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FYI, Altria owns Philip Morris Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids December 20, 2018 https://www.tobaccofreekids.org/press-releases/2018_12_20_altria_juul WASHINGTON, D.C. – The announcement that Altria is buying a 35 percent stake in Juul is a truly alarming development for public health and brings together the two companies that have been the most successful in marketing their highly addictive products to kids. Public health is the loser in a deal that joins America’s most powerful cigarette company, whose success has been driven by Marlboro’s appeal to our youth, and the company responsible for the explosive growth in e-cigarette use among our nation’s children. Altria has no interest in reducing the number of people who smoke cigarettes. They see Juul as their failsafe in case the cigarette market keeps declining so that they remain profitable no matter what happens. Altria’s interests are served by maximizing sales and profits from both the cigarette and e-cigarette markets, and they have every reason to push Juul to market its products in a way that does the least damage to the cigarette market. As for Juul, the company has lost all credibility in claiming that it cares about public health. There is no longer any question that Juul has been the driving force behind the skyrocketing youth e-cigarette epidemic that has teens and families across the country struggling to deal with nicotine addiction. Juul’s growth has been powered by its success in addicting kids, and the company’s owners have just become billionaires as a result. This deal also creates a political behemoth that is likely to increase the already huge sums these companies spend to fight regulatory and legislative efforts to discourage use of their products. This deal underscores the urgent need for effective FDA regulation of e-cigarettes and all tobacco products to stop tobacco companies from reversing decades of progress and addicting another generation of kids. The FDA should strengthen its efforts to address the youth e-cigarette epidemic by prohibiting all flavored e-cigarettes that have not been subject to public health review by the agency, stopping online sales of e-cigarettes until stronger safeguards are in place to prevent sales to kids, restricting marketing that appeals to kids, and enforcing rules prohibiting the sale of new products without prior FDA review and authorization. It is also critical that the FDA quickly implement its proposals to accelerate reductions in use of cigarettes and other combustible tobacco products. These include banning menthol cigarettes and flavored cigars and reducing nicotine levels in cigarettes to non-addictive or minimally addictive levels (and it should extend the latter proposal to other combustible products). The Altria-Juul deal shows how far the tobacco industry will go to maximize profits and sell as many products as possible, including cigarettes. The FDA and other policymakers must be equally aggressive in working to reduce tobacco use and save lives.

Video discusses how former smokers have first hand knowledge of how they got trapped into nicotine addiction and how they can use that experience to their advantage to help prevent young people they care about from making the same mistake.

Video discusses how nicotine addiction takes a toll on all users, even if they are lucky enough to never go on to develop any major medical problems associated with its use.

NOPE!

A study at the University of Birmingham shows the effect of vaping liquid after being inhaled, and it's not good. Derek Beres 21 August, 2018 Here we go again. Advocates for a “healthier” alternative to cigarettes took another hit from a recent study published in the journal, Thorax. A number of previous studies have focused on e-cigarette liquid before being vaped. For this research, University of Birmingham coauthor Dr. David Thickett, a professor in the Institute of Inflammation and Ageing, investigated the effects on the lungs after inhalation. Thickett and his team took tissue samples from eight nonsmokers to study the effects of the liquid over the next 48 hours. They discovered that the vapor causes the production of inflammatory cytokines, as well as the inhibition of a cellular “safety device,” phagocytosis. Simply put: "We show a significant increase in cytotoxicity caused by the vaping process itself." Cytokines are a broad group of proteins that affect local cells. They are particularly critical in the functioning of the immune system. They help determine the body’s response to a host of potential issues, including cancer, sepsis, trauma, and, as this study shows, inflammation. Vaping increases inflammatory behavior in lung tissue cells. It also decreases the efficacy of a process called phagocytosis, in which pathogens and cell debris are removed from the immune system. As the inflammatory cell response is increasing, the very mechanism that helps combat it is silenced. The popularity of vaping continues, however. In 2017, over one-quarter of high school seniors and 13 percent of eighth graders claimed they vaped. Research shows that college freshmen who vape are more likely to indulge in cigarettes as well. But when a company like Juul is valued at $16 billion, chances that we'll slow down are slim. And so the debate regarding the safety of cigarettes versus e-cigs continues. Thickett notes that there are still fewer carcinogens in the vaping liquid. In this sense, vaping appears safer than cigarettes. Yet Thickett says that in 20 or 30 years time, chronic obstructive pulmonary disease remains a real possibility for e-cig users. "I don’t believe e-cigarettes are more harmful than ordinary cigarettes. But we should have a cautious scepticism that they are as safe as we are being led to believe." The authors of the study also note that they have not studied the flavors used in vaping liquid, which could promote further toxic effects. The lesson remains: nothing goes into your lungs without consequence. The question is how much of a risk you’re willing to take.

https://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html E-Cigarettes Electronic cigarettes, or e-cigarettes, are tobacco products that have been sold in the U.S. for about a decade. They include e-pens, e-pipes, e-hookah, and e-cigars, known collectively as ENDS—electronic nicotine delivery systems. They’re also sometimes called JUULs, "vapes" and "vape pens." E-cigarettes are the most commonly used tobacco products among kids—and it’s become an epidemic. While much remains to be determined about the lasting health consequences of e-cigarettes, there’s evolving evidence about the health risks of e-cigarettes on the lungs—including irreversible lung damage and lung disease. The American Lung Association is very concerned that we are at risk of losing another generation to tobacco-caused diseases as the result of e-cigarettes. The Lung Association remains extremely troubled about the rapid increase of youth using these products and has repeatedly called upon the Food and Drug Administration (FDA) to increase their oversight and scrutiny of these products to protect kids. What You Need to Know About E-Cigarettes Below are answers to common questions about e-cigarettes, including health consequences, risks of secondhand emissions, kids and e-cigarettes and FDA oversight. What Are E-Cigarettes? Electronic cigarettes, or e-cigarettes, include e-pens, e-pipes, e-hookah, and e-cigars are known collectively as ENDS— electronic nicotine delivery systems. According to the FDA, e-cigarettes are devices that allow users to inhale an aerosol containing nicotine or other substances. Unlike traditional cigarettes, e-cigarettes are generally battery-operated and use a heating element to heat e-liquid from a refillable cartridge, releasing a chemical-filled aerosol. What's in E-Cigarettes? The main component of e-cigarettes is the e-liquid contained in cartridges. To create an e-liquid, nicotine is extracted from tobacco and mixed with a base (usually propylene glycol), and may also include flavorings, colorings and other chemicals (such as formaldehyde and acrolein, which can cause irreversible lung damage). Are E-Cigarettes a Gateway to Youth Smoking? The National Academies of Science, Engineering and Medicine concluded there is "substantial evidence" that if a youth or young adult uses an e-cigarette, they are at increased risk of using traditional cigarettes. What Are the Health Consequences of E-Cigarette Use? A recent study from the University of North Carolina found that even in small doses, inhaling the two primary ingredients found in e-cigarettes—propylene glycol and vegetable glycerin—is likely to expose users to a high level of toxins and that the more ingredients a user is inhaling, the greater the toxicity.1 The mid-to-long-term consequences of e-cigarettes are not yet known, as it's a new product and has been sold for less than a decade in the U.S. While much remains to be determined about these lasting health consequences of these products, we are very troubled by what we see so far. The inhalation of harmful chemicals can cause irreversible lung damage and lung diseases. Can E-Cigarettes Help Smokers Quit? The Food and Drug Administration has not found any e-cigarette to be safe and effective in helping smokers quit. If smokers are ready to quit smoking for good, they should call 1-800-QUITNOW or talk with their doctor about finding the best way to quit using proven methods and FDA-approved treatments and counseling. Are There Risks of Secondhand E-Cigarette Emissions? In 2016, the Surgeon General concluded that secondhand emissions contain, "nicotine; ultrafine particles; flavorings such as diacetyl, a chemical linked to serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin, and lead."2 Why Isn't More Being Done to Protect Kids from E-Cigarettes? In March, the American Lung Association and our public health partners filed a lawsuit against the Food and Drug Administration challenging its decision that allows electronic cigarettes and cigars—including candy-flavored products that appeal to kids—to stay on the market for years without being reviewed by the agency. The lawsuit contends that the FDA's decision leaves on the market tobacco products that appeal to kids, deprives the FDA and the public of critical information about the health impact of products already on the market, and relieves manufacturers of the burden to produce scientific evidence that their products have a public health benefit.

