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Comment by gwern | Hacker News Reader

Nicotine is great. I find it very useful. The claims about its stimulant effects are perfectly plausible.

But there is zero need to consume/use tobacco to get nicotine.

Breaking form and upvoting and commenting saying that this should be upvoted.

But seriously, I remember when the last e-cig article submitted to HN. Comments were a complete shit show of conflation of of tobacco, smoking and nicotine. It was absolutely completely cringeworthy.

Mind you the article does just fine conflating the two as well. For example, the first big evidence it produces, the meta-analysis on effect of nicotine. The article leads in with "which summarizes the last 40 years of knowledge about tobacco and nicotine effects on the brain", but the actual study is directly about nicotine only, only dealing with tobacco tangentially.

This is absolute hurtful to the discussion.

And honestly, anytime we have a discussion about non-medicinal (as in using chemicals to treat a condition that a doctor would consider not normal) use of drugs, its probably really useful to take a moment and think "how about our societal addiction to caffeine?".

There really need to be more studies on the effects of nicotine in isolation from all the other chemicals in cigarettes. There have been studies that have shown that the MAOIs in tobacco interact with nicotine pretty strongly in creating addiction. I wouldn't be surprised if the MAOIs are also related to why people with mental and mood disorders often self-regulate with tobacco.

What methods do you recommend?

From his Nictotine article, gum or patch. But e-cig might be fine too if the parts don't have lead or other hazardous substances in them, modulo maybe higher risk of addiction.

Patches and gum are really expensive.

Compared to e-cigs, sure. Compared to food, or conventional cigarettes ... they're really really cheap. 96 x2mg gums for $22 comes out to 45¢/mg. I use maybe 0-2 (edit: gums (90¢-$1.80)) a day (I probably save at least that much by making sandwiches for lunch / not eating out -- I work from home).

Use an electronic cigarette (vaporizer) or use the OTC nicotine replacement therapies (gum, lozenges, sprays).

Any good ones? I researched a year or so ago and all the brands seemed a little bit..sketchy.

eGo-T is amazingly close to actual smoking. Get a tank upgrade like the Vivi-Nova and boom, you get a hit so strong you might cough at first.

For non-smokers, less is more... nicotine is a pretty powerful stimulant, you don't necessarily want strong hits. My 2¢.

(I am a non-smoker; have tried 2mg and 4mg gum, and find 4mg similar in some ways to having a 'bad trip'. (Light-headedness, freaking out, nausea, time-dilation.))

I also gave lozenges a try after reading an article here, and found 2mg to be too much, at first. You get used to it, though.

true, as a smoker trying to ween myself to something a bit safer that lack of hit is what annoyed me with other e-cig solutions I tried. The nova tank though is a very tolerable substitute to actual smoking.

If I was a non-smoker though I would not start a nicotine habit at all. I wish I had never started smoking, it's a very difficult habit to reverse.

Anecdotal, but as a non-smoker, I don't find any withdrawal or cravings symptoms at all when I stop consuming nicotine. It's milder than stopping caffeine.

I have an EVO-D battery with a vivi nova atomizer tank. This works pretty well for me. You can switch out the vaporizer coils to make sure you get a nice fresh one, and the replacement coils are really cheap. You're going to want 2 batteries so that you can charge one while using the other. They charge with USB.

Running an Ego C Twist + Vivi Nova right now. Two batteries, a charger, and the vivi nova came about to about $40. Plus some juice, ended up at about $60 ( I got a lot of juice though).

/r/electronic_cigarettes has a pretty good FAQ on these types of things, ignore their ridiculous $200 setups though, a bit overkill IMO.

Over the long run, oral nicotine delivery is thought to increase chances of oral cancers.

Best to stick to patches.

Do you have sources? I'd be interested to see the data.

It's been years since I did this research and can't find my listing of sources.

After a quick deep dive on the topic, I found this: http://www.ncbi.nlm.nih.gov/pubmed/18852035 In short, cells from oral tissues experienced relatively more DNA damage. In absolute terms, it's not much, but reason enough to default to patches, versus oral routes, IMO.

Also, oral nicotine causes all kinds of gingival recession. This is pretty widely known (halfway decent source for this: http://www.ncbi.nlm.nih.gov/pubmed/2388141).

What patches can you use that are fairly low dose and not a 24 hour time release?

Despite oft printed warnings to the otherwise, you can just cut up the patches to customize the dose.

Duration of release? I believe you should leave it on 24/7. IIRC, it's not that nicotine improves sleep quality, but rather that nicotine withdrawal impairs sleep quality rather profoundly, and as such keeping the patch on at night allows for better sleep. I could be wrong here, though. Been a while since I've researched this.

Not the parent, but Swedish snus is a great option.

I'm curious to know who hates snus enough to downvote me:) But snus is fantastic, well-studied and well-regulated, has objectively contributed to a large reduction of cancer rates in Sweden, and is cheap and easily importable.

Smoked for 18 years, snused for 2, and tobacco free for 2.

edit, for good measure:

http://scholar.google.com/scholar?hl=en&q=swedish+snus

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Oral use of Swedish moist snuff (snus) and risk for cancer of the mouth, lung, and pancreas in male construction workers: a retrospective cohort study http://www.thelancet.com/journals/lancet/article/PIIS0140-67...

Is Swedish snus associated with smoking initiation or smoking cessation? http://tobaccocontrol.bmj.com/content/14/6/422.short

Swedish Match Company, Swedish snus and public health: a harm reduction experiment in progress? http://tobaccocontrol.bmj.com/content/10/3/253.short

Steady-State Nicotine Plasma Levels Following Use of Four Different Types of Swedish Snus Compared with 2-Mg Nicorette Chewing Gum: A Crossover Study http://ntr.oxfordjournals.org/content/7/3/397.short

Should the Health Community Promote Smokeless Tobacco (Snus) as a Harm Reduction Measure? http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj...

A long-term follow-up study on the natural course of snus-induced lesions among Swedish snus users http://onlinelibrary.wiley.com/doi/10.1002/ijc.21841/full

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Those were all on the first page of the search. Between snus and an imported unregulated mystery liquid that comes out of a bottle with a skull on it, or super expensive and annoying patches and gums, snus is really a gift to smokers.

Didn't downvote, but someone else probably did because the person you were responding to was looking for non-tobacco alternatives.

Makes sense. Though IMO it's not the tobacco you should be trying to avoid, but the cancer and the coughing.

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