The New Era of Nicotine(invariant.substack.com)
invariant.substack.com
The New Era of Nicotine
https://invariant.substack.com/p/the-new-era-of-nicotine
47 comments
Do NOT trade caffeine addiction for nicotine addiction. I’ve been addicted to and quit both cold turkey and quitting nicotine (smoking) was insanely hard. In fact so hard that I’ll never go for a nicotine product again. I’ve been off of it for over 10 years now. Quitting caffeine (coffee) is pretty easy, you might feel not so great for a day or a week depending on how addicted you are but that’s about it. It’s even easier if you reduce your caffeine intake over a few days, you’ll barely have withdrawal issues. Nicotine on the other hand causes insane cravings that take weeks or months to subside and it can take 6-12 months for you to no longer care about it at all if someone say smokes a cigarette next to you.
Funny, I was addicted to nicotine for around 10 years. I got tired of smelling like smoke and I became really tired of the taste. Decided to quit one day and just stopped and have no desire to go back. It was incredibly easy. That was around 20 years ago. Caffeine/Tea/Coffee I am fiendishly and hopelessly addicted to; having tried numerous times to quit or cut back intake and I always fail.
My experience is similar. I started drinking coffee when I was around 15 and only took two very brief breaks like <2-3 weeks through my 30's. The acute withdrawal was hell. A few years back I decided to quit caffeine for one year and get fully past the acute withdrawal. The withdrawal was hell and so was the long withdrawal. I never felt normal for a full year. I slept great but felt mentally and physically sluggish, esp. mentally, for the whole year. The drug docs call this long withdrawal PAWS for "post-acute withdrawal syndrome". Most doctors are oblivious that it applies to caffeine too. I made it a full year and resumed drinking coffee and my mind and energy improved immediately. I only drink about 2 cups in the AM now but I am very slowly weening myself off by by gradually reducing the number of scoops of coffee in my brew to protect my sleep.
I smoked for about 2 years in grad school but had no problem quiting. One day I just stopped and like you I had no desire after the initial urge was gone. Maybe I was not fully addicted yet.
I smoked for about 2 years in grad school but had no problem quiting. One day I just stopped and like you I had no desire after the initial urge was gone. Maybe I was not fully addicted yet.
I have the exact same experience when I quit coffee for any lengthy period of time. Short term withdrawal is hell, then boost of energy and the best sleep of my life consistently every night. Feel great for several weeks then realize how mundane and boring everything is without the buzz, have a cup of coffee and WOW, Im alive again! It's a brutal cycle and I fear I've done irreparable damage to my brain at this point.
As an aside, I highly recommend the Audible book "Caffeine" by Michael Pollan if you haven't already heard it. It's quite brilliant.
As an aside, I highly recommend the Audible book "Caffeine" by Michael Pollan if you haven't already heard it. It's quite brilliant.
That is basically where I am at with my relationship to caffeine/coffee. Sleep much better without it. But life feels a little duller without it as well. And then my first cup back after a long period of abstinence is absolutely magical. That feeling quickly fades after about a week of use though.
I tried limiting it to just once a week to see if I could capture the magic, but my discipline was lacking a bit, and even when I was able to stay on that schedule, it still felt like my tolerance was building.
I tried limiting it to just once a week to see if I could capture the magic, but my discipline was lacking a bit, and even when I was able to stay on that schedule, it still felt like my tolerance was building.
Nicotine itself alone is not that addictive.
It's super addictive. It's one of the most addictive things there is. [0]
I feel like in every HN thread about smoking, vaping, and nicotine these talking points about "nicotine not being that addictive" and "nicotine is in lots of foods" etc get trotted out. It's all wrong.
[0] https://pubmed.ncbi.nlm.nih.gov/7724697/
I feel like in every HN thread about smoking, vaping, and nicotine these talking points about "nicotine not being that addictive" and "nicotine is in lots of foods" etc get trotted out. It's all wrong.
[0] https://pubmed.ncbi.nlm.nih.gov/7724697/
Cigarettes -- i.e. Nicotine plus MAOIs (1970s anti-depressants) are addictive.
However, Nicotine itself is not addictive, it's habit-forming. Those are completely different neural pathways at work and completely different forms of interaction.
