E-cigarette is less addictive than cigarettes

On March 20, 2020, the National Library of Medicine and the National Institutes of Health published an e-cigarette addiction study on the official website. The study is titled “Horizontal Comparison of the Dependence of American Adults on Electronic Cigarettes and Cigarettes”. The study uses a representative of American adults as a sample and analyzes and compares 13,311 e-cigarette users and traditional smokers. Psychometric dependence of e-cigarettes and cigarettes.

E-cigarette is much less addictive than cigarettes

The researchers found that users’ dependence on e-cigarettes was significantly lower than that on regular cigarettes.

“There is no doubt that e-cigarettes are addictive, but they are different from traditional cigarettes. We compared the dual users of e-cigarettes and cigarettes, and their dependence on e-cigarettes is significantly lower than that of cigarettes (1.58 [SE = 0.05] For 2.76 [0.04]), p <0.0001). Not only that, separate group studies of e-cigarette users and smokers also showed that e-cigarettes are less addictive than cigarettes (1.95 [0.05] vs. 2.52 [0.02], p < 0.0001).”

significantly lower than that on regular cigarettes

Studies have shown that few e-cigarette users are highly dependent on e-cigarettes, but most smokers are highly dependent on cigarettes. Interestingly, the most reliant on e-cigarette users are those who switch to e-cigarettes to quit smoking and stop smoking. Those who have no history of smoking and only use e-cigarettes have the least dependence. The researchers believe that this is consistent with the idea of ​​smokers by transferring and transitioning their dependence to e-cigarettes. It may be based on such reasons and facts that they stopped smoking and completely transitioned to e-cigarettes, becoming the group most likely to use e-cigarettes frequently. However, regardless of the size of cigarette addiction, and whether or not e-cigarettes are still used, the researchers found that the results are consistent under the group comparison of various situations-the dependence on e-cigarettes is much lower than that on cigarettes. This suggests that who switched from smoking to electronic cigarettes may reduce their dependence on nicotine, as well as health risks.

The researchers finally reached a suggestive conclusion: modern medicine has pointed out that the harm of cigarettes is not caused by nicotine dependence, but caused by other toxic substances exposed to cigarette smoke. In fact, the proponents of harm reduction believe that from the perspective of harm reduction, if e-cigarettes can successfully replace cigarettes in the future to reduce the risk of users, then e-cigarettes should be dependent to a certain extent. It was even criticized because it did not allow users to rely on it, resulting in poor popularity. Therefore, when weighing e-cigarettes to reduce the expected damage to the body, we believe that some continued dependence may be beneficial or even necessary.

 

Source:

  • 1Wang T. W., Asman K., Gentzke A. S., Cullen K. A., Holder‐Hayes E., Reyes‐Guzman C., et al. Tobacco product use among adults ‐ United States, 2017. MMWR Morb Mortal Wkly Rep 2018; 67: 1225– 1232.Crossref PubMed Web of Science®Google Scholar
  • 2 National Academies of Sciences Engineering and Medicine Public Health Consequences of E‐Cigarettes. Washington, DC: The National Academies Press; 2018.Google Scholar
  • 3Mcneill A., Brose L. S., Calder R., Bauld L., Robson D. A report commissioned by Public Health England. London: Public Health England; 2018.Google Scholar
  • 4Avdalovic M. V., Murin S. POINT: does the risk of electronic cigarettes exceed potential benefits? Yes, Chest 2015; 148: 580– 582.Crossref PubMed Web of Science®Google Scholar
  • 5Etter J. F., Eissenberg T. Dependence levels in users of electronic cigarettes, nicotine gums and tobacco cigarettes. Drug Alcohol Depend 2015; 147: 68– 75.Crossref PubMed Web of Science®Google Scholar
  • 6Farsalinos K. E., Romagna G., Tsiapras D., Kyrzopoulos S., Voudris V. Evaluating nicotine levels selection and patterns of electronic cigarette use in a group of “vapers” who had achieved complete substitution of smoking. Subst Abuse: Res Treatment 2013; 7: 139– 146.Crossref PubMed Google Scholar
  • 7Jankowski M., Krzystanek M., Zejda J. E., Majek P., Lubanski J., Lawson J. A., et al. E‐cigarettes are more addictive than traditional cigarettes‐a study in highly educated young people. Int J Environ Res Public Health 2019; 16.Crossref Web of Science®Google Scholar
  • 8Morean M., Krishnan‐Sarin S., O’malley S. S. Comparing cigarette and e‐cigarette dependence and predicting frequency of smoking and e‐cigarette use in dual‐users of cigarettes and e‐cigarettes. Addict Behav 2018; 87: 92– 96.Crossref PubMed Web of Science®Google Scholar
  • 9Smith S. S., Piper M. E., Bolt D. M., Fiore M. C., Wetter D. W., Cinciripini P. M., et al. Development of the brief Wisconsin inventory of smoking dependence motives. Nicotine Tob Res 2010; 12: 489– 499.Crossref PubMed Web of Science®Google Scholar
  • 10Shiffman S., Waters A., Hickcox M. The nicotine dependence syndrome scale: a multidimensional measure of nicotine dependence. Nicotine Tob Res 2004; 6: 327– 348.Crossref CAS PubMed Web of Science®Google Scholar
  • 11Sterling K. L., Mermelstein R., Turner L., Diviak K., Flay B., Shiffman S. Examining the psychometric properties and predictive validity of a youth‐specific version of the nicotine dependence syndrome scale (NDSS) among teens with varying levels of smoking. Addict Behav 2009; 34: 616– 619.Crossref PubMed Web of Science®Google Scholar
  • 12Piper M. E., Baker T. B., Benowitz N. L., Smith S. S., Jorenby D. E. E‐cigarette dependence measures in dual users: reliability and relations with dependence criteria and E‐cigarette cessation. Nicotine Tob Res 2019. https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntz040/5381490Crossref Google Scholar
  • 13Piper M. E., Bolt D. M., Kim S. Y., Japuntich S. J., Smith S. S., Niederdeppe J., et al. Refining the tobacco dependence phenotype using the Wisconsin inventory of smoking dependence motives. J Abnorm Psychol 2008; 117: 747– 761.Crossref PubMed Web of Science®Google Scholar
  • 14Piper M. E., Mccarthy D. E., Bolt D. M., Smith S. S., Lerman C., Benowitz N., et al. Assessing dimensions of nicotine dependence: an evaluation of the nicotine dependence syndrome scale (NDSS) and the Wisconsin inventory of smoking dependence motives (WISDM). Nicotine Tob Res 2008; 10: 1009– 1020.Crossref CAS PubMed Web of Science®Google Scholar
  • 15Adkison S. E., Rees V. W., Bansal‐Travers M., Hatsukami D. K., O’connor R. J. Psychometric characteristics of the brief Wisconsin inventory of smoking dependence motives among a nonclinical sample of smokers. Nicotine Tob Res 2016; 18: 470– 476.Crossref CAS PubMed Web of Science®Google Scholar
  • 16Japuntich S. J., Piper M. E., Schlam T. R., Bolt D. M., Baker T. B. Do smokers know what we’re talking about? The construct validity of nicotine dependence questionnaire measures. Psychol Assess 2009; 21: 595– 607.Crossref PubMed Web of Science®Google Scholar
  • 17Piasecki T. M., Piper M. E., Baker T. B. Refining the tobacco dependence phenotype using the Wisconsin inventory of smoking dependence motives: II. Evidence from a laboratory self‐administration assay. J Abnorm Psychol 2010; 119: 513– 523.Crossref PubMed Web of Science®Google Scholar
  • 18 American Psychiatric Association., American Psychiatric Association Dsm‐5 Task Force. Diagnostic and statistical manual of mental disorders: DSM‐5. Washington, D.C.: American Psychiatric Association; 2013.Crossref Google Scholar
  • 19Baker T. B., Breslau N., Covey L., Shiffman S. DSM criteria for tobacco use disorder and tobacco withdrawal: a critique and proposed revisions for DSM‐5. Addiction 2012; 107: 263– 275.Wiley Online Library PubMed Web of Science®Google Scholar
  • 20Pomerleau C. S., Carton S. M., Lutzke M. L., Flessland K. A., Pomerleau O. F. Reliability of the Fagerstrom tolerance questionnaire and the Fagerstrom test for nicotine dependence. Addict Behav 1994; 19: 33– 39.Crossref CAS PubMed Web of Science®Google Scholar
  • 21Strong D. R., Pearson J., Ehlke S., Kirchner T., Abrams D., Taylor K., et al. Indicators of dependence for different types of tobacco product users: descriptive findings from wave 1 (2013‐2014) of the population assessment of tobacco and health (PATH) study. Drug Alcohol Depend 2017; 178: 257– 266.Crossref PubMed Web of Science®Google Scholar
  • 22Embretson S. E., Reise S. P. Item response theory for psychologists. Mahwah, N.J.: Lawrence Erlbaum Associates; 2000.Google Scholar
  • 23 Truth Initiative. E‐cigarettes: Facts, stats and regulations. 2019. Available at https://truthinitiative.org/research‐resources/emerging‐tobacco‐products/e‐cigarettes‐facts‐stats‐and‐regulations.Google Scholar
  • 24Manzoli L., Flacco M. E., Ferrante M., La Vecchia C., Siliquini R., Ricciardi W., et al. Cohort study of electronic cigarette use: effectiveness and safety at 24 months. Tob Control 2017; 26: 284– 292.Crossref PubMed Web of Science®Google Scholar
  • 25Hyland A., Ambrose B. K., Conway K. P., Borek N., Lambert E., Carusi C., et al. Design and methods of the population assessment of tobacco and health (PATH) study. Tob Control 2017; 26: 371– 378.Crossref PubMed Web of Science®Google Scholar
  • 26 United States Department of Health and Human Services; National Institutes of Health; National Institute on Drug Abuse; Food and Drug Administration; Center for Tobacco Products. Population Assessment of Tobacco and Health (PATH) Study [United States] Public‐Use Files. Ann Arbor, MI: Inter‐university Consortium for Political and Social Research [distributor], 2018‐09‐28. https://doi.org/10.3886/ICPSR36498.v8, 2018.Google Scholar
  • 27 United States Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse, Food and Drug Administration, Center for Tobacco Products. Population Assessment of Tobacco and Health (PATH) Study [United States] Public‐Use Files: Inter‐university Consortium for Political and Social Research [distributor]; 2018.Google Scholar
  • 28Breslau N., Johnson E. O., Hiripi E., Kessler R. Nicotine dependence in the United States: prevalence, trends, and smoking persistence. Arch Gen Psychiatry 2001; 58: 810– 816.Crossref CAS PubMed Web of Science®Google Scholar
  • 29Liu G., Wasserman E., Kong L., Foulds J. A comparison of nicotine dependence among exclusive E‐cigarette and cigarette users in the PATH study. Prev Med 2017; 104: 86– 91.Crossref PubMed Web of Science®Google Scholar
  • 30Biener L., Hargraves J. L. A longitudinal study of electronic cigarette use among a population‐based sample of adult smokers: association with smoking cessation and motivation to quit. Nicotine Tob Res 2015; 17: 127– 133.Crossref PubMed Web of Science®Google Scholar
  • 31Levy D. T., Yuan Z., Luo Y., Abrams D. B. The relationship of E‐cigarette use to cigarette quit attempts and cessation: insights from a large, nationally representative U.S. survey. Nicotine Tob Res 2018; 20: 931– 939.Crossref PubMed Web of Science®Google Scholar
  • 32Gottlieb S., Zeller M. A nicotine‐focused framework for public health. N Engl J Med 2017; 377: 1111– 1114.Crossref PubMed Web of Science®Google Scholar
  • 33 Royal College of Physicians. Nicotine without smoke: Tobacco harm reduction. London: RCP, 2016, 2016.Google Scholar
  • 34Abrams D. B., Glasser A. M., Pearson J. L., Villanti A. C., Collins L. K., Niaura R. S. Harm minimization and tobacco control: reframing societal views of nicotine use to rapidly save lives. Annu Rev Public Health 2018; 39: 193– 213.Crossref PubMed Web of Science®Google Scholar
  • 35Britton J., Arnott D., Mcneill A., Hopkinson N. Tobacco advisory Group of the Royal College of P. nicotine without smoke‐putting electronic cigarettes in context. BMJ 2016; 353: i1745.Crossref PubMed Web of Science®Google Scholar
  • 36 Food and Drug Administration. FDA Briefing Document. September 13–14, 2018 Meeting of the Tobacco Products Scientific Advisory Committee (TPSAC). Modified Risk Tobacco Product Applications (MRPTAs) MR0000068‐MR0000073 RJ Reynolds Tobacco Company. https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/TobaccoProductsScientificAdvisoryCommittee/UCM620064.pdf. Accessed June 26, 2019.Google Scholar