Date: May 26, 2015 Source: American Physiological Society (APS) Summary: With the use of e-cigarettes on the rise, especially among young people, research to uncover the health effects of e-cigs is becoming increasingly important. In a new study, researchers find that e-cig solution and vapors—even those that are nicotine-free—damage lung health. https://www.sciencedaily.com/releases/2015/05/150526084955.htm Electronic cigarette (e-cig) use has now surpassed traditional cigarette use among middle and high school students, according to the Centers for Disease Control and Prevention. This leaves many parents, public health officials and consumers asking whether e-cigarettes are better or worse for lung health than traditional cigarettes. Now, a team of researchers adds its findings to others that suggest nicotine in any form is damaging to lungs. This new research also suggests that non-nicotine-containing e-cig solutions have a damaging effect on lung health, leading researchers to call for more e-cig research. The loss of integrity in the lung endothelial cells -- the cells that make up the lining of the lungs -- can contribute to lung injury and inflammation, but it is unknown what component of cigarette smoke causes lung cells to breakdown. Researchers wrote, "We investigated if nicotine, one of the hundreds of molecules present in [cigarette smoke] extracts, is sufficient to alter lung endothelial barrier function by affecting cytoskeletal regulation," which is the cell's internal matrix that supports cell shape and function. The researchers exposed mice and both human and mouse cells to cigarette smoke and e-cigarette solution that either contained nicotine or was nicotine-free. Their findings shed light on how cigarette smoke damages the lungs and point directly to nicotine as the cause. "Nicotine has dose-dependent deleterious pulmonary effects that result in loss of lung endothelial barrier function, acute lung inflammation and decreased lung endothelial cell proliferation," they wrote. The effects of nicotine were seen both in cigarette smoke and in e-cig solutions that contained nicotine. Interestingly, nicotine-free e-cig solutions were also found to include lung-harming substances, such as acrolein. This substance, which is present in both e-cig solution and vapor, has been shown to damage the lungs by attacking the molecules that hold endothelial cells together. "The increased use of inhaled nicotine via e-cigarettes, especially among the youth, prompts increased research into the effects on health. This research reports that components found in commercially available e-cigarette solutions and vapors generated by heating them may cause lung inflammation," said lead researcher Irina Petrache, PhD. "The effects described characterize short-term effects of e-cig exposures. Whereas studies of long-term effects await further investigations, these results caution that e-cigarette inhalation may be associated with adverse effects on lung health." The article "Endothelial disruptive pro-inflammatory effects of nicotine and e-cigarette vapor exposures" is published ahead of print in the American Journal of Physiology -- Lung Cellular and Molecular Physiology.

You might as well work in a coal-fired power plant without any respiratory protection. Good article below. By Alan Mozes HealthDay Reporter https://www.webmd.com/smoking-cessation/news/20180226/toxic-metals-found-in-e-cigarette-vapor#1 MONDAY, Feb. 26, 2018 (HealthDay News) -- If you think that "vaping" is a safe alternative to smoking, new research suggests you might be inadvertently inhaling unsafe levels of toxic metals. Scientists say the tiny metal coils that heat the liquid nitrogen in e-cigarettes may contaminate the resulting vapor with lead, chromium, manganese and nickel. The finding raises the possibility that e-cigarettes are not harmless to users. "We analyzed 15 metals in e-liquid from the refill dispenser -- before the liquid meets the heating element -- in the vapor, and in the remaining e-liquid in the tank after vaping," explained study author Pablo Olmedo. He's an assistant scientist with the Johns Hopkins School of Public Health's department of environmental health and engineering, in Baltimore. "We found that the metal concentrations were generally higher in the tank and aerosol compared to the refill dispenser," said Olmedo. That suggests that the heating coil is the smoking gun, he added. But study co-author Ana Maria Rule pointed out that their team also found "the presence of some metals in some of the liquids even before they are in contact with the coil." That could mean that "in addition to the metal coil, other factors could play a role in e-cigarette metal exposure, such as the voltage used to heat the coil," said Rule, also an assistant scientist at Hopkins. Unlike traditional smoking, vaping works by heating liquids that contain nicotine. The liquid passes through a heating coil, producing a vapor that proponents claim is free of much of the carcinogens associated with burning tobacco leaves. Given that a recent U.S. National Institute on Drug Abuse survey found that one in six high schoolers has vaped in the past month, the finding could have broad public health implications, the researchers said. In the Hopkins study, published Feb. 21 in the journal Environmental Health Perspectives, investigators recruited 56 vapers in the Baltimore area to see whether the heating process introduces toxins into what is inhaled. The researchers used the vapers' own e-cigarette devices when examining the chemical content of e-liquid, vapor and residue. Tested chemicals included: aluminum, antimony, arsenic, cadmium, chromium, copper, iron, lead, manganese, nickel, titanium, tungsten, uranium and zinc. Prior research has linked prolonged inhalation of such metals to lung, liver, heart and brain damage. Chronic exposure may also depress immune system function and raise the risk for certain types of cancer, the researchers said. The team found that e-liquid exposed to heating coils produced a vapor containing significant amounts of chromium, lead, manganese, nickel and zinc. Highly toxic arsenic was also found in both the e-liquid and the heated vapor among a subset of 10 vapers, though how that metal got into the unheated e-liquid remains unclear. The team also noted that toxic metal levels seemed to be higher among vapers who changed their heating coils more often, suggesting that new coils may produce more toxins than older ones. Regardless, Rule said, vapers should know that "as far as we know, all current electronic cigarettes use a metallic coil to generate the vapor, so not vaping is the only way to avoid or mitigate this [toxic] exposure." As for whether vaping is safer than smoking or worse, Rule said the team "did not set out to compare e-cigarettes to cigarettes."

Nicodemon's Lies? by John R. Polito Nicotine Cessation Educator https://whyquit.com/whyquit/A_NicodemonsLies.html Why a question mark behind "Nicodemon's Lies"? Because there is no Nicodemon. Because there are zero monsters or demons within us. It's just another lie, our lie, as dependency ignorance tried to make sense of continued smoking. As teenagers, what most of us thought would be a brief rebellious experiment was quickly transformed into a powerful lifelong chemical addiction as regular nicotine feedings soon became mandatory. Research confirms that for many, it only took a couple of nicotine laden cigarettes before the shackles of slavery started to close. What seemed innocent soon resulted in a brain wanting disorder. Without us realizing it, nicotine was activating, saturating, de-sensitizing and up-regulating dopamine pathway receptors, as our brain's priorities teaching circuitry was taken hostage. Two, five, eight nicotine fixes a day. When will enough be enough? "I'll quit tomorrow" or "I love smoking" became our cry! Welcome to the realities of true chemical dependency. A world built upon lies. Science calls our lies denial. Denial is an unconscious defense mechanism - just below the surface - for resolving the emotional conflict and anxieties that naturally arise from living in a permanent state of self-destructive chemical bondage. Three primary areas of denial relied upon by nicotine addicts are dependency denial, cost denial and recovery denial. Truth is sacrificed for peace of mind, to remain hostage in an artificial world of "nicotine normal," or to justify relapse. Most nicotine addicts we'll see today are fully insulated by a thick blanket of unconscious denial rationalizations, minimization's, fault projections, escapes, intellectualizations and delusions that hide the pain of captivity or create the illusion that the problem is somehow being solved. The average addict musters the courage to say "no" to the wanting for that next fix about once every 2.5 years. It's then that roughly 1 in 20 will succeed in breaking free for an entire year. These horrible recovery statistics eventually result in half of us dying by our own hand, with male smokers losing an average of 13 years of life expectancy, while females lose 14. Our intentional self-destruction is undeniable evidence of the depths of denial. Denial insulates us from the extreme price paid with each and every puff - a little more of life itself. It doesn't have to be. Welcome to WhyQuit, we've been waiting on you! Aside from this article, we've put together a vast array of quality recovery tools to aid you in becoming far smarter than your addiction is strong. They include mind-expanding motivational pages, the Net's largest collection of original quitting articles, quitting tip lists, two free quitting e-books ("Never Take Another Puff" and "Freedom from Nicotine - The Journey Home"), more than 400 free video lessons, and highly focused group support at Turkeyville, our Facebook group. According to the World Health Organization, the next three years will cost 15 million of our brother and sister addicts their lives. Once residing here on Easy Street with us, we hope you'll share what you've learned as failure to either self-discover or be taught the "Law of Addiction" is a horrible reason to die. OUR LIE: My cigarettes are my friend. THE TRUTH: Friend or master? What kind of "friend" would deprive us of oxygen, take away our ability to smell, burn our clothes, destroy our teeth, harden our arteries, elevate our blood pressure, daily feed us 4,000+ chemical compounds that include arsenic, ammonia, acetone, formaldehyde, butane, massive doses of carbon monoxide, hydrogen cyanide, methane, stearic acid, vinyl chloride, mercury, and lead, together with 81 known cancer causing agents (one of which is created when nicotine breaks down - NNK), before finally killing you with cancer, a stroke, a heart attack or emphysema? Imagine seeing your executioner as a friend. Imagine residing inside a mind that is so sick it is willing to trade 13 years of life for one chemical. OUR LIE: I enjoy smoking. THE TRUTH: This may be the most deeply ingrained rationalization of all as it has a solid basis in the following flawed denial logic. "I don't do things that I don't like to do." "I smoke lots and lots of cigarettes." "Therefore, I must really enjoy smoking," instead of the correct conclusion, "therefore, I must really be chemically addicted to smoking nicotine." Did you enjoy being the unaddicted "you" or have you forgotten what it was like to live comfortably inside a mind that