CASA: Thank you Colin Mendelsohn
for making time to be with us. Kindly introduce yourself, for those that may
not be familiar with your work.
Colin: Hi. I am a medical practitioner,
tobacco treatment specialist, Associate Professor in the
School of Public Health & Community Medicine at Uni of New South Wales,
Sydney and founding chairman of the @ATHRA_AU.
I am especially interested in tobacco harm reduction.
CASA: Our first question for today, what is
Nicotine?
Colin: Nicotine is a natural chemical found in
tobacco plants which may have a role as an insecticide. It is also in some
other plants in smaller doses eg tomatoes. Nicotine is the main addictive
chemical in tobacco smoke but has only minor harmful health effects.
CASA: Where do nicotine vapor liquids,
nicotine patches and nicotine gum get their nicotine from?
Colin: Nicotine is extracted from the leaf
of tobacco plants grown on tobacco farms. It is purified and used in
nicotine patches and gum etc and vaping liquids. Synthetic nicotine made
in a laboratory is now available but is still too expensive for widespread
use.
CASA: What causes the most harm in cigarette
smoking? Is it the nicotine or combustion?
Colin: Many people incorrectly think
nicotine is the harmful chemical in smoke. In fact, almost all the harm is
caused by the thousands of toxins produced by burning tobacco. Nicotine is
a mild recreational stimulant with few significant health effects, like
caffeine.
CASA: Interesting. Which brings us to the next
question. Does nicotine cause cancer?
Colin: Nicotine has been associated with tobacco
smoking and people have incorrectly assumed it is the toxic component. This is
a persistent myth which has been around for decades. No. Nicotine is not
believed to be a carcinogen in humans. There is some laboratory evidence
that it may promote an existing cancer. However long-term studies in
humans using nicotine in snus (oral pouches) or patches have NOT found any
increased cancer risk
CASA: There have been those that allege Nicotine
causes heart disease. Does nicotine cause heart disease?
Colin: Nicotine does have some cardiovascular
effects, but these are relatively minor compared to smoking. A recent
study funded by British Heart Foundation found smokers who switch to
vaping have significantly reduced heart attack and stroke risk within one
month.
CASA: Is nicotine harmful in pregnancy?
Colin: Nicotine patches, gum, vapes or oral
pouches are always safer than smoking in pregnancy but may have some risk.
Nicotine has been linked to harm in animal studies eg low birth weight, effect
on brain & lung development, but no good evidence of harm in humans
CASA: Right. So is nicotine addictive?
Colin: Nicotine is the main addictive chemical in
tobacco smoke as it is delivered rapidly in high doses to the brain. There
are other chemicals in smoke eg MAO inhibitors which make nicotine more
addictive. Nicotine from vaping is less addictive than from smoking
CASA: Does nicotine have beneficial effects?
Colin: Nicotine has positive and enjoyable
effects. It improves concentration, memory, alertness and can give
short-term relief of anxiety and depression. It also helps with weight
control. It is beneficial for schizophrenia, Parkinsons dis, ADHD,
ulcerative colitis
CASA: The @WHO recommends
nicotine gum and nicotine patches! Can nicotine help wean smokers off
cigarettes?
Colin: Nicotine replacement products are
safe and are recommended as first line treatments for quitting. They
reduce cravings and nicotine withdrawal. However, success rates are low.
They do not help with the smoking ‘habit’ and relapse rates are high.
CASA: Not all smokers are ready to quit.
There are individuals who want to reduce harm without giving up nicotine!
What would you recommend?
Colin: They should consider switching to
safer nicotine products eg #vaping. They
can continue to enjoy nicotine and the smoking habit and
sensations, without most of the toxins in tobacco smoke. It is important
to stop smoking completely for the full health benefit.
CASA: Can nicotine containing e-cigarettes and
nicotine pouches help smokers quit smoking
Colin: Yes. There is now convincing evidence
that these products can help smokers quit. Vaping is
twice as effective as nicotine patches and gum. Nicotine pouches (#snus)
are increasingly popular and have been shown to be much more effective
than other quitting aids
CASA: Lastly, are nicotine
containing electronic cigarettes and nicotine pouches safer than
traditional cigarettes?
Colin: Nicotine vaping and pouch products
are not risk-free but are much safer than smoking, probably at least 95%
safer. Smokers who switch get far fewer toxins compared to smoking and at
much lower doses. They are healthier, feel better and save a lot of money!
