While it is estimated that more than 80 million people worldwide are vaping — a 95% less harmful alternative to smoking — the attacks against nicotine consumption in general, and vaping in particular, are intensifying. One of the most common arguments against vaping relies on opposition to nicotine itself. For many anti-vaping activists, this is a categorical problem, despite all evidence showing that nicotine is not the cause of smoking-induced illnesses.  

Recherche sur le cancer dans le Yorkshire states that “nicotine is not the cause of death from smoking. Nicotine is not a carcinogen; there is no evidence that sustained use of nicotine alone increases the risk of cancer” and concludes that the “harm from smoking comes from the thousands of other chemicals in tobacco smoke.” 

Reducing the number of smokers and allowing them to rapidly and efficiently switch to less harmful alternatives should be a major priority for public health agencies worldwide. Unfortunately, too many people confuse nicotine consumption with the diseases caused by smoking and therefore target the wrong enemy — nicotine. 

This is especially odd considering nicotine is not considered a problem in conventional nicotine replacement therapy (NRT). The package leaflet from Nicorette’s inhalator says: “It is the toxins in cigarette smoke such as tar, lead, cyanide and ammonia that cause smoking-related disease and death, not the nicotine.” Therefore, why should nicotine be a bigger problem when consumed in e-cigarettes?

We don’t see the same concern about thousands of people addicted to nicotine inhalers or gums. Instead, we see quite the contrary: smokers are not satisfied with traditional cessation methods and therefore look to other alternatives as a means to quit.

Nicorette and NicoDerm brand director Scott Yacovino correctly stated: “We know that quitting [smoking] is very difficult, so we are always looking for ways to improve and bring a great user experience to our nicotine replacement products. Obviously, the better a product tastes as it relates to flavor and experience, hopefully, the easier it is for people to stick to their quit journey.”

The same applies to consuming nicotine with vaping. Vaping has been proven 95% less harmful than smoking and has been endorsed by multiple international health bodies as a safer alternative. The reason why vaping is more effective compared to NRT is because it is also pleasurable. People are different, and therefore they also need different products when trying to quit smoking. For some, patches work; for some, snus works; for others, vaping vanilla-chocolate-cookie flavours works. A war on nicotine, when vaped or consumed with pouches, makes no sense while there is no problem in patches or gums. 

There is no doubt that nicotine triggers the release of dopamine and thus contributes to addiction to smoking. Still, it can’t be the only reason why so many people fail to quit smoking. Suppose nicotine was the sole reason for smoking addiction. In that case, every smoker using a nicotine patch would be able to quit smoking right away. This is not the case. Smokers’ addiction is based on a combination of nicotine and other ingredients of tobacco smoke together with conditioned behaviour [the so-called ‘smoking ritual’] like the coffee break, the inhalation process, or even putting something on the lips. 

A étude on the dependence on e-cigarettes and cigarettes suggests that vaping is a gateway out of smoking and eventually out of nicotine consumption: “E-cigarettes may have less potential than conventional combusted cigarettes to produce dependence, suggesting that individuals who switch from smoking to e-cigarettes may reduce their nicotine dependence as well as their health risks.” 

Anti-vaping activists and public health decision-makers should not single out a lone substance when it comes to addiction. Addiction is more complex and is not solved with a war on nicotine. Nicotine also doesn’t become a poison just because it is delivered through vaping. When nicotine isn’t a problem in gums and patches, it can’t be considered a bigger problem in vaping. The strange “nicotine in NRTS is no problem, but a big problem when vaped” approach must end. Anti-vaping activists can’t have it both ways: there is no Schroedinger’s nicotine paradox.