does not crave for nicotine? If you cannot remember what it was like being "you" then what basis do you have for honest comparison? If you truly enjoyed being addicted to nicotine then why are you here reading these words? Is it that you liked smoking or that you liked not having to experience what occurred when you didn't smoke - withdrawal? Studies have long ranked nicotine as a more addictive substance than either heroin or cocaine. In fact, cocaine's generally recognized addiction rate among regular users is 15% while nicotine's addiction rate of over 70% is at least five times as great. Imagine convincing your mind that it " likes " being addicted to the drug that addiction scientists now rank as the most addictive substance on all of planet earth. We are nicotine addicts . A pack a day smoker smokes 7,300 cigarettes each and every year. How many of your last 7,300 nicotine fixes did you really enjoy ? How many of the next 7,300 will bring tremendous joy to your life? Isn't it time to be honest? OUR LIE: My spouse, close friend or family member smokes. I'm waiting for them to quit with me. THE TRUTH: Procrastination recovery denial makes the next puff of toxins easier to suck down. Nicotine tells this junkie that they cannot quit until their friend or loved one quits too as they're around their smoke, smells, cigarettes, breath and ashtrays, and quitting is thus impossible. It's pure denial and often both friends or loved ones use the other as their excuse to remain enslaved. How long will you continue to destroy your body while waiting for someone else to quit with you? A lifetime? If and when they do quit with you, what will you do if they relapse? Will "love" cause you to do the same? One of you needs to stand tall and lead the way. It's okay to have hope for a loved one but you must quit for "you" or it's doomed from the very start. Why make your freedom, health or life dependent upon another person's decision. As for being around smokers, it's unavoidable. Should we expect planet earth's 1.2 billion nicotine addicts to disappear once we commence recovery? Won't we still see them and smell their smoke at restaurants, as they stand around outside stores or even hospitals, or as they puff away in the car beside us? Will all the stores pull-down their cigarette displays or move them from arm's reach just because we're trying to reclaim our mind and life? Why live the lie that "I smoke for love!" OUR LIE: It reduces my stress and helps calm me down. THE TRUTH: This stress buster rationalization is false. The body's pH balance is delicate. Nicotine is an alkaloid and stress an acid producing event. The more stressful the event, the quicker the body's remaining nicotine reserves are neutralized (in the same manner as pouring a baking soda solution on an acid covered car battery terminal). The stressed smoker is thrown into early chemical withdrawal adding additional anxiety to the underlying original stressful event. It's why the anxiety associated with a flat tire causes smokers to reach for a cigarette while the non-smoker reaches for a jack. The anxieties build until the doubly stressed smoker cries out "I NEED A CIGARETTE!" Within eight seconds of the first puff, the smoker's nicotine blood serum nicotine level rises and their withdrawal anxieties subside. The addict is left with the false impression that smoking cured the underlying stressful event when in fact the tire is still flat. All non-smokers experience stress too. The difference is that they don't add early nicotine withdrawal to it. In truth, stress nicotine depletion causes smokers to experience far more anxiety than non-smokers. In truth, it is much easier and calmer being the real "you" than it is living as a chemical slave. OUR LIE: My friends smoke, I'll lose them. THE TRUTH: The nicotine smoker's mind has been conditioned to believe, through association, that smoking is central to their entire life. Telephone calls, computer time, work, meals, driving, talking, walking, stress, joy, sorrow, and even romance, may have developed a subconscious association with smoking. The truth is that none of these activities will be altered whatsoever by the absence of tobacco. The truth is that quitting smoking will not deprive you of even a single friend or loved one. The truth is that smoking is costing you new friends and possible relationships as fewer and fewer non-smokers are willing to tolerate being around the smell and the smoke. Can you blame them? With the exception of quitting, your current life doesn't need to change at all unless you want it to change. It might be nice to enlarge your circle of friends to include those who don't stand around the community ashtray, but that's totally up to you. OUR LIE: It wakes me up and keeps me alert. THE TRUTH: This dependency rationalization uses a basic truth (nicotine releases adrenaline and a host of other hormones) to hide the fact that nicotine deprives us of the ability to enjoy prolonged periods of deep conscious relaxation. If always at the peak of alertness because we are addicted to and chemically dependent upon a central nervous system stimulant then when do we truly relax? This dependency rationalization also subverts and ignores a host of natural alertness techniques ranging from a simple deep breath to brief periods of stretching or moderately exhilarating activity. Instead of engaging life on life's terms, a powerful puff of nicotine starts a neurochemical chain-reaction that increases breathing rate, accelerates heart rate, constricts blood vessels, elevates blood pressure, causes the liver to release stored cholesterol into the blood stream, the adrenal gland to release glucocorticoids, the thyroid to release metabolism hormones, the hypothalamus to release corticotropin-releasing hormones, a decrease of progesterone levels in females and testosterone in males, digestive tract shut-down, a glucose release into the bloodstream followed by a boost in insulin to metabolize it, pupil dilation, and your blood to thicken. Inside those highly constricted and over-pressurized blood vessels, carbon monoxide eats away at their teflon like lining (endothelium) while nicotine amazingly vascularizes fat buildups, causing arteries to harden. More smokers die from circulatory disease each year than from lung cancer, yet denial kept almost all of them from wanting to know how or why. What goes up must come down. Once the hormones wear off and that drained feeling begins to arrive, a new puff of nicotine again whips every central nervous system neuron in a tired body like some overworked horse never allowed to rest. Alert, yes, but somewhere in that endless cycle between alert and exhausted resides the "real" you. OUR LIE: My concentration is better. THE TRUTH: Vast quantities of carbon monoxide do NOT improve concentration. Although nicotine is a stimulant and does excite certain brain neurons, it also constricts all blood vessels. Feel how cold your fingers and toes get when deprived of blood flow while smoking. Imagine what's happening to the blood vessels in your brain. If nicotine results in a stroke we probably won't need to worry much about concentration. Fresh air and exercise are far healthier brain stimulants. When quitting it's important that you understand the role that nicotine played in regulating blood sugar as its absence may cause the temporary impairment of concentration and clear thinking. If you are experiencing any concentration problems be sure and drink plenty of fruit juice the first three days if your diet and health permit (cranberry is excellent), as it will help stabilize blood sugars. Also don't skip meals! Nicotine released stored fats into our blood and in a sense fed us with every puff, but not anymore. Don't eat more food each day, just spread your normal intake out more over your entire day so that you keep fuel in your stomach and your blood sugar level. OUR LIE: It's something to do with my hands. THE TRUTH: So is playing with a loaded gun and they both have the same potential for harm. This weak addiction rationalization ignores that doodling with a pen, playing with coins, squeezing a ball or using strength grippers may be habit forming but are non-addictive. You might get ink on yourself, rich or strong wrists but your chances of serious injury or death are almost zero. OUR LIE: My coffee won't be the same. THE TRUTH: More junkie thinking! Your coffee's flavor will remain identical. In fact, it may even taste better once your taste buds heal after years of being numbed, coated and poisoned. Your sense of smell may become so refined that you'll smell fresh coffee brewing more than one hundred feet away. Although you don't need to give up your coffee or any thing else except nicotine during recovery, be aware that nicotine somehow doubles the rate ( 203%) by which caffeine is metabolized by the body. As a new ex-smoker you may only need half as much caffeine in order to obtain the same effect. If you are a heavy caffeine user and find yourself experiencing increased anxiety during recovery, or encounter difficulty sleeping, try reducing your intake by roughly half. OUR LIE: There's lots of time left to quit. THE TRUTH: This year tobacco will kill 5,000,000 humans. Roughly 1 in 4 smokers die in middle-age, each an average of 22.5 years early. In order for 22.5 to be the average, how many hundreds of thousands had to die even younger? Maybe you have plenty of time remaining and maybe not. Dying in your thirties or forties is a powerful price to pay for guessing wrong. The numbers above only reflect DEATH by tobacco. You may be lucky enough to be among the millions of nicotine smokers each year who survive and "only" have a heart attack, a stroke, a lung removed, go onto oxygen, or who receive news of permanent lung disease as they for every breath. Which puff, from which cigarette, in which pack, will pull the trigger that fires the gun? The odds of a male smoker dying from lung cancer are 22 times greater than for a non-smoker. His odds of dying from emphysema are ten times greater. How much longer will your luck hold? OUR LIE: It's one of my few pleasures in life. THE TRUTH: Does that mean that it's better than the pleasure of having a throat to deliver fresh air and great food, two lungs with which to laugh, a healthy heart to feel love, or an undamaged mind which dreams of wonderful tomorrows? Pleasure from your addiction or pleasure in committing slow suicide at the hands of a mind that thinks it can only live with the aid of a powerful stimulant? What do they call someone who derives pleasure from self-inflicted harm or who slowly puts themselves to death? Pick your own label. Which nicotine fix out of the last 5,000 was the one that brought you tremendous pleasure? Which cigarette out of the next 5,000 may be the one that sparks permanent damage or disease, or that carries death's eternal flame? If bad news arrives tomorrow will "pleasure" cross your mind? As for Newport type "pleasure," isn't the real pleasure in satisfying our brain's wanting for more? Now imagine the pleasure of going 72 hours without nicotine, the pride of once again residing inside a nicotine-free body and mind! OUR LIE: Dad just died, this isn't the time! THE TRUTH: Smoking won't bring dad back nor cure any other ill in life. Success in quitting during a period of high stress in life insures that future high stress situations will never again serve as the