My mom replaced her lifelong cigarette addiction with an addiction to that very expensive gum. It was a definite improvement health and lifestyle wise, but sadly she was never able to kick the gum. She actually hid packs of it everywhere just in case. She had visited my house only once (I live far away), yet while doing some spring cleaning a few years after she died, I found a pack of that foul gum in the back of a drawer. 
Sadly the damage was already done. Despite being on the gum for ten years at the end, lung cancer still took her from us. This is not a critique of the gum, just a random anecdote about an awesome lady who battled with the nicotine demon her entire life.
Why any nicotine products are legal is beyond me. They ruin lives and families way more than most other drugs, including all the legal ones.
Many of the companies that make those prescription products hire former FDA staffers and researchers.
I’d look into a refillable vape. It’s a hell of a lot cheaper, and it’s considerably easier to step down nicotine content and consumption. Without buying directly from major tobacco companies (although when you get right down to where the shit is the nicotine base coming from?).
I’m doing much better via this route (originally in combo with patches) than I’ve ever done trying to quit before. And regularly stepping down the nicotine concentration on the goo I stick in the robot has been much, much more effective than the disposables and pods where it’s all pretty much 5%.
There’s not enough research out at this point. But the studies so far pretty consistently show higher success rates over other nicotine replacement. It’s like 19% have completely stopped after a year vs 8% or so for patches, gum lozenges. Lower relapse rates there after.
They haven’t really existed all that long. And despite marketing themselves as way to quit smoking, bigger companies like Juul aren’t doing the research to prove it. Or market themselves that way legally.
So it’s kinda definite trend, no solid answer.
Of the 2 or 3 common meds. Most are mild anti-depressants that suppress the cravings, and Chantix directly blocks nicotine receptors. So they’re not “for cigarettes” but nicotine.
There are side effects and risks. Chantix still isn’t recommended if you have a history of depression or suicidal thoughts. And they can be expensive if you don’t have decent health insurance. But it works pretty good, particularly Chantix. No go for me for various reasons but I know many people who quit entirely, long term with Chantix. IIRC it has the highest success rate after 1 year around 40%, and the lowest relapse rate long term.
Welbutrin and Zyban didn’t work or shit for me. And numbers wise they have a much higher relapse rate years after than nicotine replacement. But I think they were something 20-25% effective after 1 year.
ETA: I’ve been reading a lot about this recently. Haven’t regularly smoked since January, grand total of 5 actual cigarettes since then, and I’ve cut the amount of nicotine I’m consuming to like 5-10% of where I was at as 1-2 pack a day smoker.
It is pretty common for a pharmaceutical comany to hire people who use to work for the FDA, so that fact alone shouldnt discredit the products. And compared to Juul, a tobacco company isn’t making money from them.
These medications went through nothing like the infamous Purdue pharma shenanigans and have substantial evidence of safety and efficacy. They have also been independently approved in other countries (here Health Canada does its own review). They are being used every day, supported by lung associations, and physicians see the impact on their patients.
Smoking related diseases are terrible. People often talk about lung cancer which is noteable for its continuingly poor 5 year survivals and being frankly a terrible illness. COPD is less discussed, more common, and just a terrifying diagnosis. The major risk factor is total exposure (pack years = packs per day time duration of smoking), not when you last smoked so quitting as early as possible is the single best way to reduce your risk.
We need tools to help people quit and nicotine substituion products like patches and gum, do not work for everyone. We shouldn’t discourage people from trying alternatives in consultation with their health care provider. Lives are literally on the line.
To end on a long tangent not directed at you but since e cigarette discussions can get passionate I like to frame my background:
(Just FYI I am not just a hobbyist looking into this stuff. I spent my PhD and about 10 years dedicated to researching lung cancer and COPD before moving into my current career focused more on neurodevelopmental disorders. I am still involved in cancer research at my University and keep up on the latest research. I am very much not suportive of the e cigarette industry which is bringing nicotine to a new generation of kids. Additionally lungs work best when they are inhaling air, the components of e-cigarettes are known to cause cellular toxicity and even at low levels long term exposure is likely problematic. I side with the lung associations that don’t think we should wait to see if a statistically significant number of people develop COPD late in life before we treat e-cigarettes as a likely harmful product. This does not mean completely eliminating them as a tool for those who can only quit with them but ensuring they are regulated and people understand their risks. )
[edited for typos]
Just to add on here.
There’s also the perspective of long term, population wide impacts and benefits from a public health policy perspective.
Early research, little long term data, and so forth. But there’s apparently pretty good indications in what we have currently that although vapes are clearly bad for you. And likely to cause long term health problems. They are likely to be less bad for you than cigarettes.
So as a point of policy it is potentially unwise to bar a product that may mitigate the population wide impacts of nicotine consumption. Some portion of smokers can not or will not quit, if they switch to a consumption method with even marginally better long term out comes.
The public health implications and costs savings could be pretty big.
Same deal the indications that it’s a pretty good pathway to quitting for a lot people.
But to whatever extent new nicotine users are starting with or sticking with vapes. That is a net negative from the same perspective, particularly if the total number of nicotine users increases.
And I think we’re seeing exactly that attempt to thread the needle in this regulatory push.
A month or so back they banned shipment of all vape products through the US mail or standard parcel services. And shipment through a courier requires ID be shown at delivery.
Companies like Juul, who market most heavily. Target young and new smokers are in for greater scrutiny. And Juul, the most popular product among new and underaged users has just gotten itself banned for fucking up safety research.
Lawsuits against Juul and tobacco companies are mostly on the marketing, and efforts to attract young users.
But vapes and vaping remain legal. There’s little action on in person dedicated stores where ages can be checked, complicated expensive devices, and $30 bottles of slime with stupid names.
Agreed.
We have plenty of medications that carry risk that is tolerable due to their utility. E-cigarettes may fall in that category.
To me the most problematic aspect of e-cigarettes is the persistance of the early “It’s just water vapour so it’s safe” messaging and the damage already done through marketing to youth. It takes a lot of work to convince people that something they can easily buy is too hazardous and “not cool”.
I personally would go as far as suggesting they should be prescription medical devices (let’s get the explodey ones and bad fluids off the market). However I am in a country where health care is pretty universally accesible so that may be a barrier to many in the States. There must be a good compromise but the current state isn’t it and I have sympathy for the regulators trying to find the balance.
The thing I find disturbing is the entire idea of vapes being an improvement. Whole leaf of what ever the fuck liquid.
Doesn’t appear to be based on anything other than stoner logic. It all comes out of the received wisdom that vapes for weed are “cleaner” than smoking it.
Outside the sounds reasonable idea that combustion temp has a direct impact on tar level. I’ve never been able to find any kind of scientific root for that at all, or even anyone who looked.
Then from that particular “fact”, to the idea that a puddle of propeline glycol, vegetable glycerin and pure nicotine is the same.
Season liberally with “just water vapor”, and carefully ignore the problems with nicotine itself.
All the safety research and info we’re now waiting for and dinging tobacco companies for not doing. Should have been done first.
There should have been a clear idea that the base concept was even true.
I dare you to find a drug or medical device company with more than 100 employees that hasn’t hired someone who worked at the FDA at one point.
The regulatory code that governs drugs and medical devices (CFR21) is notoriously dense. It helps to have someone who has navigated those regs from the inside if you care about getting your drug or device to market. That goes for shitty products as much as for revolutionary, lifesaving ones.
My point exactly. Again, anecdotally, the physical vaping devices are generally poorly made in China and they hold a considerable amount of energy in their battery.
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