MORTALITY RISKS AND CANCER RISKS VARY GREATLY BY PRODUCT Cigarettes and smoking tobacco are the most deadly recreation products on shop shelves. Nicotine has been widely used as a medicine since 1984 and is safe at the doses used in medicines. Nicotine products do not cause lung or other cancers, nor lung or heart disease. Tobacco smoking, in contrast, is the main cause of lung cancer and the main preventable cause of lung and heart disease.
POLITICAL AND REGULATORY APPROACH The first requirement is to ensure smokers can buy recreational inhaled nicotine, as it is far safer than smoked tobacco. The next step is to ensure brands are true to label, effective, child-safe, and of minimal toxicity. Extreme regulatory caution, insisting on all nicotine being sold as a medicine while tobacco remains on sale as a recreational product, could inhibit smokers’ desire to embrace nicotine as a recreational alternative to smoking.
This paper sets out the science of nicotine as it affects health. Nicotine is addictive, driving smokers to smoke for most of their lives, and indirectly shortening their lifespan by at least ten years. Nicotine, however, is not in itself a direct cause or even a minor cause of these smoking deaths or diseases. Indeed, smokers switching to far safer nicotine-vaporizer substitutes can reduce their risk while maintaining their addiction to nicotine. Across the world, deadly cigarettes are sold with government approval for recreational purchase by adults in almost every country, yet nicotine products are not approved for recreational use.
To understand the potential of nicotine products to help smokers and countries avoid the predicted one billion deaths from cigarette smoking this century, we need to understand the science behind nicotine.