Thread

People hooked on vapes try a new way to quit: cigarettes

248 points · 335 comments · alephnerd

sph · 1790065032 · focus · HN ↗
For the past 3 years I have replaced my ADHD stimulant medication with nicotine patches and they’ve been great, cheap, and legal in the country I live in now.
Recently I got the urge to try vaping again, bought all the paraphernalia and started vaping like a chimney 24/7. Got light nicotine poisoning as well. After two days, I caught myself compulsively reaching for the vape.
So I threw everything away and I’m back to patches. Took me a week to forget the compulsive hand-to-mouth urge. I now believe intradermal nicotine is the superior method of administration. At least with cigarettes the smoke is such an intense irritant you self-regulate pretty quickly compared to a cupcake flavoured vape you can just suck on all day long.
1. Melatonic · 1790066341 · focus · HN ↗
  Isn't that way shorter acting ?
  1. sph · 1790069354 · focus · HN ↗
    What is?
  2. thfuran · 1790117517 · focus · HN ↗
    And carcinogenic
    lunchbucket · 1790185753 · focus · HN ↗
    Nicotine is not carcinogenic and neither are nicotine products like patches or gum. Nicotine products are distinct from tobacco products, and tobacco contains a lot more than nicotine, and that cocktail is both carcinogenic and more addictive. That's why nicotine products are used for nicotine cessation, they are strictly less harmful and easier to quit. (That doesn't make nicotine safe but it's in an entirely different league than tobacco. Nicotine products almost certainly won't be the reason you die, whereas tobacco products often are.)
    thfuran · 1790189159 · focus · HN ↗
    I don’t really know anything about the field other than having heard somewhere over a decade ago of a then-recent study showing that it is in and of itself carcinogenic, but it seems like nicotine and several metabolites have various cancer-promoting properties: <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4363846/" rel="nofollow">https://pmc.ncbi.nlm.nih.gov/articles/PMC4363846/
    But yes, it’s certainly less bad than getting the same amount of nicotine by smoking tobacco.
    [deleted] · 1790594685 · focus · HN ↗
    [deleted]
    lunchbucket · 1790594911 · focus · HN ↗
    Totally true. But the bottom line is that one of these things kills you and the other doesn't. That doesn't mean it's safe but I do think it is important not to imply they are equally harmful or that nicotine products are carcinogenic. Nicotine isn't carcinogenic and they are not in the same ballpark of harm.
2. dasKrokodil · 1790070236 · focus · HN ↗
  > At least with cigarettes the smoke is such an intense irritant you self-regulate pretty quickly compared to a cupcake flavoured vape you can just suck on all day long.
  In my experience: no, you don't. You just arrange your life around the fact that you need to smoke all the time.
  1. nom · 1790084990 · focus · HN ↗
    it also stops being unpleasant once your brain has associated it deeply with the dopamine
    if anything, the strong smell and taste sensations makes it even more addictive
  2. sph · 1790101530 · focus · HN ↗
    I've been a heavy cigarette smoker for 12 years (pack a day min.). When I switched to vaping, I vaped continuously the entire day.
    There is no human on earth that can smoke continuously the entire day for very long. A pack a day smoker means smoking one every ~30 minutes circa.
    AngryData · 1790109464 · focus · HN ↗
    I don't know how they did it but 50 years ago some people did seem to smoke non-stop. Of course they were still an exception. Of course when they cigarettes were dirt cheap you could let atleast a few burn up with just a puff or two off it also. These days they are so expensive from taxes that setting it down and breathing for a second instead of smoking can feel like burning money.
    gerdesj · 1790116507 · focus · HN ↗
    I'm 55 (UK) and recall the '70s. Loads of people were hardened chain smokers, including my Dad back then and on through to the early noughties. Chain smoking was not an exception at all but it was a dying habit and did trail away. I can remember filling cups with fags for parties to intersperse with the nibbles - you could reach for a handful of crisps or light up or both at the same time. They looked lovely next to the pineapple and cheese hedgehog (you'll have to look that one up!)
    He'd go through something like 80 Embassy back then, a day. He gave up in 1984ish and is still trundling along. His Dad died at age 60 of lung cancer.