I can't find it right now, but there was a great paper where they gave non-smokers -- i.e. people who had never smoked, 24mg patches for a month or two, then did follow-up at 6 months. Now, 24mg is around 12 - 24 cigarettes. That's way above the amount for addiction, actually the amount is so extreme you would expect them to have had extreme difficulty with getting off them, and yet at 6 months none of them reported using pure nicotine -- also termed under "nicotine-replacement therapy" -- afterwards.
Your article from 1995 is not representative of newer research on the topic with respect to pure nicotine, versus cigarettes. In addition, nicotine outside of cigarettes is a newer distinction to be made, most pre-2000s papers do not make that distinction.
However, Nicotine itself is not addictive, it's habit-forming. Those are completely different neural pathways at work and completely different forms of interaction.
I can't find it right now, but there was a great paper where they gave non-smokers -- i.e. people who had never smoked, 24mg patches for a month or two, then did follow-up at 6 months. Now, 24mg is around 12 - 24 cigarettes. That's way above the amount for addiction, actually the amount is so extreme you would expect them to have had extreme difficulty with getting off them, and yet at 6 months none of them reported using pure nicotine -- also termed under "nicotine-replacement therapy" -- afterwards.
Your article from 1995 is not representative of newer research on the topic with respect to pure nicotine, versus cigarettes. In addition, nicotine outside of cigarettes is a newer distinction to be made, most pre-2000s papers do not make that distinction.
> Nicotine plus MAOIs (1970s anti-depressants) are addictive
There's some confusion on this point. There is a paper that shows this, but mostly the mechanism people are referring to is MAO A and B reuptake seems to be inhibited while smoking, but not after just using nicotine, which makes smoking more addictive than just nicotine. I don't dispute this; the evidence seems clear. I think that not very many people were/are on MAOIs, therefore it doesn't explain smoking addiction, and people confuse this mechanism with antidepressants. Nicotine is more addictive when you smoke tobacco to get it, or if you're on MAOIs, but it's addictive all on its own. We'll use vaping as an example for this:
A third of users vaped within 5 minutes of waking in this study [0]. Subjects in this study [1] vaped consistently despite not wanting to. Here are some cool statements they copped to:
“I hide in the bathroom to vape in secret.”
“I look forward to times that I can stay in and vape all night.”
“I love vaping, though I wish I did not.”
Here are some things that happened to them when they didn't vape:
“I cannot relax without my vape/e-cigarette.”
“My hands and arms start trembling if I have not vaped in a while.”
This study [2] compares users of Juul vapes w/ non-Juul vapes (Juul vapes deliver more nicotine), finding that "JUUL users were 1.77 (95% CI: 1.36-2.31) times as likely to report symptoms of nicotine dependence and 1.43 (95% CI: 1.02-2.01) time as likely to report using e-cigarettes on 20-30 days, compared to 1-5 days, relative to non-JUUL users".
> Nicotine itself is not addictive, it's habit-forming. Those are completely different neural pathways at work and completely different forms of interaction.
Even if this is true (I can't find any basis for it), it's at best a distinction without a difference. Here's nicotine's pharmacology:
---
Stimulation of central nAChRs by nicotine results in the release of a variety of neurotransmitters in the brain, most importantly dopamine. Nicotine causes the release of dopamine in the mesolimbic area, the corpus striatum, and the frontal cortex. Of particular importance are the dopaminergic neurons in the ventral tegmental area of the midbrain, and the release of dopamine in the shell of the nucleus accumbens, as this pathway appears to be critical in drug-induced reward (12, 13). Other neurotransmitters, including norepinephrine, acetylcholine, serotonin, γ-aminobutyric acid (GABA), glutamate, and endorphins, are released as well, mediating various behaviors of nicotine.
---
> In addition, nicotine outside of cigarettes is a newer distinction to be made, most pre-2000s papers do not make that distinction.
This is generally because there's consensus that nicotine is addictive and there's no need to do further research on it. They're not ruling out that there are chemicals besides nicotine that inhibit MAO A and B reuptake, thereby enhancing addiction to smoking (not nicotine), but there are no studies I've seen that demonstrate consistent vaping without nicotine dependency.
It's also worth saying that in young adults, vaping tends to lead to smoking [4], which is super bad.