WHO says e-cigarettes can improve public health

May 31 is the annual World No Tobacco Day. This year ’s theme is “Protecting youth from industry manipulation and preventing them from nicotine and tobacco use”. On the eve of World No Tobacco Day, the World Health Organization (WHO) released a theme report on e-cigarettes, saying that for adult smokers, switching to e-cigarettes can effectively reduce health risks. At the same time, national regulatory authorities should focus on preventing the use of e-cigarettes by young people. “It is recommended that the supervisory layer should fully consider the interests of all parties and find a regulatory balance point.”

The evidence is strong: electronic cigarettes can reduce harm

Scientists are still understanding the long-term health effects of e-cigarettes. In the report, the WHO cited the National Academy of Sciences and the School of Medicine (hereinafter referred to as NASEM) evaluation of e-cigarettes. There is conclusive evidence: “To completely use e-cigarettes instead of cigarettes can reduce the user’s exposure to many toxic and carcinogens produced by the burning of cigarettes.”

There is a lot of evidence that: “The use of e-cigarettes will lead to nicotine dependence, but less dependence than cigarettes; e-cigarette smoke may increase the risk of some diseases in the long term, but the risk is lower than cigarettes; from cigarettes to e-cigarettes can improve the body The health of the organ. ”

The WHO specifically pointed out that the latest research shows that the simultaneous use of cigarettes and e-cigarettes will lead to higher levels of oxidative stress and increase the risk of cardiopulmonary health, so dual use is not recommended.

How to reduce youth usage? Reasonable supervision and scientific cognition

The WHO report shows that countries ’regulatory policies on e-cigarettes will largely affect the use of young people.

The chart data shows that in 2017, the proportion of young people in the United States, Canada, and the United Kingdom using e-cigarettes within a week was 0.8%, 1.1%, and 0.5%, respectively. However, a year later, the data of Canada and the United States have increased to varying degrees, but the United Kingdom has dropped to 0.4%.

The UK has a relatively mature regulatory system for e-cigarettes. E-cigarettes are regarded as a tool to quit smoking and even enter hospitals.

Scientific cognition and use are the premise of reasonable supervision. In the report, the WHO also expended a lot of space on the scientific knowledge of e-cigarettes, with a view to the public having more knowledge about e-cigarettes.

Tests prove that the success rate of smoking cessation is twice that of traditional means

In the report, WHO cited an important research result published in the New England Journal of Medicine in 2019: the success rate of e-cigarette quitting smoking has almost doubled.

Study author Peter Hajek selected 886 adult smokers who participated in the British National Quit Service as test subjects, and these people have a clear need to quit smoking. He divided the participants into two groups, one group randomly assigned the smoking cessation products originally provided by the smoking cessation center, and one group provided electronic cigarettes, allowing them to choose their favorite flavors.

After a year of observation and tracking, the success rate of smoking cessation in the e-cigarette group was 18%, and that in the other group was 9.9%. The success rate of e-cigarette smoking cessation is almost twice that of traditional means.

WHO believes that there is currently no conclusion that the use of e-cigarettes will lead to an increase in smoking rates. Experimental results show that young people will increase the possibility of using cigarettes after using e-cigarettes, but WHO pointed out that there is no credible data to prove that there is a causal relationship between this association, and there are also studies that use e-cigarettes and cigarettes are independent of each other and do not interfere of.

Under reasonable regualtion, e-cigarettes will contribute to long-term tobacco control

Based on the above points, WHO makes recommendations (parts) to countries that plan to regulate e-cigarettes:

E-cigarette companies are required to provide medical product-level health declarations in their packaging, authorize their use after scientific review, and pay attention to any unexpected situations that occur after the market shifts to e-cigarettes;

Standardize sales channels (including online sales), strictly enforce laws regarding the minimum age of purchase, restrict minors and adults from obtaining tobacco products, and increase the difficulty and cost for smokers to switch from electronic cigarettes to cigarettes;

The adoption of standardized regulations minimizes the health risks of e-cigarette users:

According to safety production and waste disposal regulations, safely manufacture device and properly dispose of waste cartridges.

Specify the e liquid content and nicotine concentration, and prohibit the addition of carcinogens, mutagens and other harmful substances.

Children’s protective containers are used for the packaging of pods, and the product addiction is clearly indicated in the packaging.

The product uses a tracking function to track the evolution of consumption patterns. Monitor health or safety events in real time.

The report concluded that WHO, NASEM, and CDC (CDC) have realized the potential of e-cigarettes to improve the public health environment.

The key is the reasonable government regulation of e-cigarettes. The goal is to minimize the negative effects of the tobacco epidemic and continue to bring positive effects to public health. At the same time, non-smokers, especially young people, should be avoided from exposure to nicotine, and the interests of smokers should be fully considered to find a regulatory balance.

The report also specifically pointed out that in any context, if the government implements a strong tobacco control policy to reduce or even completely block the opportunities for e-cigarette users to switch to cigarettes, then the government’s long-term tobacco control vision will also benefit.

Nicotine products help keep COVID 19 away

Aquarter of French adults smoke. Many people were surprised, therefore, when researchers reported late in April that only 5% of 482 covid-19 patients who came to the Pitié-Salpêtrière hospital in Paris between February 28th and April 9th were daily smokers. The ratios of smokers to non-smokers in earlier tallies at hospitals in America, China and elsewhere in France varied. But all revealed habitual smokers to be significantly underrepresented among those requiring hospital treatment for the illness. Smokers, the authors of the report wrote, “are much less likely” to suffer severely from sars-cov-2, the virus that causes covid-19. Rarely, they added, is such a result seen in medicine.