mind's excuse or justification for relapse. If you think about it, if we continue to live we will all see someone we love die. Such is the cycle of life. Sadly, serious illness, injury, or the death of a loved one are some of the most convincing relapse justifications, the best yet sickest excuses of all to get our drug back. I mean, who would dare question our drug use upon our mother's death? There is no better time to quit than before your next mandatory feeding. In fact, two recent studies found that unplanned quitting attempts are twice as likely to succeed as planned ones (picture quitting day anticipation anxieties slowly eating away and destroying resolve before quitting day ever arrives). Why allow finances, work, illness, education or relationships to serve as an excuse to remain an active addict? Once free, there is no legitimate justification for ever putting nicotine back into our body - none, zero, never! OUR LIE: Lots of smokers live until ripe old age. THE TRUTH: They are much rarer than you think. Look around. If you do find old nicotine smokers almost all are in poor health or in advanced stages of smoking related diseases, many with oxygen. Laboring for every breath with lungs on their last leg, is that ripe enough for us? Nicotine smokers tend to think only in terms of dying from lung cancer. Tobacco kills in many ways. For example, circulatory disease caused by smoking kills more smokers each year than lung cancer. How long would George Burns have lived to be if he hadn't smoked cigars, 115, 125? Click here to look at the " truth ". What's wrong with dying healthy from natural causes! OUR LIE: I get bored. It helps pass the time. THE TRUTH: Tobacco does not control any clock on earth but it does control you . For the pack a day nicotine smoker it takes about 30 minutes before their blood serum nicotine level drops to the point where their mind sends them an "urge" of discomfort to remind you that it's time for a feeding. It doesn't matter where they are or what they're doing. Depending upon your daily nicotine requirements, the voice inside your head will let you know when it's time. All you're doing when bored is being alert to what lies ahead, so that you keep topping off your nicotine tank before the next urge arrives. Boredom is supposed to be a positive form of anxiety that motivates us to accomplish a task that hopefully helps preserve life, not destroy it. OUR LIE: It's my choice and I choose to smoke! THE TRUTH: It's a lie and you know it! We lost all "choice" and the ability to simply walk away the day that nicotine feedings became mandatory. The only choices now are to either arrest our dependency or to decide how early and often we'll feed it. As harsh as this sounds, nicotine dependency is a brain wanting disorder, a true mental illness. But the ignorant nicotine addict still believes the "choice" myth pounded into their brain by an endless stream of highly effective tobacco company marketing. All the pretty colored boxes, the displays, the sea of store ads, they make it seem like we can't wait to wake-up each day and run down to the store and try a new brand. Although a well set trap for gullible children and teens who can't wait to become adults, it also makes quitting more challenging than need be. The uneducated smoker likely associates smoking with reading the newspaper, coffee, travel, stress, other smokers, telephone calls, meals, celebrations, romance, or even as a necessary step prior to walking into a store. The educated nicotine addict sees all nicotine fixes as either mandatory, or an early feeding, in order to avoid the onset and discomfort of chemical withdrawal. We smoked after a meal because it was once again time for a nicotine feeding. We smoked before the meal because we didn't know how long eating would last and it isn't polite to eat and smoke at the same time. If your regular feedings are spaced thirty minutes apart, at least every thirty minutes you're going to start sensing growing want for more nicotine regardless of the activity. OUR LIE: I'm only hurting me. THE TRUTH: Have you stopped for even one moment to reflect upon the financial, physical or emotional pain that your needless dying and death will bring your loved ones? Do we care that the deadly byproducts of our addiction have the potential to harm or kill family members, whose only crime was loving us? According to the World Health Organization secondhand smoke contributes to causing lower respiratory tract infections such as pneumonia and bronchitis, colds, coughing, wheezing, worsening of asthma, middle ear disease, cardiovascular disease, and even neuro-behavioral impairment (especially in young children). It also found that maternal smoking or exposure to second-hand smoke during pregnancy is a major cause of sudden infant death syndrome (SIDS), reduced birth weight and decreased lung function. How much does it cost to attempt to cure mouth, throat or lung cancer? $100,000? $200,000? $300,000? What's the cost of a funeral today and which loved one have you designated to pay the emotional price of making arrangements for your early departure? What about the loss to loved ones of our guidance, our help around the house or any income we contribute? Where will they turn? OUR LIE: A cure for cancer is coming soon. THE TRUTH: Between Europe and North America tobacco will kill over one million this year. How many of them thought that a cure was on the way? Sadly, it was false hope. As hopeless drug addicts they waited, and waited and waited. What type of lung cancer are hoping they'll cure - squamous cell, oat cell, adenocarcinoma, or one of the less common forms of lung cancer? Even if a cure is coming for all forms and types of cancer caused by tobacco (and there are many), what will be left of your lungs by the time it arrives? If you're gambling on "how" tobacco will kill you, don't forget to consider heart attacks, strokes, and emphysema. Which cure are you betting on? OUR LIE: I smoke lights and they're not as bad. THE TRUTH: Lights, ultra-lights and milds are often capable of delivering the same amount of tar and nicotine as regular brands, depending on how they're smoked. It's why use of those terms are being banned by governments. They do not reduce most health risks including the risk of heart disease or the risk of cancer. In fact, their smokers often take longer drags which means more tar and more nicotine than advertised. Others simply smoke a greater number of lights because they feel short changed. OUR LIE: It's my right to blow smoke! THE TRUTH: And it's the right of non-smokers and ex-smokers to be free from your smoke too. Social controls to protect the rights of non-smokers are now sweeping the globe. Can a dog's life-span be cut in half by a smoking master? Would you intentionally double the risk of heart attack or triple the risk of lung cancer for a spouse or family member? Why kill the innocent too? Are non-smokers who get extremely upset at having to breathe side-stream smoke simply being obnoxious or are they fighting to protect themselves and those they love from the known harms generated from burning a plant that contains 44 known cancer causing agents and releases 4,000+ chemical compounds when burned? Do you know a child whose mother smoked while pregnant, who does not suffer from some form of impairment today? Look closely. OUR LIE: Quitting causes weight gain and it's just as dangerous. THE TRUTH: This intellectual denial pre-assumes a large weight gain and then makes an erroneous judgment regarding relative risks. Quitting does not increase our weight, eating does. Some assert that metabolic changes associated primarily with the heart not having to work as hard could account for a pound or two but as far as being " dangerous," you'd have to gain at least 75 additional pounds in order to equal the health risks associated with smoking one pack a day. Keep in mind that your general health, physical abilities and lung capacity will all improve dramatically. If patient, you will soon regain the ability to build cardiovascular endurance, and experience up to a 30% increase in overall lung function within 90 days. You'll be able to apply the same mental recovery tools needed to take control of your addiction in shedding any extra pounds, just one pound at a time. Remember, smoking was your cue that a meal had ended. Unless you develop a new healthy cue there may be fewer leftovers. Also keep in mind how easy it would be for a drug addict to use intentional weight gain to a ploy to sabotage recovery. Additionally, nicotine stimulated brain dopamine pathways and so does food. Be careful not to use food as a destructive dopamine replacement crutch. If at all concerned, consider having a supply of fresh fruits and veggies cut up, handy and ready to eat during the 2-3 weeks it takes the brain to restore natural dopamine pathway sensitivities. OUR LIE: It's too late now to heal these lungs. THE TRUTH: Nonsense! While true that each and every puff destroyed more of each lung's roughly 300 million air sacs (alveoli), we were each blessed with millions more than needed to live a full and complete life. It's amazing how much damaged lungs can repair themselves unless disease or cancer has already arrived. Even with emphysema, although destroyed air sacks will never again function, quitting now will immediately halt the needless destruction of additional sacs. You only have two options - decay or heal, including the possibility of experiencing up to a 30 percent increase in overall lung function within 90 days of quitting. If continuing assault by the 81 cancer causing chemicals so far identified in cigarette smoke, which cigarette in which pack contains the spark that gives birth to that first cancerous cell? OUR LIE: I'd quit but withdrawal never ends! THE TRUTH: Hogwash! If you remain 100% nicotine free for just 72 hours your blood will become nicotine free, your withdrawal anxieties will peak in intensity and the number of psychological craves will peak in number. The greatest challenge will be over. Actual physical withdrawal will be complete within 2-3 weeks as the brain re-sensitizes dopamine pathway receptors and down-regulates their numbers to levels seen in non-smokers. During that time you'll encounter and recondition (extinguish) all but remote or seasonal psychological habit crave triggers and begin to witness the gradually diminishing influence of thousands of nicotine replenishment memories, memories that belonged to an actively feeding addict who once again was in need of a fix. If you focus on taking recovery just one hour, challenge and day at a time, before you know it you'll experience your first day of total comfort, where never once do you think about wanting to smoke nicotine. I call it a silent celebration because you probably won't even realize that it has happened until the next day. After the first such day, they grow more and more frequent until they become your new sense of normal. If just starting out, the rich and deep sense of comfort and calm that awaits you is beyond your enslaved mind's ability to comprehension. Why? Because your dopamine pathways, your mind's priorities teacher, have been hijacked, making that next nicotine fix as important as eating food. Food craves, nicotine craves but with one critical difference. Without food we die. Without nicotine we thrive. It's why, although as real as your name, you cannot trust