Despite governments around the world endorsing safer nicotine in the form of nicotine replacement therapy, there remain widespread misconceptions about the safety of nicotine compared to harmful combustible tobacco. In the second part of our series exploring the therapeutic uses of nicotine, Michael Kariuki walks us through the current clinical uses of nicotine and the opportunity posed by safer nicotine products to greatly reduce smoking related mortality.
Chapters:
0:00 - Positives and negatives of NRT 5:13 - Where do nicotine misconceptions come from? 6:30 - UK embraces vaping in effort to combat smoking 8:55 - Thousands of lives could be saved in KenyaTranscription:
00:23
Joanna Junak: okay let's now talk about the advantages and disadvantages of therapeutic nicotine what are they?
00:43
Michael Kariuki: Yes, therapeutic nicotine number one of course it will be used to assist smokers of combustible cigarettes to quit the use of combustible cigarettes by providing therapeutic nicotine. So it is very key in smoking cessation programs that therapeutic nicotine is quite important because you remove all the harmful effects of tobacco and you are left with now this nicotine that has been shown to work. It has been shown to work as a form of therapeutic nicotine. Another benefit of nicotine is that it increases levels of alertness, euphoria, it has a relaxation effect. That is without doubt has been proved to do that and of course it improves concentration and memory because we all know what nicotine does to the nicotinic receptors in the brain, increasing the release of dopamine and in addition to that it has been shown to reduce anxiety. And it's very important to know that this is at certain dosages of nicotine that you enjoy these effects. But as the nicotine dosages increase and you undergo what we call desensitization of receptors, then things are likely to change on this. Of course, there have been so many discussions about the disadvantages of nicotine. And I just want to point out one of the very known disadvantages which is yet to be proved to be harmful, such as increasing the heart rate, causing vessel constriction of the vessels, causing what we call raised blood pressures, And a lot of discussions are still going on on the dangers of these cardiovascular effects of nicotine. Of course, we've seen some papers published trying to link nicotine with atherosclerosis, but it has not been proved simply because when you look at most of those studies, you find that the subjects whom they were studying were smokers of combustible cigarettes. And we all know the effect of tobacco and atherosclerosis. So you could attribute to the atherosclerosis purely to the tobacco use. And as more and more use of these nicotine products is being adopted, we'll be in a better position to really know what is happening. Of course, it can give you some dizziness, some lightheadedness in terms of a side effect. And this is very important because even as we prescribe these nicotine replacement therapies, we'll tell the patient or the user that watch out for lightheadedness. Watch out for some bad dreams or nightmares as you who take these nicotine replacement therapies so that they are fully aware on these side effects. One thing that I want to dispel for sure are myths that have been surrounding nicotine for a very long time, whereby we see so many health professionals and health bodies say that nicotine causes cancer. I want to put it very clear that nicotine does not cause cancer and that is a fact and that has been proven scientifically and that is what we need to teach even health professionals that nicotine does not cause cancer.
05:14
SPEAKER_00: Yes, you said that nicotine does not cause cancer. So where did the misinformation that nicotine causes cancer come from?
05:22
Michael Kariuki: That misinformation is brought about by one major issue whereby most people, most of these professionals, most of these healthcare workers believe that nicotine is equal to tobacco. And I can tell you that nicotine is not the same as tobacco, and that is why there is that misconception. We all know that tobacco has more than 6,000 cancer-causing agents, the tobacco-specific nitrosamines and many other products. But nicotine in its form as nicotine alkaloid does not cause cancer. So this misinformation stems from the fact that a majority of those who say so equate nicotine to tobacco. And it needs to be very clear that nicotine is not tobacco.
06:30
SPEAKER_00: Nicotine replacement therapy is an example of the use of therapeutic nicotine. So what is NRT and how does it differ from therapeutic nicotine in general?
06:43
Michael Kariuki: Yes, nicotine replacement therapies, as the name suggests, these are medications or therapies or drugs, pharmaceuticals, that have been specifically been developed to assist smokers to quit and there is the use of synthetic nicotine in these products such as nicotine patches, nicotine gums, nicotine lozenges, nicotine sprays, nicotine inhalers and the whole idea is to give the user of the combustible cigarette an opportunity to have these nicotine replacement therapies so that as they smoke the cigarettes, they derive all this pleasure and euphoria from nicotine. So if you can remove all the harmful products from this tobacco and remain with the nicotine, then you may be able to assist. Actually, you'll be able to assist these smokers of combustible cigarettes to quit the use of combustible cigarettes. And nicotine replacement therapies were developed with that in mind. And of course, as I said, these are World Health Organization approved. Most governments, including Kenya, The Ministry of Health, the Pharmacy and Poisons Board in Kenya does approve this nicotine replacement therapies as a form of therapy to assist more past quits. So it's a form of that therapeutic nicotine. But as I said earlier, other forms of therapeutic nicotines that are used elsewhere, for example, in the UK in the form of electronic cigarettes, have not yet been permitted and have not yet been recognized as therapeutic in nature in this country.
08:56
SPEAKER_00: And how can therapeutic forms of nicotine such as NRT help reduce the number of smoking related deaths in Kenya?
09:06
Michael Kariuki: Well, indeed, this country has about 3 million smokers of tobacco. And that includes the adult men, women and adolescents who smoke. And it cannot go without saying that in Kenya, we are losing more than 8000 people every year. due to tobacco-related diseases such as cancer brought about by tobacco, such as cancer brought about by tobacco, such as airway diseases brought about by tobacco, And it is important to emphasise that if we are able to get these smokers out of combustible cigarettes, then indeed we will have saved 8,000 people and above from these deaths related to tobacco. And of course it goes beyond that because families get strained in terms of financial resources as they take care of the sick, the hospital set-ups. The government has to allocate more resources towards treating these people. Note that once therapeutic forms of nicotine are available, such as NRT, they will go a long way. The challenge is that we have better forms of therapeutic nicotine that can assist smokers to quit, which has been proven to be far much better in terms of comparison compared to nicotine replacement therapies. So the debate has been Even as we embrace our nicotine replacement therapies that have been standard, it's important also to embrace these newer products that have been shown to be safer alternatives to tobacco consumption so that we reduce the mortality, the deaths of these patients and improve their general health being.
11:48
SPEAKER_00: Thank you, Michael. That's all for today. Tune in next time here on GFN TV or on our podcast. You can also find transcriptions of each episode on the GFN TV website. Thanks for watching or listening. See you next time.