Smokers are almost certainly not protected from initial infection by sars-cov-2. In fact, because they first handle and then puff on cigarettes, they may be especially susceptible—for transmission often takes place through the mouth’s mucous membranes. What seems to be happening is that infected smokers are less likely to develop symptoms, or, if they do develop them, are more likely than non-smokers to have symptoms which are mild. That means they are more likely to stay home and not to show up in hospital statistics.

All this suggests that something in tobacco smoke is having a protective effect. The best guess is that the something in question is nicotine. News of this hypothesis has spread like wildfire. To stop a run on nicotine chemically extracted from tobacco, which is taken in one form or another by many smokers who are trying to quit the habit, France’s health ministry suspended online sales of the substance on April 24th. Purchases from pharmacies were limited to a month’s supply per person. With encouragement from the health minister, the organisations behind the Pitié-Salpêtrière study, which include the Pasteur Institute and the Sorbonne, are preparing trials. The plan is to offer nicotine patches to covid-19 patients, front-line workers and ordinary citizens. How they fare will be compared with control groups given a placebo.

Nicotine is not thought to attack sars-cov-2 directly. It may, however, play an indirect role that involves a cell-membrane protein called ace2, to which the virus attaches itself in order to gain access to a cell. Some researchers suspect that nicotine binds to ace2 as well, and that this makes it harder for the virus to do so alongside it. Nicotine may also soothe inflammation caused by the infection, a hypothesis supported by its use to treat inflamed bowels.

The new French study, which is expected to begin in three weeks’ time, may cast light, too, on another possible therapeutic effect of nicotine. Those severely ill with covid-19 are often the victims of a hyperactive immune response called a cytokine storm. Cytokines are a group of signalling molecules. Some have the job of recruiting pathogen-fighting white blood cells to a site of infection. If too many of these cells arrive at once they can end up attacking the body’s own tissues. Jason Sheltzer, a molecular biologist at Cold Spring Harbor Laboratory, in New York state, who studies the physiological effects of cigarette smoke, says it is theoretically possible that nicotine, which interferes with this process, may lessen the damage, though his research also points to significant negative effects of cigarette smoke on coronavirus infections.

Anti-smoking campaigners have been eager to point out that none of this is a recommendation to take up smoking. If a few lucky smokers have thus evaded the worst effects of covid-19, it can hardly be said that their actions were part of some well-thought-out plan. That is not, however, an excuse for pretending observations like those from the Pitié-Salpêtrière are irrelevant, and thus failing to follow them up. If either nicotine or some other chemical found in tobacco smoke leads to a treatment, the rest of humanity may be thankful for the world’s smokers having made themselves accidental guinea pigs in a giant epidemiological experiment.

Dental experts advise smokers to switch to vapes to prevent oral cancer

“We warn smokers that smoking is the main cause of oral cancer and strongly recommend that they quit smoking. For those who are unable or unwilling to quit smoking on their own, I hope they will switch to non-burning tobacco, such as vapes.” Dean Fernando Fernandez recently spoke at a scientific forum on tobacco harm reduction.

Fernando is not only the dean of the Philippine College of Oral Surgery, but also the former chairman of the Philippine Dental Association. He has been encouraging smokers to switch to cigarettes in a safer way, citing research by the British Public Health and the British Parliament Science and Technology: “Different from cigarettes, research shows that e-cigarettes are 95% less harmful than combustible cigarettes. E-cigarettes heat and evaporate liquids at lower temperatures, and do not burn organic matter, so they do not release toxic substances produced during combustion or combustion.

Why is the relapse rate up to 97% in quit smoking?

The vast majority of people who quit smoking by willpower have a sharp decline in their happiness index after quitting. They tremble with fear and fear all the time. Sometimes they dream of smoking when they dream, and when they wake up, they will be scared to death, some sweating, some even with tears in his face …

To them, quitting smoking is really too hard!

1. The relapse rate after quitting smoking by willpower is as high as 97%, second only to heroin

1. The relapse rate after quitting smoking by willpower is as high as 97%, second only to heroin

Some research data show that the success rate of quitting smoking with willpower and staying longer than one year is only 3%, which means that up to 97% of people who quit smoking have relapsed within one year after quitting!

Maybe many people have no concept of 97%, then I give a set of comparative data:

According to the statistics of the detoxification center, the relapse rate of heroin users is 99%, and the relapse rate of ice poison users is 90%.

In other words, the relapse rate after quitting by willpower is second only to heroin, the king of drugs, and higher than any other drug!

Many ex-smokers naively think that smoking is just a physical addiction …

But have you ever wondered why many people who have quit smoking for 5 or 10 years still have relapse?

After so many years, the residual nicotine in their bodies has been metabolized and the physiological dependence has long ceased to exist, but why is relapse?

This makes absolutely no sense!

In fact, this is because smoking is not only physically addictive, but also something more important: heart/ mind addiction.

2. Heart addiction is the biggest source of pain for smokers

2. Heart addiction is the biggest source of pain for smokers

The so-called heart addiction is all the misconceptions about smoking in the mind after long-term heavy smoking, that is, the so-called smoking benefits.

The vast majority of smokers mistakenly believe that smoking can bring many “benefits” to themselves, such as relieving stress, helping to relax, concentrate, eliminate boredom, eliminate fatigue, bring enjoyment and help socialize.

Once they quit smoking, it means that they will lose their “right” to smoking and have to give up these “benefits” …

Wish for it and never get it.

This sense of psychological lack can cause huge psychological pain.

For example, if you have a 5-year-old child, when you suddenly do not let your child play toys, or suddenly do not let your child play mobile games, or suddenly do not let your child watch TV cartoons, he first will refuse to obey you and ask to continue playing. If you insist on not letting him play, he will be angry, start crying, and even become hysterical …

You didn’t hit him or scold him, but he showed real great pain.

This pain also comes from the psychological lack of feeling: want to play but can’t play, just ask for it.

3. The first reason for relapse: sacrifice and deprivation

3. The first reason for relapse: sacrifice and deprivation

People who quit smoking by willpower do not explore the nature of smoking and still believe that smoking has many benefits. They believe that they have made terrible sacrifice and have been deprived of certain rights. They worry that they will no longer be able to enjoy life and can no longer cope with stress.