the nicotine wanting message that pounds inside your head, as it is false and is destroying you. OUR LIE: But the craves last for hours! THE TRUTH: Just like the lingering thought of a nice juicy steak, lobster in butter sauce, or fresh baked hot apple pie, you can make yourself "think" about having a cigarette all day long, if that's what you really want to do. Unlike fixating on a conscious thought about smoking, subconsciously cue triggered crave anxiety attacks almost always last for less than 3 minutes. But it's important that you look at a clock and time the crave episode as cessation time distortion (a normal and expected recovery symptom) can make minutes feel like hours. The good news is that most of the anxiety surrounding crave episodes is self induced and thus controllable. Key is in not trying to hide or run from your mind's junkie thinking but exposing it to honest analysis and positive thinking. Strip away all the self-inflicted anxiety and at worst, what remains on quitting day 3 for the "average" quitter is just 18 minutes of true crave anxiety (an average of six craves, each less than three minutes in duration). OUR LIE: I'll quit after the next pack, next carton, next month, my next birthday or New Years. THE TRUTH: Oh really? Can you count on both hands and all your toes how many times you've lied to yourself with such nonsense? And which pack, carton, month or birthday will give you the best chance for success? Forget buying nicotine laden cigarettes by the pack or carton. A case is even cheaper! With the way that cigarette prices are shooting through the roof, you might as well calculate how many it will take to keep you in nicotine for life and buy them all now. The only problem with that is in determining how long you have left to live. How many more pack, carton, birthday and New Year's lies will you tell to yourself? When will they stop? If you continue on your present path, many Birthdays will likely be canceled by a rather early Deathday. You are a true drug addict in every sense and the "wanting" inside your brain is as real as the greatest truth you know. What isn't true is the message, that that next fix is important. Truth is, everything now done under nicotine's influence can be done as well as or better without it. OUR LIE: I like to smoke when I drink and I find myself smoking even more. THE TRUTH: The effects of drinking and stress upon our body's nicotine level are nearly the same. You smoke more when you drink not because you "like" to but because you MUST. Like stress, alcohol is an acid producing event that causes urine to become more acidic. The greater the acid level of urine, the quicker our kidneys remove and eliminate nicotine reserves from the bloodstream. Thus, the more you drink, the more nicotine you'll need to smoke or ingest in order to avoid sensing the onset of the anxiety of early withdrawal. Although early alcohol use contributes to destroying a great many quit attempts, understanding the nicotine-acid relationship can be of benefit in accelerating physical nicotine withdrawal so that quitters can begin feeling relief sooner. Acidic fruit juices, such as cranberry, may help reduce the normal 72 hours of withdrawal required to remove all nicotine from the blood. In that roughly 50% of all relapses are associated with alcohol use, if at all possible don't drink during the first few days of recovery. When you do decide to drink, consider drinking at home first without cigarettes around before testing your resolve around smokers. By doing so you'll help to break the your mind's psychological links between smoking and drinking with as little risk as possible. As millions of ex-smokers can attest, your beer or drink will taste better than ever once your taste buds are allowed an opportunity to heal. OUR LIE: It's too painful to quit! THE TRUTH: Compared to what? Three days of physical withdrawal (just 72 hours) in no way compares to the pain of months of chemotherapy, lung removal surgery and a two foot scar, a losing battle with throat cancer, years of trying to recover from a serious stroke or massive heart attack, or fighting for every breath through emphysema riddled lungs as you drag oxygen around for the balance of life. If you're really worried about hurt then why continue your daily destruction? OUR LIE: If I quit, I'll just start back again. I always do. THE TRUTH: The truth is that you do not have to relapse. We relapse because we rewrite the Law of Addiction, we forget why we quit, or we invent lies and stupid excuses, such as those that fill this page. Your next quit can be your last but you need to learn how to care for your recovery, while always applying the only rule that you'll ever need to obey - to NEVER TAKE ANOTHER PUFF! OUR LIE: I'll cut down or quit and smoke just one now and then. THE TRUTH: It's every addict's dream, to control the uncontrollable. You are addicted to a substance that is five times as addictive as powdered cocaine (15% vs. 75%). You may be strong enough to cut back but so long as nicotine continues to arrive you'll remain hooked, the decay will continue, and as studies suggest, even though smoking less your health risks will remain almost unchanged. If you were a pack-a-day nicotine smoker and after quitting you decide to smoke just one cigarette, you might as well get ready to smoke the other 7,300 for the year too as full and complete relapse is virtually assured. The Law of Addiction is simple - just one puff of new nicotine and it's over. Brain scans show that up to 50% of dopamine pathway receptors become occupied by nicotine within eight seconds of the first puff. While roughly half walk away from relapse totally convinced that they've gotten away with smoking just once, they've saturated and de-sensitized dopamine pathway receptors and will soon find their brain begging for more. You see, as permanent as alcoholism, once hooked we somehow stay hard wired for relapse for the balance of life. Although recovery allows the brain time to heal and function normally again the tracks of addiction remain. We cannot cure or kill our disease. Once free, we remain on probation for the balance of life. OUR LIE: I tried quitting but my family stopped supporting me or was giving me such a hard time that it caused me to throw in the towel. THE TRUTH: It's a lie. You gave up because you used your family as a cheap excuse to get your drug back. You exaggerated everything they did or didn't do. You were looking for any excuse. You're the drug addict yet you expected them to understand the weakness and thinking of a drug addict's mind. Maybe they didn't pat you on the back as often as you wanted, but is it really fair to expect them to appreciate the magnitude or duration of your challenge if they've never been through chemical withdrawal themselves? They just want you to be normal. They don't know how to react. Do they pat you on the back and keep reminding you, or hope and pray that the worst has already passed? Feeling unappreciated, picking fights and creating confrontation are tools of the addict's mind that are often used as weapons in order to reclaim their drug. Some know that if they inflict tremendous stress on loved ones that they may even convince their loved one to beg them to start smoking nicotine again, or better yet, to go buy their relapse cigarettes for them. That way, they can blame their relapse on their loved one. "They just couldn't handle my quitting." "Maybe next time!" The lengths to which we'll go in order to feed our wanting are almost beyond belief. Yes, some of us will even hurt those that love us most. OUR LIE: OK, I'm going to stop! Now I can enjoy my smokes until then! THE TRUTH: If you've done this more than once, isn't it just more junkie head games? This addict wants to feel good about smoking nicotine and they've learned that by saying that they're going to quit, that they make themselves feel better even though deep down they know that it's probably just another lie! Unless something awakens this addict, there may never be a serious quit in their future. OUR LIE: I've got to die of something! THE TRUTH: True, but if you knew that tomorrow morning at 9:22 a.m. a massive smoking induced stroke would bring your life to an abrupt end, and you'd die on a cold floor with a cigarette beside you - just as tens of thousands of smokers are found each year? Would you light that last cigarette at 9:21 a.m. and pull the trigger that kills you? Is this one of your primary use rationalizations? Look around at all the smokers you see today. The death certificates of half will read, "cause of death - smoking." Yes, they had to die of something but not an average of more than 5,000 days early. Have you met Noni, Bryan, Deb and Kim? Would any non-addicted human spend each and every day of the remainder of their life intentionally destroying more of their body's ability to receive and transport life giving oxygen? Would they continue doing so until physical exercise was no longer an option, or until this mental illness called dependency forced others to begin caring for us, as they watch us struggle just to suck oxygen from tanks and machines? Which family member have you prepared to be your care giver? Try to imagine what it's like to breathe through a straw? It's called emphysema. Why not find a straw and give it a try. What has nicotine done for you lately? OUR LIE: I can't quit alone. I'll need nicotine gum, the patch, hypnosis, e-cigs, acupuncture, magic herbs or other wonder drugs! THE TRUTH: Wrong! The simple truth is that no magic cure has ever "made" any smoker quit smoking nicotine. The key to immediate and lasting abstinence is education and understanding, in becoming vastly more dependency recovery savvy than our addiction is strong. Hypnosis and acupuncture teach us nothing, nor does use of nicotine replacement products that fail roughly 93% of users within 6 months of quitting, while making NRT slaves of a substantial percentage of those who actually quit smokings. What quitting product and procedure salesmen will never tell you is that each year cold turkey generates more successful long-term ex-users than all other quitting methods combined. Why? Because they want your money. Remember, should all else fail, you always have you! OUR LIE: It's all Nicodemon's fault, not mine! THE TRUTH: There is no Nicodemon, no little monsters, no big monsters, no monsters at all. None! In fact, the title to this article, Nicodemon's Lies, is one of the biggest lies of all. They were never Nicodemon's lies but our lies. Nicotine is simply a chemical, a drug, an alkaloid known as C10H14N2. Its I.Q. is and always has been zero. It does not think, plan, inflict punishment, nor will it conspire to make you relapse or die addicted to it. The fact that it has zero intelligence has always been your greatest weapon. Everything you see, feel, and sense during nicotine withdrawal and recovery will be grounded in chemical dependency, conditioning, reason, logic, emotion or science. Any conspirators in any past attempts to make you relapse and destroy your recovery were always and only "you!" Never once did you relapse due to external circumstances. It was 100% internal, once again you introduced nicotine into your bloodstream. The good news is that while each defeat was yours, so too will be the victory. Should you end nicotine's control of your brain's reward pathways the victory will belong only to you!