    I gave up about eight years ago after 30 odd years at roughly 20 a day. I definitely did some damage and will eventually have to find out how much. I don't have a near permanent cough and at least five major bouts of 'flu per year anymore. I did have a short bout of Covid in 2021 and I suspect it might have been really nasty if I was still a smoker then.
    cgio · 1790117906 · focus · HN ↗
    There was a rumour/some basic statistics that smokers were at more risk in bad cases of Covid but nevertheless were proportionally less likely to have heavy Covid.
    paulpauper · 1790126135 · focus · HN ↗
    Smoking was so huge in Britain. People think smoking was big in America, but the UK it's like a culture in and of itself
    vonunov · 1790133057 · focus · HN ↗
    But not in America? I mean, we have our little smoker subculture with at least some semblance of etiquette and shibboleths, and the protocols for bumming a cig (ideally, ask to buy one instead, whereupon the other party should just give you one, unless they're nearly out), and so on. We had ashtrays at the ends of the aisles in the grocery store, and restaurant hostesses asking us "smoking or non?" and bringing us ashtrays. People at work grumbling about smokers getting extra breaks all the time, and the smokers for their part having to hike to the smoking area (or enclosure, even). Common memories of the strange experience of being sent to the corner store at a one-digit age to buy a pack for someone. I'm sure that's not all there is to it but I can't think of anything else at the moment. Anyway, what are we missing? I think I sound a little bit defensive about whether America has a significant smoking culture, but I'm just curious.
    RugnirViking · 1790158760 · focus · HN ↗
    for what its worth, I was amazed when I moved from the UK to denmark that young people smoked in denmark. For me it was a thing for old people, mostly due to the price I suspect. It just wasn't cool - although vaping has changed both of these since I left, by my understanding
    [deleted] · 1790152977 · focus · HN ↗
    [deleted]
    saulpw · 1790109832 · focus · HN ↗
    John Wayne is said to have chain-smoked 5-7 packs a day? If you can smoke a cigarette every ~30 mins, that's 2/hour (actually about 1.5 packs/day), but if a cigarette takes 10 minutes to smoke and you chain-smoke, that's 6/hour (4.5 packs/day). So it's doable but John Wayne was significantly out of breath the last 10+ years of his life, perhaps from having an entire lung removed.
    dmix · 1790110459 · focus · HN ↗
    Lucille Ball's voice changed dramatically over the course of the 6yr show from heavy smoking. Their show was sponsored by cigarette companies and she used to hand out cigarettes on a platter to guest when they came over to her house.
    shipman05 · 1790121887 · focus · HN ↗
    I went to a Black Keys concert in 2007 or so that was sponsored by Camel cigarettes and they were giving out free packs of their newest variety at the door.
    caymanjim · 1790112059 · focus · HN ↗
    A lifelong chain smoker will smoke a cigarette in 1-2 minutes and light up another. 3-5 minutes is a relaxed casual smoke. Cigarettes were modified a decade or so ago to ensure that they go out quickly if not actively smoked. It's not even possible anymore to keep a cigarette burning for long enough for it to take 10 minutes.
    This is all pedantic. The point is that you can chain smoke quite a lot if you're dedicated. I've never met anyone who smoked more than two packs a day regularly or maybe three on a crazy night out of drinking and smoking. 4-5 is crazy.
    paulpauper · 1790126083 · focus · HN ↗
    had one lung removed, and the other was probably close to worthless from smoking
    xoxxala · 1790121606 · focus · HN ↗
    My step-father’s parents smoked a carton a day. Each. They started smoking before breakfast and stopped just before sleep. Their trailer home had a 2-3’ cloud of haze below the ceiling and every surface was sticky. I’m not how many years they smoked like that, but probably decades.
    As a kid, I could not breathe in there. This would have been late 70s. No way they could have afforded that habit at today’s prices.
    486sx33 · 1790125740 · focus · HN ↗
    [dead]
    paulpauper · 1790126045 · focus · HN ↗
    That is crazy. How long did they live? It would be fascinating if someone could live a long life despite smoking so much
    xoxxala · 1790128088 · focus · HN ↗
    Mid to late 70s? Their last years were nothing but medical issues (from the smoking, plus excessive drinking) and poor health. Certainly kept me from starting to smoke.
    userbinator · 1790131060 · focus · HN ↗
    It would be fascinating if someone could live a long life despite smoking so much
    Genetic variation probably has a bigger role than we'd like to admit. There are definitely outliers. I know smokers who lived into their 90s, and non-smokers who died much younger. The sibling comment says they lived into their 70s, which is probably average.
