How does e-cigarette help smoke cessation?

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In early May of this year, with North Carolina suing US e-cigarette giant Juul Labs and accusing the company of deliberately concealing the efficacy and danger of nicotine in its products, the issue of nicotine content once again brought to the public.

According to the content of the indictment, Juul seems to “dilute” the danger of nicotine in its cartridge. Juul’s cartridges are generally strong and addictive, and they are three times stronger than those are allowed to be sold in many countries for all age groups.

However, from the research data released by the American Society of Nicotine and Tobacco Research during the 2019 annual meeting, the conclusion is that the use of Juul cartridges is as effective in reducing specific tobacco-related biomarkers as smoking cessation.

This extends a very important question, “Is it beneficial for traditional smokers to have high concentrations of nicotine?”

Juilli Labs seems to have taken the first step to prove its safety if it is sponsored by Juul Labs and research conducted by third-party research laboratory Celerion Inc. According to published research data, several cancer-related biomarkers have decreased dramatically since the switch from traditional cigarettes to Juul just for few days.

The study of 90 adult smokers looked for changes in baseline in nine short-term cancer-associated biomarkers that were the result of burning traditional cigarettes.

Study participants were divided into 6 different randomized groups of 15 people each for a five-day hospitalization trial. Among them, members of the four groups switched from smoking traditional cigarettes to Juul cartridges with four different flavors and 50 mg strength. In the remaining two groups, one group must continue to smoke cigarettes, and the other group is forced to quit.

The study found that 9 selected biomarkers were reduced by 85% compared to baseline in the forced smoking and Juul groups. But these biomarkers have soared 14% in traditional cigarettes.

Therefore Juul Labs believes that Juul is a more effective aid to smoking cessation than traditional cigarettes. In addition, the results were confirmed in a study published in the New England Journal of Medicine in January. Among them, the smoking cessation effect of e-cigarette is almost twice that of nicotine gum.

The Cochrane review study used the best way to quit smoking with NRT (nicotine replacement therapy) and found three ways to use more nicotine:

1. Use two forms of NRT instead of one. NRT comes in many forms: skin patches, chewing gum, nasal and oral sprays, inhalers and throat tablets. There is high-quality evidence that adherence to patches and the use of another form of NRT, such as chewing gum, can increase the chances of quitting.

2. Start using NRT before quitting smoking. People usually start using NRT on the day they quit smoking. But when they started using NRT while they were smoking a few weeks ago, it might help more people to quit smoking.

3. High doses of NRT may help some people. Some NRTs release higher levels of nicotine than others. In the review study, people who used 4 mg of nicotine gum were more likely to quit than those who used 2 mg of nicotine chewing gum. High doses of nicotine may be especially helpful for people who smoke more, for example, people who smoke more than 20 cigarettes a day. There is evidence that using a 21 mg or 25 mg patch may increase the chances of quitting smoking compared to using a 14 mg or 15 mg patch.

The problem, however, is that when nicotine is passed through traditional cigarettes, it is considered one of the most addictive substances on the planet, so it seems strange that people should suck more, not less, to quit. For this, the Cochrane review also gives an explanation.

There are a few good reasons why using nicotine in these ways can solve the problem, not cause it.

First, smokers find smoking to be enjoyable because the nicotine in cigarettes releases the brain with dopamine, a “happy” hormone. The brain is used to this, so when a smoker has not smoked for a while, they will begin to experience some unpleasant symptoms such as addiction, sleep problems, and mood changes.

NRT provides another source of nicotine to the brain that can alleviate these symptoms. When using NRT before quitting smoking, the brain receptors are already full of nicotine when people smoke. Therefore, smokers cannot get the usual pleasure from smoking, which helps to break the link between smoking and feeling good.

Second, NRT replaced the harmful nicotine delivery method in a safe way. Some people may worry that eating more nicotine can cause side effects. Fortunately, NRT is considered safe, and this review has not found any evidence that an overdose of nicotine may occur if NRT is used as indicated. The danger of combustible cigarettes is because they contain many harmful chemicals. However, these substances are not present in NRT.

Third, NRT is not as addictive as smoking. Some people are worried about being addicted to NRT. But the way nicotine is obtained through traditional cigarettes makes them more addictive than NRT. Cigarettes deliver nicotine to the brain at an extremely fast rate and are delivered along with other chemicals that increase the stimulation of the brain by nicotine.

It can be seen that nicotine is much slower to pass from the NRT to the brain than traditional cigarettes. Without these extra chemicals, smokers will not feel the same pleasure when using NRT. This also makes NRT less addictive.

In 1976, the famous professor Mike Russell once wrote: “People smoke for the nicotine, but they die from the tar.” But e-cigarettes do not contain tar and carbon monoxide, and there is no chemical produced after burning. In some ways, Electronic cigarettes are comparable in nature to NRT products.

However, benefits are often accompanied by risks. Even if research confirms that high concentrations of nicotine may help smokers, must also remind everyone who is not smoking:

Nicotine can be addictive or dependent, and it is often difficult to restrain yourself. Reusing nicotine also increases heart speed and raises blood pressure and reduces appetite. Large doses of nicotine can cause vomiting and nausea.

Nicotine contained in a cigarette can poison a mouse, and nicotine in 20 cigarettes can poison a cow. If a person consumes nicotine in large quantities (50 to 70 mg, equivalent to the nicotine content of 40 to 60 cigarettes), it is likely to cause death. If a cigar or three cigarettes of nicotine are injected into a person’s vein for 3 to 5 minutes, they can die.

Therefore, from the above research conclusions, although high concentrations of nicotine have been proven to help smokers away from traditional tobacco products, do not agree to promote the benefits of high-concentration nicotine e-cigarettes without control measures.

After all, the social properties of e-cigarettes are far greater than the general NRT products on the market. For many teenagers, e-cigarettes are even packaged as representative of fashion, personalization, and freshness. If adolescents and non-smokers try just for once, it is easy to get addicted to e-cigarettes, and then become a loyal user, then this is contrary to the true value of e-cigarettes.

At present, Chinese domestic e-cigarette companies continue to innovate on nicotine technology, from the early nicotine smoke oil to the later nicotine salt, and then to the HINs natural compound nicotine technology released by bink a few days ago. All efforts are made for the more effective intake of nicotine.

Japan and South Korea banned nicotine in e-cigarettes, which has also led to the development of 0 nicotine content products by related companies. At present, it has also made great breakthroughs, such as the “Essence” ESUN S “Chuanbeiyu” cartridge. It does not contain nicotine, but it can completely replace nicotine in terms of easing cigarette addiction and throat hit.

Perhaps in the next few years, e-cigarettes will eventually evolve into nicotine-free products that truly become “healthy products.”

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