NICOTINE REVIEW 2015 by the Doc

Peace, Serenity, Hope, Mercy, Forgiveness and Sincerest Gratitude to all of Our Loyal Patrons:
An appreciative welcome to those interested in the opinions of a medical scientist regarding the truth about vaping; the positive and negative characteristics of its physiologic actions and the potential deleterious effects on the animal species, many of which have been studied exhaustively in laboratories all over the world, but have yet to be studied in human models; correlation of results is generally unpredictable but animal models chosen most often show similar effects on the human species. Our FDA is painfully fastidious in their assessment of these results before they will grant human trials. The average time to approval in the human species can often require a minimum of 10 years, however, they now, are “fast-tracking” those products to help the public safely. This entry will be entered in the form of bullet talking points in order to avoid annoying verbiage, a tendency to which I feel I was congenitally blessed. The entries will be clearly identified as appellated AF (confirmed to be scientific experimentation, facts with reliable references) and opinion statements (OS). Most of this entry will be gleaned from an article entitled “Nicotine (PIM)” from Inchem.org, an article with over 100 references from experts the world over. However, I have studied no less than ten books regarding the subject of “vaping,” some written by well-meaning, confirmed ex-smokers who are passionate about the decreased harm that vaping offers in lieu of combustible tobacco products, e.g., cigarettes, cigars, pipes and “dippers.” References will be available upon request:
 Nicotine (hereafter referred to as “N”) was first discovered in the sixteenth century.
 Nicotine is named after the plant Nicoiana tabacum (with this genus and species can there be any doubt regarding the origin of N.). It was named after the French ambassador in Portugal, Jean Nicot de Tillemain, who, in 1560, sent seeds to Paris to promote their “medicinal use.”
 N. was first isolated and introduced by Wilhelm Heinrich Posselt and chemist Karl Ludwig Reimann of Germany in 1828, who “considered it a poison” which is not surprising because . 0.6 to 4% of the dry weight of tobacco and chemically isolated nicotine is efficiently absorbed through the skin and a lethal dose of N to humans is only 30 to 60 mgs. Perhaps the isolators became aware of this propensity for skin absorption only after one expired due to uneducated exposure! Let this fact become well-assimilated as pure liquid nicotine is readily in the market and can be spilled on the skin, or ingested by uniformed adults and, tragically, by children, as e-liquids containing 0 to 38 mg% are often contained in colorful, fantastical bottles, often quite appetizing in appearance to the uninformed. YOU are no longer “uninformed.” But more about these facts are forthcoming in this treatise.
 The average cigarette contains one (one) mg of N. It is absorbed from lungs to brain in 10 to 20 seconds and has an elimination half-life of two hours. However, its powerful metabolite, Cotinine, remains an active metabolite for up to 18 to 20 hours in the bloodstream.
 Initially, cigarettes and other N products and foodstuffs comprised only about 4.4% of blood concentration. Insidiously, however, the dosage of N in cigarettes increased at 1.78% per year between the years 1998 and 2005, giving a heavy smoker an increased dose of nicotine This amounts to an increase of about 14.4% in 8 years. Is there any doubt that cigarette manufacturers could never be accused of safeguarding the public against the tar-nicotine combination which is carcinogenic?! The lethal dose of N to humans is 30 to 60 mgs, so the 1 mg per cigarette morphed intentionally to 14.4 mg per cigarette. How many people smoke over a pack of cigarettes per day? The ONLY saving grace is the half-life of two hours in the bloodstream never reaches the LD50 numbers which could result in mortality. But the morbidity of Cotinine of 18-20 hrs could potentially cause innumerable health risks, which could explain why the Census Bureau estimates 440,000 deaths per year. As an orthopaedic surgeon, I can voice unequivocally that over 80 to 90% of post-operative complications, including post-operative pulmonary atelectasis (and pneumonia), stroke, infection, deep vein thrombosis and pulmonary emboli, delayed wound healing and 50% longer recovery times were directly related to cigarette smoking. (AF,OS)
 Nicotine increase binds with neurotransmitters in the brain and increases their levels, specifically Dopamine which is carried to the “pleasure center” by acting as a “volume control”. It is for this reason that dopamine enters the reward circuits of the brain which contribute to the relaxation and euphoria felt to be the cause of nicotine addiction. (AF).
 Nicotine also acts on the sympathetic nervous system (in contrast with the parasympathetic nervous system) stimulating the increase in epinephrine which explains the increase in blood pressure, pulse, respiratory rate and increase in blood sugar level , simulating the “fight or flight” action of epinephrine when faced with danger.( AF,OS).
 Nicotine irreversibly binds with melanin pigment, considered to be the hypothesis of why there is an increase in lower smoking cessation rates and higher nicotine dependence level in darker skin pigmented populations. (AF,OS).
