BrownNWG

I've been using 2mg nicotine gum for several years after quitting tobacco products. I haven't noticed any long term effects. If my dosage stays low, are there any long term issues I may experience?

Congratulations on staying quit! By stopping smoking you have significantly reduced your likelihood of long-term harm. There is little and inconsistent evidence for long-term harm from low doses of nicotine from gum in adults. Nicotine - including nicotine from gum - can be harmful for the developing brain, which includes young and pregnant people.

What are your views on tobacco-free nicotine pouches (e.g., On!)? I quit smoking 8 years ago by switching to nicotine pouches, but I am admittedly completely addicted to these and go through a pack a day. I imagine these are safer than regular cigarettes but there is still a risk element to them.

These products are new to the market and there is still a lot of work that needs to be done. Some of that work is being done here at Brown! Preliminary findings show that it is a helpful and acceptable alternative for adults who smoke combustible cigarettes and have not otherwise been able to quit. The few studies that have been conducted on nicotine pouches have found far fewer cancer-causing chemicals compared to other tobacco products like snus but the short- and long-term effects of nicotine pouches aren’t clear.

Hello everyone! Thank you for having this AMA. I have a question about strategies on quitting smoking for a family member who has been smoking for 40+ years and has tried quitting countless times, but is unsuccessful. He's unsure about using e-cigarettes and nicotine replacement products. What would you recommend to do?

It’s great that you are thinking about this and how to support your family member. The “gold-standard” treatment for quitting is nicotine replacement products or a prescription for Varenicline. This doesn’t work for everyone and often takes many attempts, but tends to get easier each time someone tries. E-cigarettes are a safer alternative to cigarette smoking, especially for people who have a hard time quitting. E-cigarettes have only been around since 2007 so we are still learning about what their long term effects are. Current research supports harm reduction.

How come some people get lung / throat cancer after barely smoking/ vaping, but my uncle Scott has smoked for like 60 years and is seemingly invincible?

Uncle Scott won the genetic lottery! 50% of people who smoke will die from a smoking related cause. 80-90% of lung cancer is related to smoking.

There's been a few studies about the benefits nicotine can have for dopamine related conditions like

ADHD

and

Parkinson's

. Do you think there's a possibility that the benefits of just nicotine (not tobacco) could outweigh the negatives for these kinds of conditions? How do the costs and benefits of nicotine compare to costs and benefits of drugs like adderall and L-Dopa?

Caveat, the people answering in the room are not experts in ADHD or Parkinson’s and their relationship to smoking. We will try to track down better answers later and respond directly.

Our initial thoughts are that nicotine has similar properties to stimulant medications, like Adderall. Stimulants can actually help smokers with ADHD quit smoking. Research on costs and benefits can be challenging because of the healthcare system and due to ethical considerations (if you have a medication that works you would need a good reason to give someone nicotine instead in a drug trial).