I want to smoke but I can’t! !! Why on earth should you quit smoking? !! Do you want to quit smoking? !!

It is this sense of sacrifice and deprivation that brings inner conflict, self-doubt and tangled conflicts, causing great psychological pain!

This kind of psychological pain is real. If it is not relieved, it will also cause physical illness.

He extinguished the cigarette in his hand, but never extinguished the cigarette in his heart, so it was easy to resurrect!

Whenever the company colleagues meet and sees others smoking …

Whenever you see someone smoking after a big meal …

Whenever you meet up with good friends and see others smoking …

When these things happen, he always tries to convince himself: “I can’t smoke because I have stopped smoking!”

“I can’t smoke”, these five words are extremely sad, because quitters feel their lives are no longer complete.

This will cause them great psychological pressure, and this pressure will continue to accumulate.

Until one day, he was tempted to “smoke only a cigarette” or collapse completely under great pressure and give up.

4. The second biggest reason for relapse: encountering a major setback or a trough in life.

4. The second biggest reason for relapse: encountering a major setback or a trough in life.

People who quit smoking by willpower often find it easy to choose to relapse when they encounter major setbacks or low life.

That’s because they haven’t removed the addiction and still believe that smoking has many benefits. In the subconscious mind, smoking can relieve pain.

Whenever I quarrel with my lover or even get divorced …

Whenever work is unsatisfactory and aggrieved …

Whenever the child fights with someone outside …

When these conditions occur, his first reaction is often smoking, because he believes that smoking can relieve depression or relieve pain.

If there were cigarettes around him, he would almost certainly ignite it subconsciously.

5. The third major reason for relapse: the familiar smoking scene triggers conditioned reflex

5. The third major reason for relapse: the familiar smoking scene triggers conditioned reflex

In addition to physical addiction and heart addiction, another factor can lead to relapse: conditioned reflexes.

For a smoker who has been smoking for many years, less may have smoked tens of thousands of cigarettes, and more may have smoked hundreds of thousands of cigarettes.

Repeated stimulation of long-term heavy smoking has led him to unconsciously link various scenes and emotions in work and life with smoking one by one, forming a conditioned reflex!

If you ask a smoker: Under what circumstances do you need to smoke?

You might say, under great pressure to smoke, relax and enjoy a cigarette, concentrate on something to smoke a cigarette, feel bored and smoke, get up and smoke, smoke after meal, smoke after drinking, smoke in the toilet , A cigarette before bedtime, N cigarettes at a meeting, N packets of cigarettes to play cards …

If you ask him again, in what mood do you need to smoke?

You might say that a person smokes a cigarette at a happy event, burns a cigarette in anger, hangs up a cigarette when being stressed out, and smokes a cigarette in all thoughts …

So, under what circumstances do you not need to smoke?

I am afraid there is only one answer: smokers do not need to smoke only when they are asleep!

Even if the smoker quits for some time, when he enters these scenes or emotions, he still feels that he wants to smoke.

In fact, he doesn’t really want to smoke, this is just a conditioned reflex, which we can call a “pseudo-smoking addiction.”

Especially when he plays cards or drinks with old smokers, he is most likely to be triggered by conditioned reflexes.

At this time, he is likely to subconsciously take out a cigarette or take over a cigarette, even without realizing it.

6. How can we completely prevent relapse?

6. How can we completely prevent relapse?

① The way to prevent relapse: completely remove the heart addiction!

There must be some reason behind every cigarette smoked by every smoker, except for those smoked during conditioned reflex.

Different smokers have different reasons for smoking, some may have 100 reasons, and some may have 50 reasons.

By learning the ultimate method of quitting smoking, you can gradually remove the heart addiction by removing the every reason, and destroy each one of the benefits of smoking one by one . As long as the nature of smoking is explored, you can reverse all the misconceptions about smoking in your mind and realize that the reasons that prompted you to smoke are all illusions!

You will realize from the bottom of your heart that in fact you don’t need to smoke at all, and no one can force you to smoke!

Once you lose any reason to smoke, naturally you don’t want to smoke again!

② Prevent relapse: increase the difficulty of relapse!

What is the success of quitting smoking? That is never to smoke again.

Therefore, what we have to do is to reduce the difficulty of quitting, that is, to increase the difficulty of relapse, which means that we must create all hardware and software conditions to make relapse difficult!

How can I make sure I never smoke again after quitting? Here are some specific suggestions I gave:

l Throw away all cigarettes, lighters and ashtrays to remove the smell of smoke from the environment;

l Get into the habit of exercising everyday and drink plenty of water to accelerate the discharge of nicotine;

l Do not use any substitutes, including but not limited to sunflower seeds, chewing gum, etc .;

l Within three weeks after quitting smoking, strive to avoid dripping alcohol and not playing cards;

l Stay away from old smokers, avoid them pulling you into the water, and you can smoke less second-hand smoke.

7. What if I relapse?

7. What if I relapse?

Please remember a word: relapse, it’s not the end of the world!

I certainly don’t want you to relapse, as do yourself, but maybe you will make mistakes without following my advice.

When you have a relapse, remember a few basic facts, and follow these steps strictly to remedy:

① You have quit smoking for a while, and your physical and mental conditions have become better after you stop smoking, so you have seen the various benefits that quitting bring to you, proving that your decision to quit is correct.

② The nicotine remaining in your body is almost metabolized. Although you have added a small amount of nicotine to your body after relapse, your current condition is still a hundred times better than when you smoked.

③ Please treat this relapse as a setback instead of a complete failure. Do not break the jar because you have not broken the jar.

④ Deep introspection, sum up lessons, and find out the real reason for your relapse, and then fill this psychological loophole, keeping in mind.

⑤ What has happened cannot be changed, but so far, continue to quit smoking, put down your burden and look forward, you will finally be free!

Any smoker can learn to quit smoking for free by reading my article on smoking cessation. And if you want to find a good smoking alternative that’s more healthy than cigarettes, please choose a vape for yourself. E-cigarettes are cheaper and healthier than cigarettes. And it’s effective quitting smoking.