    ...and then there's <a href="https://en.wikipedia.org/wiki/Jeanne_Calment#Health_and_lifestyle" rel="nofollow">https://en.wikipedia.org/wiki/Jeanne_Calment#Health_and_life...
    Calment continued smoking in her elderly years until she was 117
    lloeki · 1790147074 · focus · HN ↗
    > I know smokers who lived into their 90s, and non-smokers who died much younger
    I hate this anecdata. I do know these too.
    But statistics don't lie. The odd outlier is not relevant. How many times can you roll the dice and win the saving throw? Smoking kills, and when it doesn't it destroys well-being.
    Even without the health issues smokers becoming absolute pricks because they didn't get their fix. Or how much imposing their cloud of ash is invasive, even in open air. Did you know that parents going outside to smoke in front of the door thinking of their child is mostly a feel-good thing? The minimal distance to not impact the child is 10m from outside walls, and that's not counting the nicotine and ash that permeates the skin and clothing, which gets ingested in the next hug or three, leading to significant amounts of nicotine being found in children hair.
    I know, I've been there, I've been that guy. Stressing out because I had only two left in the pack on a Sunday. Rushing to buy a pack before the shop closes like my life depended on it. Snapping out when the effect wears off. Leaving the table at restaurants to get my fix. Barely able to get through an entire movie at the cinema, and as soon as credits roll, get out and immediately swallow an entire cigarette in under a minute.
    Now that I'm out of it I can see the absolutely disrespectful behaviour, and in a way I understand because I've been there, I've been the addict that can't see how I harm not just me but others too. I've been the addict that keeps the blindfold of denial so that I could continue satisfying my craving.
    And now life is _so much_ better without it. Much better energy, focus, willpower, and freedom.
    There is _nothing_ positive about smoking. It's death in a tube, plain and simple.
    bluecheese452 · 1790162873 · focus · HN ↗
    The data is pretty clear. The existence of outliers does not change this.
    rsynnott · 1790169054 · focus · HN ↗
    Well, I mean, context:
    > Her husband introduced her to smoking, offering cigarettes[5]: 4–21 after meals, but she did not smoke outside these post-meal occasions.
    Having a cigarette after meals is less than ideal of course, but it's not like it's a pack-a-day habit.
    gaigalas · 1790132672 · focus · HN ↗
    2-pack-a-day smoker here (~40 cigs per day), for over 10 years (twice that if you consider the time I was 1 pack or less a day).
    I stopped smoking and started vaping for a while (~1.5 years) and went back to smoking after some bad vape experiences. At some point, even the smell of the liquid would cause me nausea.
    My health is surprisingly good despite the habit. I walk every day, and I can do longer cardio without loosing breath or feeling tired. I'm either lucky or sitting on some ticking time bomb that went unnoticed so far.
    I definitely recommend not starting on either though.
    tonyarkles · 1790136614 · focus · HN ↗
    My sister-in-law was so upset when we ran a 10K together, I beat her by 5 or 6 minutes, and when she found me at the finish line I was having a smoke.
    Genetic lottery for sure. I’m still quitting but it’s not really because of acute or chronic health problems, mostly cost and being tired of stinking all the time.
    jghn · 1790124469 · focus · HN ↗
    > There is no human on earth that can smoke continuously the entire day for very long
    Out of curiosity how old are you? I remember plenty of places in my younger days where it was commonplace for people to light up their next cig off of their current one pretty much nonstop
    paulpauper · 1790126011 · focus · HN ↗
    It's just lighting and inhaling. It does not take any extra time
    lunchbucket · 1790141440 · focus · HN ↗
    I'm sure some people acclimate to it but if you give it a try I think you'll find first your throat will get burned, then you'll start to cough more and more, and eventually you'll throw up. And I think GP was suggesting that, beyond acclimating, there's also other demands on your time and you usually can't smoke through them all.
