Truth, Lies and Poppycock

Blogs are supposed to opinionated.  The are intended to put ideas that are valid out there for the perusal of any eyes to see.  They are a person's interpretation of truth and a way of getting a message out to anyone who cares to spend a few minutes delving into another human being's mind. 

Poppycock, the are narcissistic and self indulgent viewpoints that feed the ego of the blogger.

They are not subject to prepublication peer review and as such have credence only if they are followed. It is from this frame of reference that this blog resurfaced, was renamed and reinvented.

This blog written to attempt to keep up with the world of THR- Tobacco Harm Reduction.  It is framed from a biopsychosocial perspective.  That there is an interdependence and undeniably linked relationship between biochemical processes, psychological makeup and social experiences and pressures.  THR understanding requires the objective and subjective interpretation of how each individual has biological individuality, thought processes that are unique and sociocultural experiences that are different and that each piece of that mixture causes external interpretation of a situation to evoke its own conclusion. We are not cast from the same mold.  In saying that we are also very much alike in this models framework.

Smoking tobacco is a well studied entity that is certainly harmful to multiple body systems.  The smoker knows this and continues, the most likely candidate for this continuing pseudo-denial is nicotine and the positive reinforcement of the act of smoking.  Pavlovian, behavioral, cognitive and pleasure seeking schema all fall into play. It has shown to be one of the most difficult addictions (define that as you like) to break. 

As Mark Twain observed,"...when they used to tell me I would shorten my life ten years by smoking, the little knew the devotee the were wasting their puerile word upon-- the little knew how trivial and valueless I would regard a decade with no smoking in it!."and "As an example to others, and not that I care for moderation myself, it has always been my rule never to smoke when I sleep and never to refrain when awake."

Nicotine is a powerful chemical agent within the brain, it increases alertness and stamina. It also causes nicotinic acetylcholine receptors to up-regulate- increase in number, and thus causes a biological change in the brain that partially accounts for the cessation withdrawal.  Millions die globally from tobacco related deaths.  Statistical analysis shows us that there is an average number of years lost per cigarette consumed.  Ah statistics, a wonderful and important area- but interpretable.  Why does one smoker die of a tobacco related disorder and another seem barely phased lighting up at 80.  My own father had an up to 3 pack habit and at 79 had lung function tests that showed no significant difference from the norms of his age group. We are all different, we are genetically a maelstrom of diversity.

People with psychiatric disorders tend to smoke more than those without such maladies.  Schizophrenics and Bipolar Disorder inflicted individuals smoke far above the normal statistical rate.  They appear to be self medicating. Thus psychological makeup plays a role in smoking. One remarkable observation is that many people who quit for years start back despite their memory of the pains of withdrawal.

Socially, if you grow up in a smoking family you are more likely to smoke.  Is that genetic as well or simply parental modeling.  The average smoker starts mid teens, and usually due to peer pressure from their social groups.

THR is not about simply decreasing risk and harm.  It is also about education and prevention of initial cigarette initiation. Education is thus a part of reduction strategies, one that has limited success to date as adolescents see themselves as immortal, I'll quit later and impervious to the negative outcomes.

THR's main focus should be at decreasing the harm from tobacco in those that use but cannot or have the Twain perspective. Tobacco smoke is the result of combustion of the tobacco leaf.  Combustion produces a chemical change in many of the compounds in tobacco.  The resultant agents have varying degrees of pathological outcomes- some are carcinogenic (at least 60 of the 4000 plus produced on tobacco burning.  Nicotine is in itself not the carcinogenic agent.  So gums, patches and inhalers with nicotine were sanctioned for cessation.  Drugs like Chantix (I will be blogging on that in a future blog) arose.  Community support groups, hypnosis, aversion therapies and Nicotine Anonymous have evolved.  Quit rates after six months are still  very low.One of the problems with these methods is their one sided treatment.  There is a complex array of behaviors that encompass smoking.  The oral inhalation, throat hit (feeling of tobacco smoke hitting the throat), the hand holding, and many more.  These other methods treat the biological but not the psychological aspects of smoking.

In 2006 Vaping was introduced into the smoking world. The use of a non-combustible technique to vaporize a nicotine and propylene glycol or vegetable glycerin solution which was inhaled like a cigarette (to be called analogue in the future) to mimic the behavioral and the biological effects of smoking.  Vaporization is a physical change  from liquid to droplet vapor,  The result the 4000 compounds are eliminated.  People at first called it a  fad- it is now a potential revolution in THR.  The exhaled vapor looks like smoke and the physical appearance of smoking have taken smokers to ex-smokers (although many claim they still consider themselves smokers, just not analogue  smokers. Subjective reports from vapors is that they feel better in weeks.

This is not nicotine cessation, it is much like gums or patches.  Many continue to vape at nicotine levels that arevape after going to zero nicotine.  It is Harm Reduction.

The exhaled vapor looks like smoke but is more like the exhaled are on a December Day in Northern Ontario.  It is vapor- not smoke. There is no match and no combustion.

And all was well- except the zero tolerance factions who want nicotine banned in all forms equate the smoke with the vapor, talk second hand smoke talk and a potential life saving agent becomes attacked. Then there are organizations like CASAA.org and many forums that fight for the right to THR. 

There is a battle out there and it is filled with have truths and lies. Anti-smoking groups spin THR into perpetuating the habit, influencing the young to start "safer" smoking- which is a speculation, vaping is not 100% safe. Boston University said it was 98-99% safer than smoking.

So enough for now.  Twain was prolific on smoking and this last paraphrase speaks it all for smokers- "Quitting smoking is easy. I have done it a thousand times."

And finally from Hippocrates- 'at first do no harm."  The anti's that would ban vaping will only push people back to smoking, thus increasing their potential morbidity.