The author and friends around him most have smoked for more than 2 decades. After they vape on e-cigarettes (like SNOWPLUS, MOTI), NOBODY has smoked again.

CDC confirms Vitamin E acetate is the culprit of lung disease in 2500 people, not vapes

E-cigarettes are popular all over the world, at the same time, a series of lung disease cases have been triggered, among which more than 2500 e-cigarettes related lung disease patients have appeared in the United States. According to the latest news from the major media, the CDC recently identified the main cause of lung disease and even death cases caused by e-cigarettes.

According to the media reports, the health monitoring system established in the United States after the terrorist attacks in September 2001 was used to find out the cause of the lung injury related to electronic cigarettes that killed 54 Americans and sent more than 2500 people to hospitals.

Using the system, researchers at the Centers for Disease Control and Prevention found a sharp rise in lung cases in June.

Anne Schucha, the CDC’s chief deputy director, said the sharp rise strongly points to one culprit: vitamin E acetate, an additive found in the vapors of e-cigarettes containing marijuana.

“This does not mean that no other chemical can or is causing lung injury,” schutzer said at a news conference However, based on additional data on vitamin E acetate found in lung samples damaged by vapors. She attributed most of the condition to this additive.

The CDC is still trying to understand the mechanism by which the substance damages lung tissue. It may interfere with natural fluids in the lungs called surfactants, which help to make the lung tissue elastic, and the by-product of this substance may be another toxic chemical.

Emergency room doctors in Wisconsin first noticed outbreaks of these lung injuries in June. They alerted state and federal health officials, and quickly began investigating the geographic extent of the disease, looking for possible causes.

Investigators focused on the vapors of e-cigarettes containing cannabis extract, especially those purchased online or on the street.

Further research has focused on vitamin E acetate, which is used in some preparations to dilute much more expensive tetrahydrocannabinol oil.

As part of this survey, it is important to know the time when the e-cigarette-related lung disease outbreak occured. U.S. health officials want to know when these e-cigarette-related lung diseases first appeared and whether they missed other cases before the initial report. That’s why they turn to surveillance data collected from more than 3200 emergency rooms in most states of the United States.

They found that since January 2017, the number of emergency room visits in the group who smoked e-cigarettes has gradually increased.

“These visits are not limited to lung damage, so people may also be affected by other health effects,” said Katherine Hartnett, an epidemiologist at the Centers for Disease Control and Prevention. The researcher said people may also go to the emergency room because of nicotine poisoning, or because of tetrahydrocannabinol, the main psychoactive ingredient in marijuana.

After narrowing the search to people under 35, researchers found a sharp rise in cases in June 2019 – at the same time, doctors in Wisconsin reported their first case.

The number of cases climbed from June to a peak in September. Since then, the number of cases has declined, but the CDC still counts about 100 cases a week, and the number of deaths continues to rise.

On December 20, the U.S. Food and drug administration also announced measures to combat illegal e-cigarettes. The agency seized 44 websites promoting e-cigarettes. The agency has developed an “e-cigarette killing operation” in response to a large number of lung cases caused by e-cigarettes in the United States.

Is electronic cigarette safe? British experts tell you it’s as safe as coffee

According to the Sun on November 13, the electronic cigarette industry has recently become the focus of public attention due to some hot topics.

According to a report released by a German medical professor, electronic cigarettes may cause damage to the brain, lungs, heart and blood vessels, but the specific extent of the damage is not clear.

In a rare case of e-cigarettes in Nottingham, England, a 16-year-old teenager was almost life-threatening due to an allergy to chemicals in the liquid.

as safe as coffee
Peter Hajek, British medical expert

The Sun interviewed Peter Hajek, a British medical expert, who is the director of health and lifestyle research at the Wolfson Institute of preventive medicine at Queen Mary University in London.

Professor Peter Hayek pointed out that nicotine in e-cigarettes does have a short-term stimulating effect, which, like drinking coffee, is not dangerous in itself. The Nottingham boy has a rare allergic reaction, the only one among the 3.6 million smokers in the UK. He still affirmed the relative harm reduction effect and safety of e-cigarettes.

Electronic cigarette shop in UK with coffee area
Electronic cigarette shop in UK with coffee area

“It’s ridiculous to trumpet the dangers of electronic cigarettes,” the Sun commented in its report, “In the ideal world, no one should smoke or vape, but we must face the reality that people still smoke, and cigarettes have great harm. Britain has achieved great success on the road of tobacco control. Only when it is mad can it follow other countries to issue e-cigarette ban. The problem in the United States is that it allows markets to develop, leading to panic and even death. In Britain, 220 people die every day from cigarettes, and e-cigarettes are saving lives.

SnowPlus and Guangming district government of Shenzhen, China reach strategic cooperation
E-coffee

Here is the interview:

Q: Shouldn’t electronic cigarettes be safer than cigarettes?

A: Yes, e-cigarettes are much less harmful than cigarettes. The health risks of electronic cigarette users are 95% lower than that of traditional cigarette users, and the risks of cancer, heart disease and lung disease are also greatly reduced. According to a report by the PHE, the potential risk of cancer among vapers is less than 0.5% of that of traditional smokers.

Q: Will vaping kill people?

A: At least not in the UK.

Q: How do you explain the damage to Ewan Fisher’s lung caused by vapes?

A: The teenager’s condition is a rare allergic reaction to a chemical component in the electronic cigarette. There are 3.6 million smokers in the UK, and the disease case number is the only one.

Q: What are the causes of e-cigarette related deaths in the United States?

A: The outbreak of lung disease in the United States is caused by pollutants in the illegally produced cannabis / thc e-cigarettes. This is not the type of electronic cigarette in the UK.

Q: According to a research report by a German medical professor, electronic cigarettes can damage the brain, heart, lung and blood vessels. Should e-cigarette users be worried?

A: There are actually two findings in this report. One is that nicotine in e-cigarettes can cause short-term stimulation to people, but its stimulation level is similar to coffee drinking, and it is not dangerous in itself; the other is that acrolein produced by vape is harmful to mice, but it can not be directly equated with human. (Whether it is referential or not has been debated in academia.)

Q: Is there any risk in e-cigarettes?

