Nicotine addiction

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The May 2 editorial on proposed Food and Drug Administration regulations for e-cigarettes (“FDA’s Spark”) outlined reasons to limit such use among minors. Such rules are long overdue, and further rules may be warranted once more research has been done on the risks and other effects of e-cigarettes.

However, incorrect was the statement, “nicotine is addictive no matter how it is delivered.” This is not true, as clearly shown by lack of addiction to nicotine that is delivered by the patch and other FDA-approved nicotine replacement products to treat tobacco dependence. These products administer nicotine slowly and gradually to relieve tobacco withdrawal, taking many minutes (or even a few hours with the patch) to have much effect. This is in very sharp contrast to the 20 seconds it takes for tobacco smoking to deliver nicotine to the brain, which mostly accounts for why nicotine via smoking does produce such high risk of addiction.

The speed, amounts and other characteristics of nicotine delivery from e-cigarettes are not clearly known and may vary by the brand used. Yet the absence of the thousands of other constituents in tobacco smoke likely reduces most of the harm from vaping e-cigarettes. How much harm is reduced and whether e-cigarettes may help tobacco-dependent adults quit smoking remain to be determined in controlled research.

Professor of Psychiatry
University of Pittsburgh

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