...Science calls our lies denial. Denial is an unconscious defense mechanism - just below the surface - for resolving the emotional conflict and anxieties that naturally arise from living in a permanent state of self-destructive chemical bondage. Nicodemon's Lies? by John R. Polito Nicotine Cessation Educator https://whyquit.com/whyquit/A_NicodemonsLies.html Why a question mark behind "Nicodemon's Lies"? Because there is no Nicodemon. Because there are zero monsters or demons within us. It's just another lie, our lie, as dependency ignorance tried to make sense of continued smoking. As teenagers, what most of us thought would be a brief rebellious experiment was quickly transformed into a powerful lifelong chemical addiction as regular nicotine feedings soon became mandatory. Research confirms that for many, it only took a couple of nicotine laden cigarettes before the shackles of slavery started to close. What seemed innocent soon resulted in a brain wanting disorder. Without us realizing it, nicotine was activating, saturating, de-sensitizing and up-regulating dopamine pathway receptors, as our brain's priorities teaching circuitry was taken hostage. Two, five, eight nicotine fixes a day. When will enough be enough? "I'll quit tomorrow" or "I love smoking" became our cry! Welcome to the realities of true chemical dependency. A world built upon lies. Science calls our lies denial. Denial is an unconscious defense mechanism - just below the surface - for resolving the emotional conflict and anxieties that naturally arise from living in a permanent state of self-destructive chemical bondage. Three primary areas of denial relied upon by nicotine addicts are dependency denial, cost denial and recovery denial. Truth is sacrificed for peace of mind, to remain hostage in an artificial world of "nicotine normal," or to justify relapse. Most nicotine addicts we'll see today are fully insulated by a thick blanket of unconscious denial rationalizations, minimization's, fault projections, escapes, intellectualizations and delusions that hide the pain of captivity or create the illusion that the problem is somehow being solved. The average addict musters the courage to say "no" to the wanting for that next fix about once every 2.5 years. It's then that roughly 1 in 20 will succeed in breaking free for an entire year. These horrible recovery statistics eventually result in half of us dying by our own hand, with male smokers losing an average of 13 years of life expectancy, while females lose 14. Our intentional self-destruction is undeniable evidence of the depths of denial. Denial insulates us from the extreme price paid with each and every puff - a little more of life itself. It doesn't have to be. Welcome to WhyQuit, we've been waiting on you! Aside from this article, we've put together a vast array of quality recovery tools to aid you in becoming far smarter than your addiction is strong. They include mind-expanding motivational pages, the Net's largest collection of original quitting articles, quitting tip lists, two free quitting e-books ("Never Take Another Puff" and "Freedom from Nicotine - The Journey Home"), more than 400 free video lessons, and highly focused group support at Turkeyville, our Facebook group. According to the World Health Organization, the next three years will cost 15 million of our brother and sister addicts their lives. Once residing here on Easy Street with us, we hope you'll share what you've learned as failure to either self-discover or be taught the "Law of Addiction" is a horrible reason to die. OUR LIE: My cigarettes are my friend. THE TRUTH: Friend or master? What kind of "friend" would deprive us of oxygen, take away our ability to smell, burn our clothes, destroy our teeth, harden our arteries, elevate our blood pressure, daily feed us 4,000+ chemical compounds that include arsenic, ammonia, acetone, formaldehyde, butane, massive doses of carbon monoxide, hydrogen cyanide, methane, stearic acid, vinyl chloride, mercury, and lead, together with 81 known cancer causing agents (one of which is created when nicotine breaks down - NNK), before finally killing you with cancer, a stroke, a heart attack or emphysema? Imagine seeing your executioner as a friend. Imagine residing inside a mind that is so sick it is willing to trade 13 years of life for one chemical. OUR LIE: I enjoy smoking. THE TRUTH: This may be the most deeply ingrained rationalization of all as it has a solid basis in the following flawed denial logic. "I don't do things that I don't like to do." "I smoke lots and lots of cigarettes." "Therefore, I must really enjoy smoking," instead of the correct conclusion, "therefore, I must really be chemically addicted to smoking nicotine." Did you enjoy being the unaddicted "you" or have you forgotten what it was like to live comfortably inside a mind that does not crave for nicotine? If you cannot remember what it was like being "you" then what basis do you have for honest comparison? If you truly enjoyed being addicted to nicotine then why are you here reading these words? Is it that you liked smoking or that you liked not having to experience what occurred when you didn't smoke - withdrawal? Studies have long ranked nicotine as a more addictive substance than either heroin or cocaine. In fact, cocaine's generally recognized addiction rate among regular users is 15% while nicotine's addiction rate of over 70% is at least five times as great. Imagine convincing your mind that it " likes " being addicted to the drug that addiction scientists now rank as the most addictive substance on all of planet earth. We are nicotine addicts . A pack a day smoker smokes 7,300 cigarettes each and every year. How many of your last 7,300 nicotine fixes did you really enjoy ? How many of the next 7,300 will bring tremendous joy to your life? Isn't it time to be honest? OUR LIE: My spouse, close friend or family member smokes. I'm waiting for them to quit with me. THE TRUTH: Procrastination recovery denial makes the next puff of toxins easier to suck down. Nicotine tells this junkie that they cannot quit until their friend or loved one quits too as they're around their smoke, smells, cigarettes, breath and ashtrays, and quitting is thus impossible. It's pure denial and often both friends or loved ones use the other as their excuse to remain enslaved. How long will you continue to destroy your body while waiting for someone else to quit with you? A lifetime? If and when they do quit with you, what will you do if they relapse? Will "love" cause you to do the same? One of you needs to stand tall and lead the way. It's okay to have hope for a loved one but you must quit for "you" or it's doomed from the very start. Why make your freedom, health or life dependent upon another person's decision. As for being around smokers, it's unavoidable. Should we expect planet earth's 1.2 billion nicotine addicts to disappear once we commence recovery? Won't we still see them and smell their smoke at restaurants, as they stand around outside stores or even hospitals, or as they puff away in the car beside us? Will all the stores pull-down their cigarette displays or move them from arm's reach just because we're trying to reclaim our mind and life? Why live the lie that "I smoke for love!" OUR LIE: It reduces my stress and helps calm me down. THE TRUTH: This stress buster rationalization is false. The body's pH balance is delicate. Nicotine is an alkaloid and stress an acid producing event. The more stressful the event, the quicker the body's remaining nicotine reserves are neutralized (in the same manner as pouring a baking soda solution on an acid covered car battery terminal). The stressed smoker is thrown into early chemical withdrawal adding additional anxiety to the underlying original stressful event. It's why the anxiety associated with a flat tire causes smokers to reach for a cigarette while the non-smoker reaches for a jack. The anxieties build until the doubly stressed smoker cries out "I NEED A CIGARETTE!" Within eight seconds of the first puff, the smoker's nicotine blood serum nicotine level rises and their withdrawal anxieties subside. The addict is left with the false impression that smoking cured the underlying stressful event when in fact the tire is still flat. All non-smokers experience stress too. The difference is that they don't add early nicotine withdrawal to it. In truth, stress nicotine depletion causes smokers to experience far more anxiety than non-smokers. In truth, it is much easier and calmer being the real "you" than it is living as a chemical slave. OUR LIE: My friends smoke, I'll lose them. THE TRUTH: The nicotine smoker's mind has been conditioned to believe, through association, that smoking is central to their entire life. Telephone calls, computer time, work, meals, driving, talking, walking, stress, joy, sorrow, and even romance, may have developed a subconscious association with smoking. The truth is that none of these activities will be altered whatsoever by the absence of tobacco. The truth is that quitting smoking will not deprive you of even a single friend or loved one. The truth is that smoking is costing you new friends and possible relationships as fewer and fewer non-smokers are willing to tolerate being around the smell and the smoke. Can you blame them? With the exception of quitting, your current life doesn't need to change at all unless you want it to change. It might be nice to enlarge your circle of friends to include those who don't stand around the community ashtray, but that's totally up to you. OUR LIE: It wakes me up and keeps me alert. THE TRUTH: This dependency rationalization uses a basic truth (nicotine releases adrenaline and a host of other hormones) to hide the fact that nicotine deprives us of the ability to enjoy prolonged periods of deep conscious relaxation. If always at the peak of alertness because we are addicted to and chemically dependent upon a central nervous system stimulant then when do we truly relax? This dependency rationalization also subverts and ignores a host of natural alertness techniques ranging from a simple deep breath to brief periods of stretching or moderately exhilarating activity. Instead of engaging life on life's terms, a powerful puff of nicotine starts a neurochemical chain-reaction that increases breathing rate, accelerates heart rate, constricts blood vessels, elevates blood pressure, causes the liver to release stored cholesterol into the blood stream, the adrenal gland to release glucocorticoids, the thyroid to release metabolism hormones, the hypothalamus to release corticotropin-releasing hormones, a decrease of progesterone levels in females and testosterone in males, digestive tract shut-down, a glucose release into the bloodstream followed by a boost in insulin to metabolize it, pupil dilation, and your blood to thicken. Inside those highly constricted and over-pressurized blood vessels, carbon monoxide eats away at their teflon like lining (endothelium) while nicotine amazingly vascularizes fat buildups, causing arteries to harden. More smokers die from circulatory disease each year than from lung cancer, yet denial kept almost all of them from wanting to know how or why. What goes up must come down. Once the hormones wear off and that drained feeling begins to arrive, a new puff of nicotine again whips every central nervous system neuron in a tired body like some overworked horse never allowed to rest. Alert, yes, but somewhere in that endless cycle between alert and exhausted resides the "real" you. OUR LIE: My concentration is better. THE TRUTH: Vast quantities of carbon monoxide do NOT improve concentration. Although nicotine is a stimulant and does excite certain brain neurons, it also constricts all blood vessels. Feel how cold your fingers and toes get when deprived of blood flow while smoking. Imagine what's happening to the blood vessels in your brain. If nicotine results in a stroke we probably won't need to worry much about concentration. Fresh air and exercise are far healthier brain stimulants. When quitting it's important that you understand the role that nicotine played in regulating blood sugar as its absence may cause the temporary impairment of concentration and clear thinking. If you are experiencing any concentration problems be sure and drink plenty of fruit juice the first three days if your diet and health permit (cranberry is excellent), as it will help stabilize blood sugars. Also don't skip meals! Nicotine released stored fats into