Public perceptions of nicotine have long been marred by its association with harmful constituents of tobacco smoke, despite the substantial evidence showing that nicotine is not responsible for the many non-communicable diseases caused by tobacco smoking. Nicotine, safely administered, has long been accepted by governments and health authorities, including the WHO, as a valuable tool to aid smoking cessation in the form of nicotine replacement therapy. Joining us today is Michael Kariuki, a consultant pediatrician and epidemiologist from Kenya, to discuss the therapeutic applications of nicotine and the vital role of safer nicotine products in aiding smoking cessation.
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0:00 - Coming up on today's programme 0:43 - What is therapeutic nicotine? 6:17 - WHO endorses NRTTranscription:
00:04
Joanna Junak: Hello and welcome! I'm Joanna Junak and this is GFN News on GFN.TV. Therapeutic nicotine refers to the broad use of nicotine in clinical applications, primarily in the treatment of addictions. What is therapeutic nicotine? How does it work? And how is it used as a part of nicotine replacement therapy? Joining us today to discuss therapeutic nicotine, along with its benefits and downsides, is Michael Kariuki, consultant, paediatrician, epidemiologist, public health advocate and researcher, as well as the Secretary-General and founder of the Harm Reduction Society Kenya. Hello, Michael. Thank you for joining us today. Can you tell us what therapeutic nicotine is and what its uses are?
01:12
Michael Kariuki: Yeah, thank you very much. Therapeutic nicotine as the term suggests therapeutic. Therapeutic is something that is a product that can be used for treatment. And when we talk about therapeutic nicotine, we are looking at nicotine as a treatment drug. And for sure, indeed, we know that nicotine is therapeutic for those who are planning to stop smoking combustible cigarettes in what we call smoking cessation. It is very key in some of the products for smoking cessation, ranging from nicotine replacement therapies, which are quite widely used in Kenya and this part of the world. The main problem being the costs. And of course, we all know about the efficacy of nicotine replacement therapies. as compared to these other safer alternatives, which are quite common in, for example, the UK, where they use e-cigarettes as a modality to assist smokers of combustible cigarettes to quit smoking. In addition to that, therapeutic nicotine has been studied extensively especially in some diseases such as Parkinson's disease, diseases such as Alzheimer's disease. And we all know that nicotine does increase attention, concentration and memory. And in these two diseases, a lot of studies have been done which have proved to be some therapeutic effect of nicotine in these diseases, and that nicotine tends to delay the onset of these diseases and also delay the progression. We have also seen that nicotine has been studied extensively as therapy for attention deficit hyperactive disorder, as well as Tourette's syndrome. This is a tick disorder. and it has been shown to have an effect on that as well as depression and other psychiatric conditions such as schizophrenia whereby we know patients with schizophrenia or depression have been proved to have a better outcome through observation studies and other studies done that we all know that Patients with psychiatric conditions such as schizophrenia and depression will tend to smoke more. And the whole idea is that the nicotine they are deriving from these cigarettes tend to reduce the side effects of these diseases and the progression. of schizophrenia and depression. And it has been studied extensively in those two areas. We also know that nicotine or therapeutic nicotine has also been studied in diseases such as ulcerative colitis and arthritis. So there are many applications which therapeutic nicotine has been studied extensively. But one that we know for sure without a doubt and has been applied practically is the use of nicotine in cessation of smoking to assist those who are using combustible cigarettes to quit smoking. We have seen a lot of studies about nicotine and assisting those who are obese in getting to reduce their weight simply because nicotine has been shown to act on the satiety center whereby your feeding drastically goes down on this particular aspect. On these particular diseases, a lot of research has been done and what has been shown is that indeed therapeutic nicotine may have a role in these diseases and disorders.
06:17
Joanna Junak: Okay, and what forms of therapeutic nicotine do we see in Africa, particularly in Kenya where you work?
06:27
Michael Kariuki: Yes, the main forms that are available here in the form of nicotine replacement therapies, which are approved, and what we have is we have nicotine patches, we have nicotine lozenges, we have nicotine sprays, we have nicotine gums, and these are the main forms of nicotine replacement therapies that are found in this part of the world as therapeutic nicotine and more so for assisting smokers to quit smoking combustible cigarettes. We are still in the process of debating about the safe alternatives which also have nicotine such as electronic cigarettes and they are used to assist smokers to put down combustible cigarette, but that debate is still raging. And so far as we speak, they have generally not been accepted as therapeutic forms of nicotine. And what we have is the nicotine replacement therapies, not only in Kenya, but widely in Africa. And this stems from the fact that these forms of therapeutic nicotine are approved by WHO. So most of these countries, including Kenya, will adopt World Health Organization recommendations on this therapeutic nicotine. But we have seen in other countries where the adoption of electronic cigarettes is really picking up, such as the UK.