harm that benefits may be negated.

[18] Because of all the commercially-funded propaganda against nicotine, the researchers who dicovered the medical properties of nicotinic acid had to invent a new name in order to get its vitamin status approved. They came up with 'niacin', which is simply a selective contraction of nicotinic acid. Perhaps for nicotine they will need to invent a term such as nocin and/or refer to a different, synthetic isomer.

There is a good deal of crossover in many respects between nicotine and nicotinic acid (vitamin B3) as several of the beneficial effects are common to both.

[19] Make sure to exclude animal nicotine models from any connection with human effects - they absolutely do not transfer and cannot transfer. There are any number of in vitro or animal trials that show all manner of things said to be attributable to nicotine, such as a propensity for promotion of cancer (either new or existing), or the ability to create dependence, or other such claims. The problem here is that it is proven beyond all doubt that nicotine has no association with cancer in humans in any form, and nicotine cannot create dependency in humans without co-administration with tobacco.

Where this leaves the researchers who conducted such trials is up to you. You could be charitable and just say that animal models for nicotine obviously don't transfer to humans, and these researchers must somehow have been unaware of the huge volume of data that proves nicotine is not associated with cancer in humans and cannot create dependency in humans without potentiation; or you could get into a discussion on funding sources, COIs etc.

[20] Once the taboo has been killed off, eventually, it may be expected that nicotine will get a vitamin B number, like nicotinic acid. Active ingredients in the diet that have several demonstrated beneficial functions and disease prevention effects in the human organism are generally there for a purpose.

[21] Chronic (= extended, over time, long term) nicotine consumption cannot be shown to be harmful except in uncommon cases of genetic predisposition to vascular disease; neither the FDA nor NICE (or the MHRA) can provide any materials that show otherwise.

[22] To run an unchallengeable RCT to determine the percentage of persons who can be made dependent on pure nicotine, or pure nicotine delivered by an ecig, without ever consuming tobacco, would almost certainly be impossible for practical reasons.

This is what you would need to do, in order to produce a result that could not be easily challenged:

a) Recruit 30,000 subjects who have never, ever, consumed tobacco in any form or been in any kind of research trial previously.

b) Give the 30,000 names to (and only to) an independent research group unconnected with the primary researchers, who (1) first establish that the subjects have never consumed tobacco in any form, then (2) eliminate all who have had any contact with clinical research previously so that those remaining cannot have taken part in pre-trials to eliminate the 'wrong' subjects, and (3) allocate the subjects randomly to 3 trial groups, without knowing what type of subjects (age, sex etc.) go into any group.

c) Establish well-managed double-blind administration protocols for the trial, by putting in place mechanisms that absolutely prevent any researcher knowing which subject is in which group.

d) Administer the following materials in 3 groups: pure nicotine (the test group), carrot juice (the control group), and placebo (the placebo group). Some way will have to be found that ensures the subjects cannot tell which group they are in - for example all subjects will be given a sweetened orange liquid and take a pill, daily. The non-tested options will be placebos.

e) Run the trial for 4 months.

f) Monitor the subjects and finally evaluate any signs of dependency.

g) Report the numbers for any positive results.

No doubt you will find that two or three people in the nicotine and carrot juice groups show signs of dependence although you will not have established how strong this dependence is (it might for example be extremely easy to break). You can then subtract the number who became dependent on the placebo, as they are simply exhibiting dependence on getting attention and reporting their 'symptoms', and which will be common to all groups. You will probably be left with about 2 persons in 10,000 who can be made (probably slightly and not seriously) dependent on carrot juice or nicotine. This kind of figure is classed as invisible. You'd need a 3% positive result, repeatable, to make anything constructive out of it - which we already know is impossible.

Alternatively you could use ecigs with nicotine, either instead of or alongside the nicotine pills. This would allow you to measure the dependence profile of ecigs, or the dependence profile of nicotine in ecigs versus NRT-style delivery.

Such trials would cost millions, and we already know the result in any case: inconsequential. You can most probably create dependence on carrot juice or even bananas in a few people per million; ditto for pure nicotine. It is meaningless. In order to create dependence on nicotine at measurable levels you must have tobacco in the equation at some point.

 

 


created 2014-12-31
update 2015-12-24