our blood and in a sense fed us with every puff, but not anymore. Don't eat more food each day, just spread your normal intake out more over your entire day so that you keep fuel in your stomach and your blood sugar level. OUR LIE: It's something to do with my hands. THE TRUTH: So is playing with a loaded gun and they both have the same potential for harm. This weak addiction rationalization ignores that doodling with a pen, playing with coins, squeezing a ball or using strength grippers may be habit forming but are non-addictive. You might get ink on yourself, rich or strong wrists but your chances of serious injury or death are almost zero. OUR LIE: My coffee won't be the same. THE TRUTH: More junkie thinking! Your coffee's flavor will remain identical. In fact, it may even taste better once your taste buds heal after years of being numbed, coated and poisoned. Your sense of smell may become so refined that you'll smell fresh coffee brewing more than one hundred feet away. Although you don't need to give up your coffee or any thing else except nicotine during recovery, be aware that nicotine somehow doubles the rate ( 203%) by which caffeine is metabolized by the body. As a new ex-smoker you may only need half as much caffeine in order to obtain the same effect. If you are a heavy caffeine user and find yourself experiencing increased anxiety during recovery, or encounter difficulty sleeping, try reducing your intake by roughly half. OUR LIE: There's lots of time left to quit. THE TRUTH: This year tobacco will kill 5,000,000 humans. Roughly 1 in 4 smokers die in middle-age, each an average of 22.5 years early. In order for 22.5 to be the average, how many hundreds of thousands had to die even younger? Maybe you have plenty of time remaining and maybe not. Dying in your thirties or forties is a powerful price to pay for guessing wrong. The numbers above only reflect DEATH by tobacco. You may be lucky enough to be among the millions of nicotine smokers each year who survive and "only" have a heart attack, a stroke, a lung removed, go onto oxygen, or who receive news of permanent lung disease as they for every breath. Which puff, from which cigarette, in which pack, will pull the trigger that fires the gun? The odds of a male smoker dying from lung cancer are 22 times greater than for a non-smoker. His odds of dying from emphysema are ten times greater. How much longer will your luck hold? OUR LIE: It's one of my few pleasures in life. THE TRUTH: Does that mean that it's better than the pleasure of having a throat to deliver fresh air and great food, two lungs with which to laugh, a healthy heart to feel love, or an undamaged mind which dreams of wonderful tomorrows? Pleasure from your addiction or pleasure in committing slow suicide at the hands of a mind that thinks it can only live with the aid of a powerful stimulant? What do they call someone who derives pleasure from self-inflicted harm or who slowly puts themselves to death? Pick your own label. Which nicotine fix out of the last 5,000 was the one that brought you tremendous pleasure? Which cigarette out of the next 5,000 may be the one that sparks permanent damage or disease, or that carries death's eternal flame? If bad news arrives tomorrow will "pleasure" cross your mind? As for Newport type "pleasure," isn't the real pleasure in satisfying our brain's wanting for more? Now imagine the pleasure of going 72 hours without nicotine, the pride of once again residing inside a nicotine-free body and mind! OUR LIE: Dad just died, this isn't the time! THE TRUTH: Smoking won't bring dad back nor cure any other ill in life. Success in quitting during a period of high stress in life insures that future high stress situations will never again serve as the mind's excuse or justification for relapse. If you think about it, if we continue to live we will all see someone we love die. Such is the cycle of life. Sadly, serious illness, injury, or the death of a loved one are some of the most convincing relapse justifications, the best yet sickest excuses of all to get our drug back. I mean, who would dare question our drug use upon our mother's death? There is no better time to quit than before your next mandatory feeding. In fact, two recent studies found that unplanned quitting attempts are twice as likely to succeed as planned ones (picture quitting day anticipation anxieties slowly eating away and destroying resolve before quitting day ever arrives). Why allow finances, work, illness, education or relationships to serve as an excuse to remain an active addict? Once free, there is no legitimate justification for ever putting nicotine back into our body - none, zero, never! OUR LIE: Lots of smokers live until ripe old age. THE TRUTH: They are much rarer than you think. Look around. If you do find old nicotine smokers almost all are in poor health or in advanced stages of smoking related diseases, many with oxygen. Laboring for every breath with lungs on their last leg, is that ripe enough for us? Nicotine smokers tend to think only in terms of dying from lung cancer. Tobacco kills in many ways. For example, circulatory disease caused by smoking kills more smokers each year than lung cancer. How long would George Burns have lived to be if he hadn't smoked cigars, 115, 125? Click here to look at the " truth ". What's wrong with dying healthy from natural causes! OUR LIE: I get bored. It helps pass the time. THE TRUTH: Tobacco does not control any clock on earth but it does control you . For the pack a day nicotine smoker it takes about 30 minutes before their blood serum nicotine level drops to the point where their mind sends them an "urge" of discomfort to remind you that it's time for a feeding. It doesn't matter where they are or what they're doing. Depending upon your daily nicotine requirements, the voice inside your head will let you know when it's time. All you're doing when bored is being alert to what lies ahead, so that you keep topping off your nicotine tank before the next urge arrives. Boredom is supposed to be a positive form of anxiety that motivates us to accomplish a task that hopefully helps preserve life, not destroy it. OUR LIE: It's my choice and I choose to smoke! THE TRUTH: It's a lie and you know it! We lost all "choice" and the ability to simply walk away the day that nicotine feedings became mandatory. The only choices now are to either arrest our dependency or to decide how early and often we'll feed it. As harsh as this sounds, nicotine dependency is a brain wanting disorder, a true mental illness. But the ignorant nicotine addict still believes the "choice" myth pounded into their brain by an endless stream of highly effective tobacco company marketing. All the pretty colored boxes, the displays, the sea of store ads, they make it seem like we can't wait to wake-up each day and run down to the store and try a new brand. Although a well set trap for gullible children and teens who can't wait to become adults, it also makes quitting more challenging than need be. The uneducated smoker likely associates smoking with reading the newspaper, coffee, travel, stress, other smokers, telephone calls, meals, celebrations, romance, or even as a necessary step prior to walking into a store. The educated nicotine addict sees all nicotine fixes as either mandatory, or an early feeding, in order to avoid the onset and discomfort of chemical withdrawal. We smoked after a meal because it was once again time for a nicotine feeding. We smoked before the meal because we didn't know how long eating would last and it isn't polite to eat and smoke at the same time. If your regular feedings are spaced thirty minutes apart, at least every thirty minutes you're going to start sensing growing want for more nicotine regardless of the activity. OUR LIE: I'm only hurting me. THE TRUTH: Have you stopped for even one moment to reflect upon the financial, physical or emotional pain that your needless dying and death will bring your loved ones? Do we care that the deadly byproducts of our addiction have the potential to harm or kill family members, whose only crime was loving us? According to the World Health Organization secondhand smoke contributes to causing lower respiratory tract infections such as pneumonia and bronchitis, colds, coughing, wheezing, worsening of asthma, middle ear disease, cardiovascular disease, and even neuro-behavioral impairment (especially in young children). It also found that maternal smoking or exposure to second-hand smoke during pregnancy is a major cause of sudden infant death syndrome (SIDS), reduced birth weight and decreased lung function. How much does it cost to attempt to cure mouth, throat or lung cancer? $100,000? $200,000? $300,000? What's the cost of a funeral today and which loved one have you designated to pay the emotional price of making arrangements for your early departure? What about the loss to loved ones of our guidance, our help around the house or any income we contribute? Where will they turn? OUR LIE: A cure for cancer is coming soon. THE TRUTH: Between Europe and North America tobacco will kill over one million this year. How many of them thought that a cure was on the way? Sadly, it was false hope. As hopeless drug addicts they waited, and waited and waited. What type of lung cancer are hoping they'll cure - squamous cell, oat cell, adenocarcinoma, or one of the less common forms of lung cancer? Even if a cure is coming for all forms and types of cancer caused by tobacco (and there are many), what will be left of your lungs by the time it arrives? If you're gambling on "how" tobacco will kill you, don't forget to consider heart attacks, strokes, and emphysema. Which cure are you betting on? OUR LIE: I smoke lights and they're not as bad. THE TRUTH: Lights, ultra-lights and milds are often capable of delivering the same amount of tar and nicotine as regular brands, depending on how they're smoked. It's why use of those terms are being banned by governments. They do not reduce most health risks including the risk of heart disease or the risk of cancer. In fact, their smokers often take longer drags which means more tar and more nicotine than advertised. Others simply smoke a greater number of lights because they feel short changed. OUR LIE: It's my right to blow smoke! THE TRUTH: And it's the right of non-smokers and ex-smokers to be free from your smoke too. Social controls to protect the rights of non-smokers are now sweeping the globe. Can a dog's life-span be cut in half by a smoking master? Would you intentionally double the risk of heart attack or triple the risk of lung cancer for a spouse or family member? Why kill the innocent too? Are non-smokers who get extremely upset at having to breathe side-stream smoke simply being obnoxious or are they fighting to protect themselves and those they love from the known harms generated from burning a plant that contains 44 known cancer causing agents and releases 4,000+ chemical compounds when burned? Do you know a child whose mother smoked while pregnant, who does not suffer from some form of impairment today? Look closely. OUR LIE: Quitting causes weight gain and it's just as dangerous. THE TRUTH: This intellectual denial pre-assumes a large weight gain and then makes an erroneous judgment regarding relative risks. Quitting does not increase our weight, eating does. Some assert that metabolic changes associated primarily with the heart not having to work as hard could account for a pound or two but as far as being " dangerous," you'd have to gain at least 75 additional pounds in order to equal the health risks associated with smoking one pack a day. Keep in mind that your general health, physical abilities and lung capacity will all improve dramatically. If patient, you will soon regain the ability to build cardiovascular endurance, and experience up to a 30% increase in overall lung function within 90 days. You'll be able to apply the same mental recovery tools needed to take control of your addiction in shedding any extra pounds, just one pound at a time. Remember, smoking was your cue that a meal had ended. Unless you develop a new healthy cue there may be fewer leftovers. Also keep in mind how easy it would be for a drug addict to use intentional weight gain to a ploy to sabotage recovery. Additionally, nicotine stimulated brain dopamine pathways and so does food. Be careful not to use food as a destructive dopamine replacement crutch. If at all concerned, consider having a supply of fresh fruits and veggies cut