>How come some people get lung / throat cancer after barely smoking/ vaping, but my uncle Scott has smoked for like 60 years and is seemingly invincible?

Uncle Scott won the genetic lottery! 50% of people who smoke will die from a smoking related cause. 80-90% of lung cancer is related to smoking.

Is it known what percentage of cravings a person has in a typical day for tobacco is the result of actual withdrawal vs habit?

>Hello! How unhealthy are nicopods? They're these nicotine pouches that you put under your upper lip. Usually the substance in the pouch is just glucose powder, sometimes with a flavour but usually flavourless. + The nicotine of course.

We answered a similar question above: https://www.reddit.com/r/IAmA/comments/10jkffc/comment/j5ld6ug/?utm_source=share&utm_medium=web2x&context=3

>What's inherently so bad about nicotine? Yes it's toxic but so is caffeine. Why don't we have nicotine drinks or something similar to wean people off nicotine in a slow controlled manner?

Copying part of our response above: you are right that there is little and inconsistent evidence for long-term harm from low doses of nicotine in adults. However, nicotine can be especially harmful for the developing brain (which includes young people and the developing fetus). The biology of nicotine dependence is different from caffeine. Brain changes from nicotine are larger than from caffeine. Nicotine replacement therapies (such as patch, gum) help people wean off nicotine in a slow and controlled manner. A nicotine drink is an interesting idea!

>2 questions: first, is nicotine inherently harmful? Second, a light smoker is considered someone who smokes less than 10 per day, is there research on people who smoke even less than this, e.g. "socially?"

Copying part of our response above, there is little and inconsistent evidence for long-term harm from low doses of nicotine in adults. Nicotine - including nicotine from gum - can be harmful for the developing brain, which includes young and pregnant people. For your second question, yes there has been research focused on light, intermittent smokers, sometimes called ”chippers” in our field. Check out some of the research by Saul Shiffman.

Thanks for your response!

>What are your views on tobacco-free nicotine pouches (e.g., On!)? I quit smoking 8 years ago by switching to nicotine pouches, but I am admittedly completely addicted to these and go through a pack a day. I imagine these are safer than regular cigarettes but there is still a risk element to them.

These products are new to the market and there is still a lot of work that needs to be done. Some of that work is being done here at Brown! Preliminary findings show that it is a helpful and acceptable alternative for adults who smoke combustible cigarettes and have not otherwise been able to quit. The few studies that have been conducted on nicotine pouches have found far fewer cancer-causing chemicals compared to other tobacco products like snus but the short- and long-term effects of nicotine pouches aren’t clear.

Thanks for the information! I will look into this.

>I saw you mention in another comment that vape/e-cigs are "less harmful" than smoking? Did I get that right? Can you provide me verifiable information on this? I've smoked on and off for years, and frankly of all the addictions I've quit in my life, nicotine is the hardest. I've been sceptical of vape, because of its relative newness. But the times that I turned to vape, it definitely made my lungs feel "better", relatively to smoking.
>
>If I was confident in its safety, I would definitely return to it as an alternative.

Current research shows that e-cigarettes, especially newer generations, contain less harmful chemicals than combustible cigarettes. However, we do not know the long-term effects of e-cigarettes on health (they’ve only been around since 2007 and issues could take longer to show up). Those who regularly smoke cigarettes and switch to e-cigarettes (even partially) are more likely to quit smoking altogether and have fewer cancer-causing chemicals in their blood. A lot of recent research has been summarized in a recent paper: https://doi.org/10.1186/s12931-021-01737-5 . But this field is changing quickly as we learn more so it’s important to stay vigilant!

Hello! How unhealthy are nicopods? They're these nicotine pouches that you put under your upper lip. Usually the substance in the pouch is just glucose powder, sometimes with a flavour but usually flavourless. + The nicotine of course.

What is considered a low dose?

>I've found that nicotine patches provide a kind of topical anti-inflammatory function. I use them on my knee when it gets sore and it works like a charm.
>
>Is there any evidence that would support this concept?

Nicotine can be anti-inflammatory in some situations, but it can also make things worse in other situations (especially oral inflammation). It’s always important to weigh the beneficial and harmful effects in a conversation with your medical provider.

>I've finally quit nicotine after 5 years of vaping. After being clean for over a month, I still get random and intense cravings for nicotine. Is there any data on how long it will take before these cravings completely go away?

Great question and congratulations on quitting! Craving and other withdrawal symptoms typically peak on the 3rd day and then stay high for 3-4 weeks before starting to taper off. However, it can persist for longer periods of time. For people who experience cravings for a longer time, nicotine replacement products can help people stay quit during difficult times.