[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668279/
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330178/
[2]: https://pubmed.ncbi.nlm.nih.gov/34614433/
[3]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946180/
[4]: https://pubmed.ncbi.nlm.nih.gov/34999270/
There's some confusion on this point. There is a paper that shows this, but mostly the mechanism people are referring to is MAO A and B reuptake seems to be inhibited while smoking, but not after just using nicotine, which makes smoking more addictive than just nicotine. I don't dispute this; the evidence seems clear. I think that not very many people were/are on MAOIs, therefore it doesn't explain smoking addiction, and people confuse this mechanism with antidepressants. Nicotine is more addictive when you smoke tobacco to get it, or if you're on MAOIs, but it's addictive all on its own. We'll use vaping as an example for this:
A third of users vaped within 5 minutes of waking in this study [0]. Subjects in this study [1] vaped consistently despite not wanting to. Here are some cool statements they copped to:
“I hide in the bathroom to vape in secret.”
“I look forward to times that I can stay in and vape all night.”
“I love vaping, though I wish I did not.”
Here are some things that happened to them when they didn't vape:
“I cannot relax without my vape/e-cigarette.”
“My hands and arms start trembling if I have not vaped in a while.”
This study [2] compares users of Juul vapes w/ non-Juul vapes (Juul vapes deliver more nicotine), finding that "JUUL users were 1.77 (95% CI: 1.36-2.31) times as likely to report symptoms of nicotine dependence and 1.43 (95% CI: 1.02-2.01) time as likely to report using e-cigarettes on 20-30 days, compared to 1-5 days, relative to non-JUUL users".
> Nicotine itself is not addictive, it's habit-forming. Those are completely different neural pathways at work and completely different forms of interaction.
Even if this is true (I can't find any basis for it), it's at best a distinction without a difference. Here's nicotine's pharmacology:
---
Stimulation of central nAChRs by nicotine results in the release of a variety of neurotransmitters in the brain, most importantly dopamine. Nicotine causes the release of dopamine in the mesolimbic area, the corpus striatum, and the frontal cortex. Of particular importance are the dopaminergic neurons in the ventral tegmental area of the midbrain, and the release of dopamine in the shell of the nucleus accumbens, as this pathway appears to be critical in drug-induced reward (12, 13). Other neurotransmitters, including norepinephrine, acetylcholine, serotonin, γ-aminobutyric acid (GABA), glutamate, and endorphins, are released as well, mediating various behaviors of nicotine.
---
> In addition, nicotine outside of cigarettes is a newer distinction to be made, most pre-2000s papers do not make that distinction.
This is generally because there's consensus that nicotine is addictive and there's no need to do further research on it. They're not ruling out that there are chemicals besides nicotine that inhibit MAO A and B reuptake, thereby enhancing addiction to smoking (not nicotine), but there are no studies I've seen that demonstrate consistent vaping without nicotine dependency.
It's also worth saying that in young adults, vaping tends to lead to smoking [4], which is super bad.
[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668279/
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330178/
[2]: https://pubmed.ncbi.nlm.nih.gov/34614433/
[3]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946180/
[4]: https://pubmed.ncbi.nlm.nih.gov/34999270/
A report from 1995 published in Berlin? You could do better than that.
It's a review of 70 papers. The evidence is overwhelming.
The truth is probably more similar to (meth)amphetamines. Class 2 drug, very classic stimulant that you see junkies ruin their lives over on the street. Not even legal to prescribe at all to people in some countries.
Vast majority of ADHD people that it is prescribed to (like %99+) do not get addicted to the medication, and often forget to take it. It's the people just trying to get 'high' in general with doses way beyond the medical cases where it leads to addiction.
So yes, it's probably pretty addictive if your using it in a way thatleads people to get addicted to it, and not if your not using it in a way that tends to not lead to addiction.
Vast majority of ADHD people that it is prescribed to (like %99+) do not get addicted to the medication, and often forget to take it. It's the people just trying to get 'high' in general with doses way beyond the medical cases where it leads to addiction.
So yes, it's probably pretty addictive if your using it in a way thatleads people to get addicted to it, and not if your not using it in a way that tends to not lead to addiction.
I’ve found this to seem more like a popular myth than reality, in my personal experience.
Which part? I agree that a lot of prescribed stimulant users are functional addicts. I also believe, as someone subscribed a stimulant for adhd who was productive beforehand, that patients and doctors know this and it is a calculated addiction.