3. cucumber3732842 · 1790083559 · focus · HN ↗
  >For the past 3 years I have replaced my ADHD stimulant medication with nicotine patches
  My first thought was "That's a no brainer why didn't I think of that".
  Then I remembered that I grew up during peak anti-smoking and so they made nicotine out to be some sort of borderline meth boogeyman rather than just extra addictive extra effective caffeine that comes in bad for your health form factors and that all that propaganda got sent straight to long term memory and I was indoctrinated by it at such a young age it didn't even occur to me to think outside the box like that.
  Nicotine patches are expensive for what they are but they're basically free compared to meds.
  1. sph · 1790101941 · focus · HN ↗
    It's two very touchy subjects: nicotine and ADHD. I'm not fond to talk about it because misinformation and ignorance is just rampant. Nicotine has indeed been turned into the boogeyman.
    Anyway, I told my psych about my plan, and he agreed there is research indicating nicotine works as a third-line stimulant medication for ADHD. In many modern, Western countries adult ADHD is not even recognized, let alone medicated, so one has to make do with what's available.
    In my experience it is almost as effective as amphetamines, with fewer side effects, much longer lasting (a patch lasts 16+ hours), and very cheap - if you get them on ebay from China. Addiction potential is null: addiction is a function of how quickly the effect peaks, and it takes 3 hours. Not even lisdexamfetamine can compare with how unaddictive patches are.
    That said, if I had access to prescription amphetamines, I'd go back to them, but I sure don't miss the days all it did was making me incredibly horny and focused scrolling social media all day long. It was a little too effective at keeping me engaged for my own good, so using a subpar medication means learning to live with ADHD, adjusting your life around your own quirk, rather than only relying on the medication to fix everything for you.
    fsiefken · 1790108576 · focus · HN ↗
    as a medication alternative there's saffron, which also helps (not as good)
    Phemist · 1790108612 · focus · HN ↗
    Did you read gwerns post on it by any chance?
    <a href="https://gwern.net/nicotine" rel="nofollow">https://gwern.net/nicotine
    sph · 1790148205 · focus · HN ↗
    I did, I mostly agree. They certainly don’t paint nicotine as the loathsome, terrifying substance everyone believes it to be. It’s a mildly addictive stimulant just a bit more toxic than caffeine.
    ravenstine · 1790116954 · focus · HN ↗
    I've come to a similar conclusion.
    On one hand, yes, nicotine in many ways does deserve the reputation it's received. Then again, a lot of the blame should go more towards smoking rather than nicotine the substance.
    Nicotine is highly addictive, but as you mentioned, the delivery method plays a huge role in its addictive potential, and most people don't realize this. The chances that you'll become addicted to patches is incredibly low. If they were that addictive, then they'd likely be way more effective in helping people quit smoking; in reality, it's somewhere between 10 and 20 percent of patch users who successfully end up quitting smoking that way. Even with the highest dose patches, the addiction potential is still relatively low because the patches release the nicotine over a very long period of time and make it difficult or impossible to associate the use of the substance with a ritualistic activity like lighting and puffing on a cigarette.
    And yeah, it's not a subject you can really bring up with anyone besides recreational drug users. Very few will be receptive to the idea that nicotine has legitimate uses and can be used without getting addicted.
  2. huurtehoog · 1790116147 · focus · HN ↗
    > rather than just extra addictive extra effective caffeine
    That is a severe understatement. Nicotine is consistently ranked as one of the most addictive drugs, near cocaine and heroin.
    Only about 6% nicotine users manage to quit every year.
    <a href="https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/nicotine-addictive" rel="nofollow">https://nida.nih.gov/publications/research-reports/tobacco-n...
    simoncion · 1790123817 · focus · HN ↗
    You:
    Only about 6% nicotine users manage to quit every year.
    Your linked article:
    Yet, only about 6 percent of smokers are able to quit in a given year.
    Other than when it talks about prescription smoking cessation tools, the article does not mention anything other than tobacco smokers. The last paragraph of the article actually discusses the observation that the ritual of smoking often provides substantial behavioral reinforcement to the smoker who is attempting to quit smoking.