What's inherently so bad about nicotine? Yes it's toxic but so is caffeine. Why don't we have nicotine drinks or something similar to wean people off nicotine in a slow controlled manner?

How come some people get lung / throat cancer after barely smoking/ vaping, but my uncle Scott has smoked for like 60 years and is seemingly invincible?

2 questions: first, is nicotine inherently harmful? Second, a light smoker is considered someone who smokes less than 10 per day, is there research on people who smoke even less than this, e.g. "socially?"

>There's been a few studies about the benefits nicotine can have for dopamine related conditions like
>
>ADHD
>
> and
>
>Parkinson's
>
>. Do you think there's a possibility that the benefits of just nicotine (not tobacco) could outweigh the negatives for these kinds of conditions? How do the costs and benefits of nicotine compare to costs and benefits of drugs like adderall and L-Dopa?

Caveat, the people answering in the room are not experts in ADHD or Parkinson’s and their relationship to smoking. We will try to track down better answers later and respond directly.

Our initial thoughts are that nicotine has similar properties to stimulant medications, like Adderall. Stimulants can actually help smokers with ADHD quit smoking. Research on costs and benefits can be challenging because of the healthcare system and due to ethical considerations (if you have a medication that works you would need a good reason to give someone nicotine instead in a drug trial).

>It's often said that smoking relieves stress, is this true? What factors make it so difficult to quit smoking other than addiction?

This is a great question! Stress relief is one of the main reasons people continue to smoke. On the other hand, nicotine is a stimulant that actually increases how “activated” your body is. In other words, it can relieve stress in the short term, but long term use can increase stress (which is one of the reasons it is related to anxiety and depression). There are a lot of things that can make quitting difficult. Craving, stressors, reminders in your everyday life, habit, routine, having a partner/peers/family member who smokes, loneliness, and smoking to cope with other challenges can all make quitting more difficult.

I saw you mention in another comment that vape/e-cigs are "less harmful" than smoking? Did I get that right? Can you provide me verifiable information on this? I've smoked on and off for years, and frankly of all the addictions I've quit in my life, nicotine is the hardest. I've been sceptical of vape, because of its relative newness. But the times that I turned to vape, it definitely made my lungs feel "better", relatively to smoking.

If I was confident in its safety, I would definitely return to it as an alternative.

What are your views on tobacco-free nicotine pouches (e.g., On!)? I quit smoking 8 years ago by switching to nicotine pouches, but I am admittedly completely addicted to these and go through a pack a day. I imagine these are safer than regular cigarettes but there is still a risk element to them.

I've found that nicotine patches provide a kind of topical anti-inflammatory function. I use them on my knee when it gets sore and it works like a charm.

Is there any evidence that would support this concept?

I've finally quit nicotine after 5 years of vaping. After being clean for over a month, I still get random and intense cravings for nicotine. Is there any data on how long it will take before these cravings completely go away?

>I (M58) and I'll have stopped smoking 3 years ago in the summer after 40 years of 20ish a day habit. I do still use nic salt vapes.
>
>Does the effect\damage of smoking stay with me (and my lungs) for life?

Congratulations on 3 years of staying quit! Your lungs begin to heal and improvements can be seen as soon as a few weeks after quitting. 20 years after quitting, the risk for most cancers in former smokers is equal to the risk for cancer in people who have never smoked.

>Thank you for replying back to my question. I never heard of Varenicline before. What exactly does it do and how does someone go about getting it? The family member in question is afraid of trying new products. Which method would be easiest to attempt for someone who is so used to smoking cigarettes?

Varenicline (aka CHANTIX) is a prescription medication that must be obtained from a licensed healthcare provider. It temporarily blocks craving for nicotine but it does have side effects. It is most effective when paired with counseling. Nicotine Replacement Therapy (such as gum, patches) can be a good first step for people who do not feel comfortable consulting a doctor. There is a growing body of research on combining Varenicline + nicotine replacement therapy but it’s too early to say if the combination is better.

>Now that nicotine and smoking are declining, has lung cancer dropped in a similar rate?
>
>I heard from a cancer nurse HPV is now one of the suspected causes of lung, but especially throat, mouth cancers that used to be blamed on tobacco.

Smoking and lung cancer rates are declining. Some but not all of the decline in cancer rates is likely due to smoking. However, some groups of people, such as women and some racial/ethnic groups (e.g., Black/African Americans), still have high rates. Smoking is still the number one cause of preventable disease and death in the US (450,000 last year). 80-90% of lung cancer deaths are attributable to smoking.