Tuesday 11 June 2013

Doctors Confused About Nicotine

Via Nursing in Practice comes this quite shocking revelation.
A survey of GPs has revealed some falsely believe one of the greatest health risks from smoking is nicotine. 
Nicotine is the addictive component of tobacco smoke, but unlike some other constituents of tobacco smoke, it is not carcinogenic (cancer-causing) and according to the Royal College of Physicians (RCP) 'medicinal nicotine is a very safe drug.' 
The majority of survey respondents (96% UK, 98% Sweden) said that they regularly discussed smoking cessation with their patients, but less than half believe that long-term nicotine replacement therapy (NRT) is preferable to smoking (31% UK, 48% Sweden). 
The survey findings show that a substantial proportion of GPs (40%) believe nicotine to be the first or second riskiest component of cigarettes, incorrectly identifying it as more harmful than smoke. 
Many (44% UK, 56% Sweden) also wrongly believe that nicotine in tobacco products is associated with cancer, while 15% in the UK and 22% in Sweden believe the same for pharmaceutical nicotine.
One wonders who they must be listening to, because it doesn't appear to be the RCP.
"Nicotine itself is not a particularly hazardous drug," says Professor John Britton, who leads the tobacco advisory group for the Royal College of Physicians.
Nor does it seem to be ASH.
In 1976 Professor Michael Russell wrote: “People smoke for nicotine but they die from the tar.” Indeed, the harm from smoking is caused almost exclusively by toxins present in tobacco released through combustion. By contrast, pure nicotine products, although addictive, are considerably less harmful. Electronic cigarettes consequently represent a safer alternative to cigarettes for smokers who are unable or unwilling to stop using nicotine.
Their thinking is also not in accordance with guidance from NICE.
Prof Kelly added that the guidance endorses cutting down on smoking with the help of licensed nicotine products such as patches and gum to help reduce the harm caused by tobacco. 
He pointed out that while nicotine is a 'relatively harmless' substance, there is a lack of clarity over the safety of nicotine replacement therapy (NRT) and what substance actually causes death. 
the guidance from the National Institute for Health and Care Excellence  says doctors seeking to help smokers can advise ‘these products (e-cigs) are likely to be less harmful than cigarettes’. 
Professor Aveyard said he will tell patients that using e-cigarettes is ‘better than smoking.'
Remember, then, that next time some GP harangues you about smoking (or even e-cig use), he might not have the first clue what he is talking about and could be just reacting to confused messages being delivered by idiot politicians and their civil service arm-benders.

The only question remaining is who has led idiot politicians and their civil service arm-benders to produce such confused messages in the first place. Could it be that the past decade avalanche of anti-smoking denormalisation tactics has convinced doctors that anything contained in a cigarette is on the same danger level as the black death?

Well, yeah. That's about the sum of it.


SteveW said...

Attempting to correct others' misconceptions about tobacco smoke, whilst ignoring the plethora of TSNAs and stating that "...Nicotine is the addictive component of tobacco smoke..." has a little bit of a delicious taste to it :-)

Good job we've dumbed education down so much that most will just swallow this pigswill wholesale.

JonathanBagley said...

The results from Sweden are very hard top believe. It is common knowledge there that snus is virtually harmless and contains a whopping dose of nicotine. Swedish GPs advise smokers to switch to snus.

Rursus said...

This will fit perfectly to put this mosaic together stone by stone:

"In conclusion, our study does not indicate any harmful effect of nicotine when given in its pure form by inhalation."

"Waldum HL, et al.: Long-term effects of inhaled nicotine. (1996) [Life Sci. 58:1339-1346.]"


SteveW said...

Nice link Rursus - I don't suppose you have a copy of the full paper by any chance?

Dick_Puddlecote said...

The tobacco control industry try to claim that this has nothing to do with snus and, even if it did, that it would not be replicated elsewhere because Sweden is unique, apparently.

SteveW said...

I'm given to believe that doctors in this country no longer take the Hippocratic oath.

Tom Phillips said...

The amount of simplistic advice we get every day makes it hard to understand the real situation. One day I read that product X is bad for you in one area of your health and the next that product X is actually good for you in another.
So smoking is bad for you but nicotine itself is good now?

Bemused said...

True. It's optional.