    I also note that I was able to quit nicotine cold-turkey after smoking cigarettes for two years. I've never been able to quit caffeine... and -although it is notably shorter in duration- caffeine withdrawal is WAY worse than nicotine withdrawal.
    huurtehoog · 1790158235 · focus · HN ↗
    Thank you for checking the source. Celebrating that is more important than me being right so kudos.
    If we're going by anecdote I know way more people who quit caffeine than nicotine.
    simoncion · 1790232971 · focus · HN ↗
    > If we're going by anecdote I know...
    Given how sloppy you were with the article you implicitly claimed to have read, I have zero confidence in the accuracy of your anecdotes.
    > Thank you for checking the source.
    Respectfully, why the hell didn't you check it? It's only a couple of pages long. Did you do something dreadfully silly like employ some LLM to "assist" you with your conversation?
    astura · 1790158081 · focus · HN ↗
    It might be addicting, but it's still overcomable, since 2002 there's more former smokers in the US than active smokers. 66% of all Americans who have ever smoked have successfully quit.
  3. JauntTrooper · 1790117385 · focus · HN ↗
    Nicotine isn't just 'extra effective caffeine.'
    The research seems to indicate it's a cancer accelerant -- it doesn't cause cancer directly, but it promotes the growth and spread of existing tumors.
    Studies suggest it does this through several pathways including:
    (a) preventing cancer cells from self-destructing (b) making tumor cells divide more quickly (c) stimulating the growth of new blood vessels in and around tumors, helping them grow; and (d) helping cancer cells metastasize more easily by increasing mobility via epithelial-mesenchymal transition.
    It also lowers the effectiveness of chemo and radiotherapy.
    Admittedly, most of these are animal/lab studies, in part because it's hard to design a good study in humans since so many patients also use/used cigarettes and vapes, which confounds the results. Still, there's enough evidence out there to be cautious.
4. snarfy · 1790109057 · focus · HN ↗
  I smoked my first cigarette at 6, really started at 13 and smoked 2 packs a day for 30 years. Patches are the best way.
  1. onemoresoop · 1790115890 · focus · HN ↗
    How did you taper off patches? Are you still on them?
    snarfy · 1790157801 · focus · HN ↗
    I still wear them now, but I've quit them before. It took about a year. Same steps as the 6 week steps, just drawn out further.
    They tell you not to cut them, because that cuts into their profits. It's a sticker. The amount of nicotine you get is directly proportional to the surface area. A step 3 patch is exactly 1/3 the size of a step 1. This makes it extremely easy to control the exact amount to tapper off.
    The hard part most people don't get is the addiction is only about 50% physical to the nicotine. Your brain craves the habit regardless of the chemical. Habits suck. People seek help to stop chewing their fingernails. I still go for walks with the regularity of smoking. I can feel it. It builds up. I need to go for a walk. Same as going for a cigarette before.
  2. gerdesj · 1790117846 · focus · HN ↗
    I smoked for roughly 30 years and was not in very good shape when I gave up eight years ago - that improved rather a lot.
    The problem is that nicotine is not the only addictive substance involved. If it was then you could chew gum, wear patches or whatever and off you go. There is an extremely complicated set of chemicals involved in fag smoke. There is also the habit effect and other complications.
    In the end I think that boring old will power is the only way and any trick or tool or whatever that you can deploy to bolster that is how you give up.
    My initial plan was to vape but I soon found that unsatisfying and it looked to me like trying to substitute one habit with another.
    Once I started stopping, I didn't want to stop! It was extremely hard but I always reminded myself that I had got so far and that that time would be wasted if I had to start again. I followed doubled up time periods - one day, two days, 1/2 a week, a week, a fortnight, a month, two months ("cripes, this might work") and so on.
    A mental tool I developed was a couple of mantras: "I don't want to smell" and "I don't want to die". Whenever I felt the cravings I repeated those to myself and I have no idea why but it did work for a while at a time. Gradually the need tailed off (say around two years)
    I remember having quite vivid dreams where I would "crack" and start smoking again. I had to do quite a lot of mental verification to prove to myself that it was just a dream. At one point I even smelt my clothes to prove to myself it was all a dream.
    We are all different and there is no right or wrong way to quit. One thing we can all agree on is it is hard, very hard but not impossible. Pick a strategy that might work for you and be prepared to change it but please do have a go. It really is worth it.
