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

248 points · 335 comments · alephnerd

  1. sph · · 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. cucumber3732842 · · 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 · · 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.

        1. fsiefken · · focus · HN ↗
          as a medication alternative there's saffron, which also helps (not as good)
        2. Phemist · · focus · HN ↗
          Did you read gwerns post on it by any chance?

          <a href="https:&#x2F;&#x2F;gwern.net&#x2F;nicotine" rel="nofollow">https:&#x2F;&#x2F;gwern.net&#x2F;nicotine

          1. sph · · 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.
        3. ravenstine · · focus · HN ↗
          I&#x27;ve come to a similar conclusion.

          On one hand, yes, nicotine in many ways does deserve the reputation it&#x27;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&#x27;t realize this. The chances that you&#x27;ll become addicted to patches is incredibly low. If they were that addictive, then they&#x27;d likely be way more effective in helping people quit smoking; in reality, it&#x27;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&#x27;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 · · focus · HN ↗
        &gt; 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:&#x2F;&#x2F;nida.nih.gov&#x2F;publications&#x2F;research-reports&#x2F;tobacco-nicotine-e-cigarettes&#x2F;nicotine-addictive" rel="nofollow">https:&#x2F;&#x2F;nida.nih.gov&#x2F;publications&#x2F;research-reports&#x2F;tobacco-n...

        1. simoncion · · 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&#x27;ve never been able to quit caffeine... and -although it is notably shorter in duration- caffeine withdrawal is WAY worse than nicotine withdrawal.

          1. huurtehoog · · focus · HN ↗
            Thank you for checking the source. Celebrating that is more important than me being right so kudos.

            If we&#x27;re going by anecdote I know way more people who quit caffeine than nicotine.

            1. simoncion · · focus · HN ↗
              &gt; If we&#x27;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.

              &gt; Thank you for checking the source.

              Respectfully, why the hell didn&#x27;t you check it? It&#x27;s only a couple of pages long. Did you do something dreadfully silly like employ some LLM to &quot;assist&quot; you with your conversation?

        2. astura · · focus · HN ↗
          It might be addicting, but it&#x27;s still overcomable, since 2002 there&#x27;s more former smokers in the US than active smokers. 66% of all Americans who have ever smoked have successfully quit.
      3. JauntTrooper · · focus · HN ↗
        Nicotine isn&#x27;t just &#x27;extra effective caffeine.&#x27;

        The research seems to indicate it&#x27;s a cancer accelerant -- it doesn&#x27;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&#x2F;lab studies, in part because it&#x27;s hard to design a good study in humans since so many patients also use&#x2F;used cigarettes and vapes, which confounds the results. Still, there&#x27;s enough evidence out there to be cautious.

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