4 ms·

I hate to say this, but I've been finding Nicotine to be very useful for dealing with anxiety, restlessness, and boredom with rote tasks. I've had some issues

I hate to say this, but I've been finding Nicotine to be very useful for dealing with anxiety, restlessness, and boredom with rote tasks. I've had some issues with depression and anxiety that I've been managing with my doctor, but there are still times where extreme stress can cut through the drugs and still give me some issues (work has been very political lately). I started craving a cigarette, which is weird because I was only ever a cigar smoker, very infrequently at that, and gave it up (very easily, given I usually went months between cigars) years ago. So under the guise of "if you're craving potato chips, maybe you're low on sodium", I bought a small, very low dosage, disposable e-cigarette at a convenience store. And the last two weeks have been some of my most stable, calm, consistently productive weeks in a very long time. Now, I know Nicotine is very addictive, and I have no plans to go back to smoking. I'm planning to switch to a nicotine patch, as the vapor is irritating to my throat and there is still some concern of increased lung cancer risk. I think a patch will be easier to meter out the dosage, too, rather than puffing on a pen every time I feel like it. Sum total, I think I'm receiving a net benefit right now (it has also calmed my snack cravings and my blood pressure is now at a 5-year low). Anyway, it's dangerous to self-medicate, but most people do anyway, whether it's with alcohol or bad relationships or the internet, and it's not my job to tell you what you can or cannot do. Just trying to relay that there might be some decision tradeoffs that might leave you with a net benefit.