5. altairprime · 1790110897 · focus · HN ↗
  Hey, another person with addiction-intolerant ADHD! I have run into so few people who encountered and noted it. Most people can’t just treat a compulsion by curtailing it through willpower, though I still don’t comprehend why. Ironic that the willpower disorder wins the day versus the baseline.
6. Spooky23 · 1790114402 · focus · HN ↗
  I always wondered if ADHD and smoking were related.
  I’m ADHD boy for sure, and my dad and his younger sister are both very much not like my aunt, who is more like me. Shes in her 80s now, and was the only smoker - literally smoked cartons a week for about as long as I remember.
  1. onemoresoop · 1790115957 · focus · HN ↗
    ADHD people get hooked to smoking quite easily. Nicotine's a stimulant after all.
  2. sph · 1790147871 · focus · HN ↗
    I deleted my comment talking about it because it usually goes badly with the HN audience and their preconceived notions.
    But I have had the hypothesis (as a layman) that growing around smokers affects the brain of a child, they self-medicate with tobacco, and the cycle continues, and it has for many generations until today when smoking is frowned upon and self-medication is no longer readily available. I don’t think smoking is the cause of all of ADHD, but we’ll eventually learn that dopamine dysfunction has a lot of different causes.
    petercooper · 1790151428 · focus · HN ↗
    I've had similar thoughts! I grew up around a heavy smoker. My dad told me to never smoke and I never have. But I randomly tried a nicotine lozenge in my 40s and found it such a "lightbulb on" moment that I've been using pouches for a few years now and my executive functioning still feels better for it (though not as much now as in the first two years, alas).
7. ravenstine · 1790116197 · focus · HN ↗
  I, too, have experimented with the patches over the last year. Nicotine is great in a lot of ways, but whether it's a tool or a crutch depends on both the person and the delivery method.
  The patches are different, not just because it lacks that same connection to compulsive and ritualistic activity, but it simply doesn't provide the same quick "hit" that makes smoking far more addictive.
  On the other hand, someone prone to addictive tendencies probably shouldn't even use the patches. Even the patches can be a gateway to vaping and smoking for such a person. I have simply never been the type to become addicted to any drug or substance, other than the occasional overeating. This isn't to say that I don't have the potential to get hooked on more powerful drugs, but my innate desire to use them is a lot less than I think is average. Even during times where I've habitually drunk copious amounts of alcohol, I've always been able to realize "this kinda sucks so I think I'm gonna stop" and then I just do without really much struggle other than some brain fog for a few days. Similarly, I sometimes use phenibut, and people talk about how easy it is to become dependent on it and how hard it is to get off it, and that hasn't been my experience in the slightest. Someone without a clear objective around how they use substances like that will be much more likely to end up suffering.
  That said, the patches are great for focus and anxiety when used in low doses in moderation. I don't necessarily advise that everyone use them as I have, but I also don't think they're anywhere near as harmful as one might assume. I don't feel the need to ever switch to smoking or vapes, or even gums and pouches.
  1. paulpauper · 1790126267 · focus · HN ↗
    That said, the patches are great for focus and anxiety when used in low doses in moderation
    There is almost no good evidence of this. Effect sizes are tiny, if any. Just placebo and anecdotal. The effect is so small it's not even worth it from
    ravenstine · 1790133621 · focus · HN ↗
    This has not been my experience. Obviously there's no way I can disprove a placebo effect, but I don't find myself to be particularly prone to placebo effects or magical thinking. The vast majority of the time,, I don't notice much effect if at all from the "amazing" psychoactives, nootropics, pharmaceuticals, supplements, etc., short of full blown psychedelics and stimulants. Perhaps I'm prone to the nocebo effect. Then again, if I nearly always have the nocebo effect, it would seem odd to me that suddenly I would have the placebo effect with patches. Is it like adderall? No, but I would be stunned if researchers performed a double-blind study of patches on me as the sole subject and couldn't find a measurable difference in my behavior in terms of task persistence.
    sph · 1790147456 · focus · HN ↗
    No evidence that nicotine is a stimulant? What?
8. [deleted] · 1790139963 · focus · HN ↗
  [deleted]

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