The average methhead doesn’t take a micro dose just so they’re able to stay motivated and focused at work. If they did their wouldn’t be such a stigma. As an example the popular image of cocaine is a working man’s drug despite the fact it’s just as bad as meth when abused in large doses (induces psychosis, etc)
The average methhead doesn’t take a micro dose just so they’re able to stay motivated and focused at work. If they did their wouldn’t be such a stigma. As an example the popular image of cocaine is a working man’s drug despite the fact it’s just as bad as meth when abused in large doses (induces psychosis, etc)
Well said, thanks for the explanation. Sorry for being so blunt. Your first paragraph is my position and experience as well.
I semi-frequently forget to take my second dose of Ritalin in the day. Though honestly it helps me a little because here I can’t fill a new prescription of it until the exact day I run out. Gives me a little bit of a buffer.
Gwern did a very detailed (per usual) write-up on nicotine and came to a similar conclusion: https://www.gwern.net/Nicotine
I use (a lot of) NRT, gum and lozenges. I started due to its nootropic benefit (likely self medicating my ADHD years before I got a diagnosis), without ever being a smoker. It is definitely addictive. Probably not as addictive as tobacco since there's less of a ritual and culture, and there aren't the MAOI components which apparently enhance how addictive it is.
I've tried to quit a few times, and haven't done so yet. And it is harmful in large doses, the few times I gone more than a couple days without it, I get a tingling sensation in my hands and feet as my circulation improves, since nicotine in large doses is bad for your circulation.
I've tried to quit a few times, and haven't done so yet. And it is harmful in large doses, the few times I gone more than a couple days without it, I get a tingling sensation in my hands and feet as my circulation improves, since nicotine in large doses is bad for your circulation.
Cigarettes contain a pharmacy's worth of chemicals. I've read that their addictiveness may come from the combination of MAOI inhibitors + nicotine, or some other combination.
Holy shit stop that. That's like taking morphine to quit alcohol.
Don't listen to the naysayers nicotine is cool. It's on the same level as sugar, caffeine, and what not.
Though people might know the risks, they often aren't the ones taking the risks. Much of the risk people take is externalized and the opportunity costs ignored.
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Knowing the origins of nicotine, an alternative use that should be investigated is as a pesticide. Completely discarding alternative research into nicotine due to other bad actors seems short sighted.
We already do: https://en.wikipedia.org/wiki/Neonicotinoid
These compounds are arguably partially responsible for the issue of colony collapse disorder.
These compounds are arguably partially responsible for the issue of colony collapse disorder.
Nicotine-derived compounds are already widely used in agriculture
This enthusiasm to profit from borderline poison is unsettling. Not sure I could look my kids in the face if heavily invested in these industries.
It is curious that political action is not first and foremost in our minds, if at all. We take it for granted that all manner of immoral production and consumption will be permitted.
Instead passive and voluntary actions like simply not investing in companies and not buying their products - possibly framed as something more principled like divestment - is our default setting.
Instead passive and voluntary actions like simply not investing in companies and not buying their products - possibly framed as something more principled like divestment - is our default setting.
Yeah, a scenario where everyone's "default setting" is trying to ban everything they consider "immoral" sounds pretty terrible.
Indeed, the first solution to every problem should be one size fits all and involve the implicit or explicit threat of imprisonment or death.
Well political action is being taken in different parts of the world. https://www.rnz.co.nz/national/programmes/morningreport/audi...
Would you do the same for someone working at Facebook? Someone who makes alcohol?
It’s a moral stance and those are personal, not societal.
It’s a moral stance and those are personal, not societal.
> Would you do the same for someone working at Facebook? Someone who makes alcohol?
This is about nicotine so these examples strike me as off topic.
> It’s a moral stance and those are personal, not societal.
Society level, moral choices are made all the time. Just ask some Supreme Court justices. And governments profit from nicotine consumption through sin taxes. Whose taxes should be solely devoted to paying for the externalities consumption causes.
This is about nicotine so these examples strike me as off topic.
> It’s a moral stance and those are personal, not societal.
Society level, moral choices are made all the time. Just ask some Supreme Court justices. And governments profit from nicotine consumption through sin taxes. Whose taxes should be solely devoted to paying for the externalities consumption causes.
Do you work on ad-tech or social media sites?
A lot of people worship at the altar of the almighty dollar. I mean shit, the head of the FDA goes to work for a giant tobacco company. Money talks.