adrianm 8y ago
I think you should talk to a doctor about this.
- moron4hire 8y ago
  I don't think that is a helpful comment, especially considering I did say I am working closely with my doctor to monitor my health and mood. The practice of medicine is not actually that hard. It's all about risk profiles and benefit tradeoffs. The Lexapro I have been prescribed for my anxiety and the Advair for my asthma could very well be more dangerous for me than any trans-dermal Nicotine patch might be. Our Food and Drug Administration has decided that it's relatively safe for me to buy Nicotine in whatever amounts I want without any more restriction than me being more than 18 years old. They've decided that Advair and Lexapro have risk profiles worth forcing me to go through my doctor before allowing me to have any. We have thousands of years of data that shows Nicotine doesn't just randomly make you want to kill yourself. We have a lot of evidence that smoking tobacco can increase risk of cancer, and that the additives in commercial cigarettes can increase that risk a lot, but that doesn't apply to Nicotine specifically. There is some evidence that any sort of lung irritant can increase the risk of lung cancer, so even vaping might not be completely safe, but neither do we know the magnitude of that risk, especially separate from the many other irritants we're exposed to on a regular basis. I'm not trying to advocate for using Nicotine. There is a risk of smokers pointing to information like this and saying "see, my disgusting habit is not that bad". That's not at all what I'm saying. But just because I don't have MD after my name doesn't mean I can't make informed decisions on my own about my own treatment. I'm just sick of this infantilizing concept that intelligent adults can't figure out a few things on their own.
  - spydum 8y ago
    While I whole heartedly agree with your logic and opinions on this: have you met many adults? They are awful at critical thinking. It strikes me that this is indeed a good chunk of why health/medicine is hard. Some people literally can’t be trusted to evaluate complex decisions effectively. So you end up with highly regulated practices, and those people who have the mental capacity are left out.
  - adrianm 8y ago
    I’m a cancer patient undergoing treatment. Please be careful, you don’t want this.
thrower123 8y ago
Nicotine was one of the few nootropics that had real measureable positive effects in gwern's testing. Unfortunately it's addictive as hell, but nonetheless, you'd think that as much as we research into opiods and other narcotics, there would be more effort to find safer forms of nicotine or nicotine derivatives. https://www.gwern.net/Nootropics https://www.gwern.net/Nootropics
- dageshi 8y ago
  Genuine question based on personal experience, is nicotine itself addictive or is it nicotine + method of delivery? Cause as someone who smokes cigars (don't inhale, do absorb nicotine via the mouth lining) I really don't find them addictive at all, that seems broadly the case with most cigar/pipe smokers we generally aren't addicted to them. And yet cigarettes are obviously super addictive, so is it something else in cigarettes that's adding to the addictive nature? Or inhaling into the lungs, where presumably you'd get a much faster hit or higher dose?
  - Pete_D 8y ago
    Another Gwern link: https://www.gwern.net/Nicotine https://www.gwern.net/Nicotine Highlight: "Wikipedia summarizes Guillem et al 2005 as "Technically, nicotine is not significantly addictive, as nicotine administered alone does not produce significant reinforcing properties" - the addictiveness coming from MAOIs (eg. Khalil et al 2000, Khalil et al 2006) & possibly other compounds present in tobacco" So I'd expect cigars and pipe smoking to be addictive. My personal experience is smoking cigarettes occasionally (average less than one a day), and I wouldn't say I was addicted either. My current hypothesis for why cigarettes seem more addictive is frequency. Searching "cigarettes per day average" turns up estimates mostly around 15 per day; most cigar/pipe smokers aren't anywhere near that. (Disclaimer: I am not a doctor or scientist.)
  - idDriven 8y ago
    As Pete_D linked below there is now some evidence questioning the addictiveness of pure nicotine, however for ethical purposes these studies are generally done using animal models, most commonly rats so YMMV. Animal studies don't always correlate 1:1 to human studies. The majority of studies I have read still find nicotine more addictive than placebo. Definitely traditional cigarette products, many of the manipulations done in treating most brands of cigarettes (the exception being brands marketed as natural i.e. American Sprits) made them more addictive by adding additional constituents and potentiators. In the combustion of tobacco products as well you have the active constituents bound to the smoke molecules, which are larger and therefore more absorbed in the lungs. So yes you would be getting more effect from lung-inhaling a combusted product. Vapor products have a much smaller particulate size so are mostly absorbed by the mouth and upper airway and much less lung-dependent. The other issue that may help to influence addiction is that there is some evidence that exposure to nicotine while the brain is still developing, leads to a tendency to use higher doses as an adult. This may translate to developing brains get used to this powerful nootropic and are more addicted as adults, as speculation, it would be hard to design a study to test this. In terms of vapor, freebase nicotine has traditionally been used in vapor products, these tend to show slower absorption and more even blood levels over time. What Juul innovated, and why their product is so much more effective that previous electronic cig-alikes (like Blu) that use freebase nicotine is the development of nicotine salts that allow for increased peak absorption more mirroring the absorption curve of a traditional cigarette. The relative addictive potential of nicotine salts vs. freebase nicotine has not yet been scientifically investigated. The World Health Organization and other health organizations that tend to prefer harm-reduction and scientific objectivity estimate vaping is at least 95% less harmful than tobacco as a nicotine delivery system. (Source: can cite links, RN who reads journal articles for fun. Smoker since 14 y/o switched to vape full-time almost a decade ago.)
Pete_D 8y ago
Since you say you're on a very low dose, may I suggest gum or lozenges? I tried nicotine patches for focus a while ago and found that even the weakest ones were far too strong.
- moron4hire 8y ago
  Did you try cutting the patches in half?
  - Pete_D 8y ago
    I didn't - I'd heard it was dangerous since breaking the membrane meant you'd absorb the contents a lot more quickly at the cut edge.

adrianm 8y ago

I think you should talk to a doctor about this.

moron4hire 8y ago
I don't think that is a helpful comment, especially considering I did say I am working closely with my doctor to monitor my health and mood. The practice of medicine is not actually that hard. It's all about risk profiles and benefit tradeoffs. The Lexapro I have been prescribed for my anxiety and the Advair for my asthma could very well be more dangerous for me than any trans-dermal Nicotine patch might be. Our Food and Drug Administration has decided that it's relatively safe for me to buy Nicotine in whatever amounts I want without any more restriction than me being more than 18 years old. They've decided that Advair and Lexapro have risk profiles worth forcing me to go through my doctor before allowing me to have any. We have thousands of years of data that shows Nicotine doesn't just randomly make you want to kill yourself. We have a lot of evidence that smoking tobacco can increase risk of cancer, and that the additives in commercial cigarettes can increase that risk a lot, but that doesn't apply to Nicotine specifically. There is some evidence that any sort of lung irritant can increase the risk of lung cancer, so even vaping might not be completely safe, but neither do we know the magnitude of that risk, especially separate from the many other irritants we're exposed to on a regular basis. I'm not trying to advocate for using Nicotine. There is a risk of smokers pointing to information like this and saying "see, my disgusting habit is not that bad". That's not at all what I'm saying. But just because I don't have MD after my name doesn't mean I can't make informed decisions on my own about my own treatment. I'm just sick of this infantilizing concept that intelligent adults can't figure out a few things on their own.
- spydum 8y ago
  While I whole heartedly agree with your logic and opinions on this: have you met many adults? They are awful at critical thinking. It strikes me that this is indeed a good chunk of why health/medicine is hard. Some people literally can’t be trusted to evaluate complex decisions effectively. So you end up with highly regulated practices, and those people who have the mental capacity are left out.
- adrianm 8y ago
  I’m a cancer patient undergoing treatment. Please be careful, you don’t want this.