A: E-cigarettes may bring some risks, but our data only come from the users of e-cigarettes in two or three years. So far, no serious health problems have been found.

Q: Is electronic cigarettes addictive?

A: E-cigarettes satisfy smokers who have become nicotine dependent, but they are not attractive to non-smokers. Now the proportion of non-smokers who become smokers is very small.

Q: Why isn’t e-cigarettes as addictive as smoking?

A: Nicotine is very addictive when combined with other chemicals in tobacco. Pure nicotine replacement therapies, such as nicotine gum, nicotine inhalers or current e-cigarettes, are less addictive.

Q: Can e-cigarettes help smokers quit smoking?

A: There is clear evidence and data that e-cigarettes can help smokers quit smoking.

E-cigarettes induce teenagers? But the number of smokers does decrease

Experiment

For the proposition of “e-cigarettes induce teenagers”, public medicine, government, schools and other parties often use a logic: e-cigarettes contain addictive nicotine, and teenagers will start to smoke cigarettes containing the same nicotine when they are addicted to nicotine.

Some early studies have linked e-cigarettes to traditional tobacco.

For example, in April 2018, a research paper Electronic cigarette use and progression from experimentation to established smoking from the University of California linked “adolescent smoking” with “electronic cigarette use”. In this one-year study, 1295 young people aged 12-17 who had tried cigarettes but smoked no more than 100 cigarettes in total were not considered “traditional smokers”.

The experimental results show that compared with the subjects who have never used electronic cigarettes, the probability of smoking cigarettes among the users of electronic cigarettes is much higher. In the paper, the authors also clearly put forward that this can only show that the “electronic cigarette” and “cigarette” use of teenagers have a “correlation”, but not a “causal relationship”.

According to the study, “shared risk factors” of tobacco use can be attributed to young people smoking electronic cigarettes or between cigarette smoking. For example, in the occasion of drinking, or around friends smoking, will jointly lead to smoking and vaping.

E-cigarettes induce teenagers? But the number of smokers does decrease
Source

Researchers led by Arielle Selya investigated 12000 students in grade 8-10, and designed complex statistical methods to explain the differences among young people, namely the so-called “common risk variables”, such as basic information such as race and gender; more disciplined or adventurous daily behaviors of young people; alcohol use and drug use history; whether received health risk education on tobacco products; whether feel uncomfortable when people around you smoke.

Before controlling these characteristic variables, using electronic cigarette can increase the probability of smoking traditional tobacco by nearly 36 times.

But when the researchers took 14 “common risk variables” into account, the impact disappeared.

E-cigarettes do increase the risk of young people “trying” to smoke, but they don’t end up being regular smokers.

That is to say, vaping and smoking are two parallel states. There is no relationship between them. Whether affected by the environment or for personal reasons, the use groups of e-cigarettes and cigarettes themselves are highly overlapped. Even if there is no electronic cigarette, they still smoke cigarettes.

Arielle Selya’s research questions the previous research. “E-cigarette is the threshold of cigarette entry” is just a fallacy of landslide (using a series of causal inference, but exaggerating the causal strength of each link, and getting unreasonable conclusions).

Many praised the logic and methodology of the study, while others thought it was just another piece of evidence in the growing and conflicting field of e-cigarettes.

 

Limit

Some insiders said that Selya’s research is a very important one using innovative methods.

Dr. Sharon Levy, director of the substance use and addiction program for adolescents at Boston Children’s Hospital, said, “This study uses complex data analysis strategies, but unfortunately, I don’t have much confidence in these findings. Because it doesn’t take into account the basic nature of addiction and epidemics, that is, once people are addicted to a substance, they will try every way to get it and use it. ”

Chadi, a professor at the University of Montreal, also noted that the study used data from 2015-2016. This period has not yet reached the peak of the rapid growth in the use of electronic cigarettes by teenagers. Newer, higher nicotine products such as Juul were only beginning to be widely available then, so today’s same study may show different results.

oday's same study may show different results.

Selya said it was a “major limitation” of her research, and admitted in her paper that the study did not focus on adolescents over time, but relied on them to recall current and previous tobacco use. With the passage of time, it is necessary to carry out more long-term research on adolescents.

This also proves that, in most cases, there are errors and biases in the data statistics and experiments of electronic cigarettes. Selya believes that there is now a “subconscious” phenomenon of regulate e-cigarettes as combustible cigarettes. These efforts are good, but they still have shortcomings.

“The public health community generally believes that e-cigarettes are the starting point of nicotine use and can easily attract new users. But the latest data do not support this hypothesis.

Before we have a more solid understanding of the impact of e-cigarettes, it is very important to delay the formulation of e-cigarettes policy. In fact, excessive restrictions on e-cigarettes may encourage teenagers to smoke cigarettes. ”

 

Teenagers’ addiction

Teenagers' addiction

In every country that strictly limits or even suppresses e-cigarettes, “protecting teenagers” is the primary consideration of multi game.

The adult world is calling for industry standards, corporate responsibility and policy regulation. However, the voice of minors and the methodology that meets the needs of this group are rarely expressed by the media.

First of all, teenagers have the ability of scientific judgment and risk-taking in some degree.

Eliza Shapiro, a senior high school student in New York, spoke on CNN in September, representing some teenagers’ views on the issue of e-cigarettes.

Eliza Shapiro, a senior high school student in New York, spoke on CNN in September, representing some teenagers' views on the issue of e-cigarettes.

She said, “The vast majority of teenagers use e-cigarettes to enjoy the feeling of high concentrations of nicotine. They feel peer pressure and want to look cool. I think most students who use e-cigarettes have heard that e-cigarettes are not good for them, but in fact, young people always take risks to do something unsafe, not only e-cigarettes but also other things.

Young people are always rebellious. The more adults refuse them to do something, the more curious they will be to try.

So how to deal with young people vaping?

Discuss risks with scientific basis and implementation.

It can be compared to sex education: at present, most schools have stopped talking about abstinence to students, instead, they will teach them how to ensure safety and improve risk awareness.

Teenagers respond to real data and science. If you really want young people to take e-cigarettes seriously, officials should listen to science. ”

Teenagers should be protected in society, and they are also being protected from many aspects.