 The government gets about 25 billion dollars per year in tobacco taxes, but also sustains $440 billion dollars and 440 thousand deaths annually, directly attributable to smoking. Does it take a brain surgeon (who I am praying will be our next president) to do the math here? This puts your government senselessly in the red, a color getting darker and darker because of the tobacco lobby. As this color deepens, your bank account also gets darker and darker red! Let us NOT STAND FOR THIS. CONTACT YOUR CONGRESSMAN AND INFORM HIM THAT YOU KNOW THAT HE IS SUSTAINING THIS TRAGIC DISCONNECT!!! Vote a pediatric neurosurgeon into office and watch how quickly the pendulum swings in our favor! Again, congratulations on choosing a safer alternative to smoking, one which puts you in the top 1% of intelligentsia in the world The percentage of population in Europe who smoke are over twice as bad; 70% of Chinese smoke, ironic since the e-cig was created by pharmacist Hon Lic in 1903 when he searched for an alternative. He watched his father perish from lung cancer. Continental Africa is even worse, and millions of these ethnic groups are immigrating to the US annually, increasing your taxes and destroying your environment. The only thing worse than tobacco smoke is exhaust from your car. Perhaps one should invent a device that attaches to your car’s tailpipe so that you can really do some serious, but not so very different, harm. (OS)
 The President of The World Health Organization has stated that “…vaping is likely to be the most significant innovative addition to the healthcare industry so far in the 21st century.” Initially, the smoking industry tried unsuccessfully to quash this competitive activity, but when unsuccessful, they decided as a group to enter the race. The Lorelie tobacco company (perhaps the largest in the smoking world) has bought up 40% of vaping entrepreneurial companies, but launched their endeavor with an e-cigarette that makes smoking camel dung preferable. Try one before you avail yourselves to an ingenious vaping tube-style or box mod (preferably one of the newest that protects the consumer with a plethora of safety features) and you might never enter the gratifying world of vaping. Is this their goal? DON’T BE FOOLED!!! PATRONIZE A REPUTABLE, HEALTH CONSCIOUS ENTERPRISE LIKE Doc’S Vape eScape, and experience the delicious, charming, ingenuity of countless entrepreneurs entering the market every day. Incidentally, the largest distributor in the world comes out of China, one which produces “clones” of authentic vaping devices which perform as well as a one-armed paper hanger!!! DON’T BE FOOLED BY THESE DEVICES WHICH PRODUCE AN INFERIOR QUALITY EXPERIENCE, AND ARE NO MORE COMMITTED TO QUALITY AND IMPROVED HEALTH THAN THEY ARE IN REDUCING THE WORLD’S LARGEST ENVIRONMENTAL FOOTPRINT, FAILING TO PARTICIPATE IN THE KEOTO FORUM, ATTENDED BY COUNTRIES THAT ARE COMMITTED TO A REDUCTIION IN THEIR CARBON FOOTPRINT, WHICH ALLEGEDLY IS THE VILLAIN IN “GLOBAL WARMING,” IF SUCH A PHENOMENON EXISTS (I personally do not believe it does after reviewing the preponderance of scientific evidence that proves the < one degree of change over decades, and most probably represents a normal evolutionary and predictable alteration in the world climate. God is certainly no fool and His plans ARE ALWAYS, ALWAYS GOOD. (AF,OS)
 I’ve tried to give you the mostly “negative” facts about N and if you stayed with me through this vaping soliloquy, you are a real trooper and deserve to be blessed with vaping which is “100 times safer than cigarettes.” You are also to be congratulated for entering the “gentry” class, the class of which you no longer stink, hack, spoil the atmosphere or your environment, cause grief to all those family members, friends and even a preponderance of innocent bystanders who are compelled to endure the second hand smoke phenomenon as well as anxiously observe their loved ones and fellow citizens dig their own graves, willfully deducting “9 years” from their life expectancy. My next edition ( 3) will no doubt seal your good judgment to vape when you learn the legion of beneficial features about N (without tar added). I will seal your desire to vape and create a vaping evangelist in you; an admirable class of people who evince obvious mature judgement, show good example to their families, and DO NOT demonstrate a gateway habit to smoking. Water vapor is the product of vaping, and only adds water vapor to the clouds which make our farmers more successful. Only 5% of the smoking population has switched to vaping, in part due to the fact that federal grants for research seems to be preponderantly awarded to those who wish to add to the “negative “ bibliography of vaping and, egregiously vilify a good and enjoyable habit which, on balance, makes cigarette smoking a habit for fools and weak-kneed individuals who refuse to even consider a healthier change in theirs and their families’ and other citizen’s lives. ERGO, WE VAPORS HAVE A LOT OF WORK TO DO. Be a leader, have the courage to swim upstream as our noble salmon do to sacrifice their lives for their offspring.
 See you again in about a week, and . . .thanks for helping to make this blog an informational juggernaut! The Doc (OS)