It’s gross but it’s the world we live in and the culture we’ve largely cultivated.
I do not though and will not invest in tobacco companies for this reason.
It’s gross but it’s the world we live in and the culture we’ve largely cultivated.
I do not though and will not invest in tobacco companies for this reason.
If you have a pension fund, target date fund, market index, or many variety of diversified products in an IRA, 401k, or similar retirement account, you almost assuredly have money invested in tobacco.
If you look at history, nicotine has been nearly unstoppable. If one cigarette company stops selling them, they will simply cede market share to another. If all stop selling, it would inevitably create a massive black market - there are specific markets that attempt prohibition, you can see what happened historically.
Instead, isn't it rational to be realistic and aim for harm reduction? If Consumers can receive a satisfactory nicotine experience from a product that is going to be far less harmful, isn't that still a net positive?
If you look at history, nicotine has been nearly unstoppable. If one cigarette company stops selling them, they will simply cede market share to another. If all stop selling, it would inevitably create a massive black market - there are specific markets that attempt prohibition, you can see what happened historically.
Instead, isn't it rational to be realistic and aim for harm reduction? If Consumers can receive a satisfactory nicotine experience from a product that is going to be far less harmful, isn't that still a net positive?
There will always be many things in this world. I don’t have to directly support them though. Tobacco companies do not care about harm reduction, they care about money. The way they make money is to sell a product which is objectively harmful.
I’m not saying they won’t exist, I am choosing to not support them though. I am realistic. But I’m not going to compromise what I believe in to ride on the back of their success in hurting millions of people on the plant, many of whom are not making an informed choice. Every child in a smoking household did not get a choice. Pets too.
You make your choices and I’ll make mine.
I’m not saying they won’t exist, I am choosing to not support them though. I am realistic. But I’m not going to compromise what I believe in to ride on the back of their success in hurting millions of people on the plant, many of whom are not making an informed choice. Every child in a smoking household did not get a choice. Pets too.
You make your choices and I’ll make mine.
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If 50% of people avoid investing in industries that are profitable and hurt/kill people, that means people with no such reservation take the profit. You essentially pass the gains to people OK with causing cancer.
I don’t think the avoid investments you don’t believe in changes anything except making others money.
I don’t think the avoid investments you don’t believe in changes anything except making others money.
You could use the same type of logic to argue that voting is meaningless. And indeed investment is also a form of voting. One individual usually changes very little(except in this case one individual could make a tremendous difference depending on their net worth), but that's not necessarily a justification for doing nothing. Look up Kant for relevant philosophy.
> You could use the same type of logic to argue that voting is meaningless
Wouldn’t it be more apt to compare it to not voting? If morally principled people opt not to vote then the leader is chosen by those who are not morally principled, and the parent comment argues that if morally principled people opt to divest from tobacco then only the morally unprincipled remain as the shareholders in the industry.
Wouldn’t it be more apt to compare it to not voting? If morally principled people opt not to vote then the leader is chosen by those who are not morally principled, and the parent comment argues that if morally principled people opt to divest from tobacco then only the morally unprincipled remain as the shareholders in the industry.
That distinction doesn't really matter here. The point is that no matter whether I vote or not, the size of the effect of my decision is roughly the same, namely 1 vote. Therefore the fact that I'm only 1 vote is not in itself an argument for deciding either way.
Buying and owning shares sustains what the company does. That's the vote. Shareholder voting is another more fine grained dimension, and one that requires compromising ones integrity.
And that's OK. Invading neighbouring countries in order to make use of their resources is a "good deal" for the invader. Just because some states might do that doesn't mean other states should say "hey, we're missing out here !".
and that's OK? oof you strongely need to readjust your moral compass.
OK my post was ambiguous. What I was trying to convey was that just because others are making money from it doesn't mean that morally it's fine to do so oneself. Everyone has to make their own decisions, clearly supporting the production of one of the greatest poisons of the last hundred years is unsupportable but there will be some who do that.
Not sure how safe it is. At most I was doing 1-2 times per week, now more like 1-2 every couple of months. So I imagine at that level it is statistically negligible. But from what I ready there aren't any known long term risks.
Anyways, on the topic of the article. I mostly agree, as long as people know the risks, then we should let them do what they want. With that said, Juul was particularly scummy and deserved to get banned by the FDA.