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Nicotine safety and misconceptions
Karl Fagerström
Abstract
Cigarette smoking is a major cause of death and disease
worldwide. Nicotine has been shown to be the agent in
tobacco smoke that leads to addiction. However, the overwhelming
majority of the health consequences of smoking are caused
by other ingredients in tobacco smoke such as carbon monoxide,
numerous carcinogens, and other toxins that have been
identified. Medicinal nicotine is used to wean people
from the nicotine normally obtained by smoking. Whereas
cigarettes are designed to maximize the addictive potential
of nicotine, current medicinal nicotine products are by
far less addictive. Medicinal nicotine may produce some
adverse pharmacological effects; however, these are generally
not clinically significant.
The effects of nicotine from medicinal nicotine products
are much lower compared to smoking, even among smokers
with pre-existing tobacco-related disease. There are some
long-term safety data on medicinal nicotine products;
furthermore, snus, a form of smokeless tobacco that delivers
higher levels of nicotine, has been shown to lower the
risk of myocardial infarction and lung cancer compared
to smoking among exclusive snus users. Available evidence
suggests that nicotine, delivered without the other constituents
of tobacco smoke, has minimal adverse heath consequences.
We will discuss the health effects of nicotine from medicinal
nicotine compared to those from cigarette smoking, with
particular reference to cardiovascular effects, carcinogenicity
and lung disease; also, how these products could be used
to help more smokers quit smoking.
Karl Fagerström
The Smokers' Information Centre, Helsingborg, Sweden
karl.fagerstrom@swipnet.se
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