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.