thrower123 8y ago

Nicotine was one of the few nootropics that had real measureable positive effects in gwern's testing. Unfortunately it's addictive as hell, but nonetheless, you'd think that as much as we research into opiods and other narcotics, there would be more effort to find safer forms of nicotine or nicotine derivatives. https://www.gwern.net/Nootropics https://www.gwern.net/Nootropics

dageshi 8y ago
Genuine question based on personal experience, is nicotine itself addictive or is it nicotine + method of delivery? Cause as someone who smokes cigars (don't inhale, do absorb nicotine via the mouth lining) I really don't find them addictive at all, that seems broadly the case with most cigar/pipe smokers we generally aren't addicted to them. And yet cigarettes are obviously super addictive, so is it something else in cigarettes that's adding to the addictive nature? Or inhaling into the lungs, where presumably you'd get a much faster hit or higher dose?
- Pete_D 8y ago
  Another Gwern link: https://www.gwern.net/Nicotine https://www.gwern.net/Nicotine Highlight: "Wikipedia summarizes Guillem et al 2005 as "Technically, nicotine is not significantly addictive, as nicotine administered alone does not produce significant reinforcing properties" - the addictiveness coming from MAOIs (eg. Khalil et al 2000, Khalil et al 2006) & possibly other compounds present in tobacco" So I'd expect cigars and pipe smoking to be addictive. My personal experience is smoking cigarettes occasionally (average less than one a day), and I wouldn't say I was addicted either. My current hypothesis for why cigarettes seem more addictive is frequency. Searching "cigarettes per day average" turns up estimates mostly around 15 per day; most cigar/pipe smokers aren't anywhere near that. (Disclaimer: I am not a doctor or scientist.)
- idDriven 8y ago
  As Pete_D linked below there is now some evidence questioning the addictiveness of pure nicotine, however for ethical purposes these studies are generally done using animal models, most commonly rats so YMMV. Animal studies don't always correlate 1:1 to human studies. The majority of studies I have read still find nicotine more addictive than placebo. Definitely traditional cigarette products, many of the manipulations done in treating most brands of cigarettes (the exception being brands marketed as natural i.e. American Sprits) made them more addictive by adding additional constituents and potentiators. In the combustion of tobacco products as well you have the active constituents bound to the smoke molecules, which are larger and therefore more absorbed in the lungs. So yes you would be getting more effect from lung-inhaling a combusted product. Vapor products have a much smaller particulate size so are mostly absorbed by the mouth and upper airway and much less lung-dependent. The other issue that may help to influence addiction is that there is some evidence that exposure to nicotine while the brain is still developing, leads to a tendency to use higher doses as an adult. This may translate to developing brains get used to this powerful nootropic and are more addicted as adults, as speculation, it would be hard to design a study to test this. In terms of vapor, freebase nicotine has traditionally been used in vapor products, these tend to show slower absorption and more even blood levels over time. What Juul innovated, and why their product is so much more effective that previous electronic cig-alikes (like Blu) that use freebase nicotine is the development of nicotine salts that allow for increased peak absorption more mirroring the absorption curve of a traditional cigarette. The relative addictive potential of nicotine salts vs. freebase nicotine has not yet been scientifically investigated. The World Health Organization and other health organizations that tend to prefer harm-reduction and scientific objectivity estimate vaping is at least 95% less harmful than tobacco as a nicotine delivery system. (Source: can cite links, RN who reads journal articles for fun. Smoker since 14 y/o switched to vape full-time almost a decade ago.)

Pete_D 8y ago

Since you say you're on a very low dose, may I suggest gum or lozenges? I tried nicotine patches for focus a while ago and found that even the weakest ones were far too strong.

moron4hire 8y ago
Did you try cutting the patches in half?
- Pete_D 8y ago
  I didn't - I'd heard it was dangerous since breaking the membrane meant you'd absorb the contents a lot more quickly at the cut edge.