There is less and less room for every generation of teenagers to make mistakes, and the risk cost is higher and higher on their way to adulthood. But the development of science and media has also made these children learn to measure right and wrong and pros and cons earlier.

In addition, behind the use of electronic cigarettes by teenagers, there is a hidden particularity of this group.

behind the use of electronic cigarettes by teenagers, there is a hidden particularity of this group.

Why do teenagers like nicotine?

The classic theory of addiction is based on direct neurobiology, which is often understood as the physiological response brought by brain “reward mechanism“, and it is inevitable.

However, psychologist Bruce Alexander from Vancouver did a classic mouse Park experiment. The mouse is placed in a cage without anything. Give it a cup of pure water and a cup of water with morphine. The mouse will choose to live in a drunken dream.

In another “mouse Eden” cage, there are plenty of cheese and other food, balls for playing, rollers, slides, and many other mouse companions. In the face of the same two glasses of water, the mice in the park will not drink the liquid that makes them addicted to anesthesia, nor will they have excessive symptoms.

"mouse park" cage, there are plenty of cheese and other food, balls for playing,

Alexander was surprised to find that it was not water but cage that decided the mouse not to become addicted.

The same is true for humans.

As a group animal, it is human’s instinct to establish connection, so we are all happy to maintain social relations with others in our daily life. But the trauma, pressure, helplessness and isolation of real life make people rely on other things that can be comforted. It can be tobacco, wine or virtual network.

We need to know that teenagers have had several cases of Internet addiction and game addiction in various countries.

The opposite of addiction is not lucidity, but connection.

This is also another way of thinking about teenagers’ physical and mental health. Those who have become addicted to electronic cigarettes should not only say “no, no” to them, but also think about their real needs in life?

Maybe this is the biggest common risk variable.

E-cigarettes are far less harmful than cigarettes – the unprecedented conviction of the British health expert

According to the Sun on October 30, Professor John Newton, an official of the British Ministry of public health, said that the UK was always convinced of the harm reduction of e-cigarettes. The main culprit of the U.S. epidemic was the illegal products containing THC.

Professor Newton mentioned two figures: 220 people die from cigarettes every day in the UK, while only 200 health problems have been caused by e-cigarettes in the past five years. There is no doubt about the harm reduction of regular e-cigarettes. At present, the real risk of the industry is due to the misunderstanding that people begin to return from e-cigarettes to traditional cigarettes.

The culprit of the electronic atomization epidemic in the United States is gradually becoming clear. According to the latest report from the Centers for Disease Control and Prevention (FDA), at least 84% of the 19 deaths from lung disease have used THC containing products. Dr Anne shuhart, FDA’s chief deputy director, told the media that the data clearly point to products containing THC, not nicotine.

John Newton
Professor John Newton

John Newton is the head of the central and southern region of the Department of public health and a professor at University of Manchester. He pointed out that the outbreak of lung disease in the United States has nothing to do with nicotine e-cigarettes, which have existed in the United States for more than ten years. For regular e-cigarettes, the Department of public health in England has been communicating to the public the results of the study that “e-cigarettes are 95% less harmful than smoking”. Professor Newton said that the UK’s Ministry of public health has always adhered to the concept of “as certain as ever”.

Professor Newton also stressed the importance of buying e-cigarettes through regular channels. Regular e-cigarette products are subject to relevant standards and regulations, and their quality and safety are more guaranteed. Unlike black market products, which cannot be reached due to supervision, they are added at will. For example, the US FDA has issued PMTA certification for new tobacco products, while the UK follows the European Union’s tobacco products directive and is supervised by relevant departments. In countries that have not yet promulgated regulations, there are also top enterprises that independently formulate enterprise standards.

Based on the harm reduction of regular products, Professor Newton suggested that smokers should turn to e-cigarettes completely, and users of e-cigarettes should stop smoking completely. “What we really worry about is that what happened in the United States and other countries made people misunderstand the relative safety of e-cigarettes, and then forced to stop switching to e-cigarettes, or even switch back to traditional cigarettes from using e-cigarettes,” he said. “This is the real risk, because the harm of traditional cigarettes to life is beyond doubt.”.

At present, the UK is the country with the most perfect electronic cigarette control in the world. Health officials in the UK regard e-cigarettes as a safe alternative to traditional cigarettes, an effective way to quit smoking, and set stricter rules. According to the latest report of the Ministry of public health, e-cigarettes help more than 50000 Britons quit smoking every year, and at least 1.3 million people have quit smoking completely due to e-cigarettes.

E-cig report

The UK’s support for e-cigarettes is based on an in-depth study of the harm reduction of e-cigarettes. According to the report of the Ministry of public health, due to the reduction of more than 70 known carcinogenic ingredients in traditional cigarettes, the risk of cancer among vapes is far lower – the potential risk of cancer among vapers is less than 0.5% of that of traditional smokers.

There is a global consensus on the harm reduction of e-cigarettes. The American Cancer Society (ACS) made it clear that scientists are still studying the possible health hazards caused by the long-term use of electronic cigarettes, but it is important that the content of carcinogenic chemicals in the electronic cigarette is far lower than that in the cigarette smoke.

CDC: it is clear that lung disease is not related to nicotine vapes

Dr. Dana Menei Dermann, director of the Centers for Disease Control and prevention,said they have definitely narrowed it down to products that contain THC, which are related to most patients with lung injury. The specific substances have not yet been identified.

Tetrahydrocannabinol is the main psychoactive component of cannabis, and CDC said the products identified were obtained from the streets or other informal sources (such as friends, family or illegal dealers).

Specific chemicals that cause disease and death have not been identified.

But the outbreak has nothing to do with nicotine containing e-cigarettes that have been used in the United States for more than 10 years safely.

The first case appeared at the end of March this year, and, like all other cases, appears to be a sudden lung disease.

Due to the sudden outbreak of the disease, several states in the United States have banned the use of spices in electronic cigarettes and taken urgent action.

The British Department of public health is more concerned that the over reaction to this event seen in the United States and other countries may aggravate people’s misunderstanding of the relative safety of nicotine e-cigarettes, prevent smokers from using e-cigarettes, and may drive smokers who have switched to e-cigarettes back to smoking, which will undoubtedly endanger life and is a real risk.