up, handy and ready to eat during the 2-3 weeks it takes the brain to restore natural dopamine pathway sensitivities. OUR LIE: It's too late now to heal these lungs. THE TRUTH: Nonsense! While true that each and every puff destroyed more of each lung's roughly 300 million air sacs (alveoli), we were each blessed with millions more than needed to live a full and complete life. It's amazing how much damaged lungs can repair themselves unless disease or cancer has already arrived. Even with emphysema, although destroyed air sacks will never again function, quitting now will immediately halt the needless destruction of additional sacs. You only have two options - decay or heal, including the possibility of experiencing up to a 30 percent increase in overall lung function within 90 days of quitting. If continuing assault by the 81 cancer causing chemicals so far identified in cigarette smoke, which cigarette in which pack contains the spark that gives birth to that first cancerous cell? OUR LIE: I'd quit but withdrawal never ends! THE TRUTH: Hogwash! If you remain 100% nicotine free for just 72 hours your blood will become nicotine free, your withdrawal anxieties will peak in intensity and the number of psychological craves will peak in number. The greatest challenge will be over. Actual physical withdrawal will be complete within 2-3 weeks as the brain re-sensitizes dopamine pathway receptors and down-regulates their numbers to levels seen in non-smokers. During that time you'll encounter and recondition (extinguish) all but remote or seasonal psychological habit crave triggers and begin to witness the gradually diminishing influence of thousands of nicotine replenishment memories, memories that belonged to an actively feeding addict who once again was in need of a fix. If you focus on taking recovery just one hour, challenge and day at a time, before you know it you'll experience your first day of total comfort, where never once do you think about wanting to smoke nicotine. I call it a silent celebration because you probably won't even realize that it has happened until the next day. After the first such day, they grow more and more frequent until they become your new sense of normal. If just starting out, the rich and deep sense of comfort and calm that awaits you is beyond your enslaved mind's ability to comprehension. Why? Because your dopamine pathways, your mind's priorities teacher, have been hijacked, making that next nicotine fix as important as eating food. Food craves, nicotine craves but with one critical difference. Without food we die. Without nicotine we thrive. It's why, although as real as your name, you cannot trust the nicotine wanting message that pounds inside your head, as it is false and is destroying you. OUR LIE: But the craves last for hours! THE TRUTH: Just like the lingering thought of a nice juicy steak, lobster in butter sauce, or fresh baked hot apple pie, you can make yourself "think" about having a cigarette all day long, if that's what you really want to do. Unlike fixating on a conscious thought about smoking, subconsciously cue triggered crave anxiety attacks almost always last for less than 3 minutes. But it's important that you look at a clock and time the crave episode as cessation time distortion (a normal and expected recovery symptom) can make minutes feel like hours. The good news is that most of the anxiety surrounding crave episodes is self induced and thus controllable. Key is in not trying to hide or run from your mind's junkie thinking but exposing it to honest analysis and positive thinking. Strip away all the self-inflicted anxiety and at worst, what remains on quitting day 3 for the "average" quitter is just 18 minutes of true crave anxiety (an average of six craves, each less than three minutes in duration). OUR LIE: I'll quit after the next pack, next carton, next month, my next birthday or New Years. THE TRUTH: Oh really? Can you count on both hands and all your toes how many times you've lied to yourself with such nonsense? And which pack, carton, month or birthday will give you the best chance for success? Forget buying nicotine laden cigarettes by the pack or carton. A case is even cheaper! With the way that cigarette prices are shooting through the roof, you might as well calculate how many it will take to keep you in nicotine for life and buy them all now. The only problem with that is in determining how long you have left to live. How many more pack, carton, birthday and New Year's lies will you tell to yourself? When will they stop? If you continue on your present path, many Birthdays will likely be canceled by a rather early Deathday. You are a true drug addict in every sense and the "wanting" inside your brain is as real as the greatest truth you know. What isn't true is the message, that that next fix is important. Truth is, everything now done under nicotine's influence can be done as well as or better without it. OUR LIE: I like to smoke when I drink and I find myself smoking even more. THE TRUTH: The effects of drinking and stress upon our body's nicotine level are nearly the same. You smoke more when you drink not because you "like" to but because you MUST. Like stress, alcohol is an acid producing event that causes urine to become more acidic. The greater the acid level of urine, the quicker our kidneys remove and eliminate nicotine reserves from the bloodstream. Thus, the more you drink, the more nicotine you'll need to smoke or ingest in order to avoid sensing the onset of the anxiety of early withdrawal. Although early alcohol use contributes to destroying a great many quit attempts, understanding the nicotine-acid relationship can be of benefit in accelerating physical nicotine withdrawal so that quitters can begin feeling relief sooner. Acidic fruit juices, such as cranberry, may help reduce the normal 72 hours of withdrawal required to remove all nicotine from the blood. In that roughly 50% of all relapses are associated with alcohol use, if at all possible don't drink during the first few days of recovery. When you do decide to drink, consider drinking at home first without cigarettes around before testing your resolve around smokers. By doing so you'll help to break the your mind's psychological links between smoking and drinking with as little risk as possible. As millions of ex-smokers can attest, your beer or drink will taste better than ever once your taste buds are allowed an opportunity to heal. OUR LIE: It's too painful to quit! THE TRUTH: Compared to what? Three days of physical withdrawal (just 72 hours) in no way compares to the pain of months of chemotherapy, lung removal surgery and a two foot scar, a losing battle with throat cancer, years of trying to recover from a serious stroke or massive heart attack, or fighting for every breath through emphysema riddled lungs as you drag oxygen around for the balance of life. If you're really worried about hurt then why continue your daily destruction? OUR LIE: If I quit, I'll just start back again. I always do. THE TRUTH: The truth is that you do not have to relapse. We relapse because we rewrite the Law of Addiction, we forget why we quit, or we invent lies and stupid excuses, such as those that fill this page. Your next quit can be your last but you need to learn how to care for your recovery, while always applying the only rule that you'll ever need to obey - to NEVER TAKE ANOTHER PUFF! OUR LIE: I'll cut down or quit and smoke just one now and then. THE TRUTH: It's every addict's dream, to control the uncontrollable. You are addicted to a substance that is five times as addictive as powdered cocaine (15% vs. 75%). You may be strong enough to cut back but so long as nicotine continues to arrive you'll remain hooked, the decay will continue, and as studies suggest, even though smoking less your health risks will remain almost unchanged. If you were a pack-a-day nicotine smoker and after quitting you decide to smoke just one cigarette, you might as well get ready to smoke the other 7,300 for the year too as full and complete relapse is virtually assured. The Law of Addiction is simple - just one puff of new nicotine and it's over. Brain scans show that up to 50% of dopamine pathway receptors become occupied by nicotine within eight seconds of the first puff. While roughly half walk away from relapse totally convinced that they've gotten away with smoking just once, they've saturated and de-sensitized dopamine pathway receptors and will soon find their brain begging for more. You see, as permanent as alcoholism, once hooked we somehow stay hard wired for relapse for the balance of life. Although recovery allows the brain time to heal and function normally again the tracks of addiction remain. We cannot cure or kill our disease. Once free, we remain on probation for the balance of life. OUR LIE: I tried quitting but my family stopped supporting me or was giving me such a hard time that it caused me to throw in the towel. THE TRUTH: It's a lie. You gave up because you used your family as a cheap excuse to get your drug back. You exaggerated everything they did or didn't do. You were looking for any excuse. You're the drug addict yet you expected them to understand the weakness and thinking of a drug addict's mind. Maybe they didn't pat you on the back as often as you wanted, but is it really fair to expect them to appreciate the magnitude or duration of your challenge if they've never been through chemical withdrawal themselves? They just want you to be normal. They don't know how to react. Do they pat you on the back and keep reminding you, or hope and pray that the worst has already passed? Feeling unappreciated, picking fights and creating confrontation are tools of the addict's mind that are often used as weapons in order to reclaim their drug. Some know that if they inflict tremendous stress on loved ones that they may even convince their loved one to beg them to start smoking nicotine again, or better yet, to go buy their relapse cigarettes for them. That way, they can blame their relapse on their loved one. "They just couldn't handle my quitting." "Maybe next time!" The lengths to which we'll go in order to feed our wanting are almost beyond belief. Yes, some of us will even hurt those that love us most. OUR LIE: OK, I'm going to stop! Now I can enjoy my smokes until then! THE TRUTH: If you've done this more than once, isn't it just more junkie head games? This addict wants to feel good about smoking nicotine and they've learned that by saying that they're going to quit, that they make themselves feel better even though deep down they know that it's probably just another lie! Unless something awakens this addict, there may never be a serious quit in their future. OUR LIE: I've got to die of something! THE TRUTH: True, but if you knew that tomorrow morning at 9:22 a.m. a massive smoking induced stroke would bring your life to an abrupt end, and you'd die on a cold floor with a cigarette beside you - just as tens of thousands of smokers are found each year? Would you light that last cigarette at 9:21 a.m. and pull the trigger that kills you? Is this one of your primary use rationalizations? Look around at all the smokers you see today. The death certificates of half will read, "cause of death - smoking." Yes, they had to die of something but not an average of more than 5,000 days early. Have you met Noni, Bryan, Deb and Kim? Would any non-addicted human spend each and every day of the remainder of their life intentionally destroying more of their body's ability to receive and transport life giving oxygen? Would they continue doing so until physical exercise was no longer an option, or until this mental illness called dependency forced others to begin caring for us, as they watch us struggle just to suck oxygen from tanks and machines? Which family member have you prepared to be your care giver? Try to imagine what it's like to breathe through a straw? It's called emphysema. Why not find a straw and give it a try. What has nicotine done for you lately? OUR LIE: I can't quit alone. I'll need nicotine gum, the patch, hypnosis, e-cigs, acupuncture, magic herbs or other wonder drugs! THE TRUTH: Wrong! The simple truth is that no magic cure has ever "made" any smoker quit smoking nicotine. The key to immediate and lasting abstinence is education and understanding, in becoming vastly more dependency recovery savvy than our addiction is strong. Hypnosis and acupuncture teach us nothing, nor does use of nicotine replacement products that fail roughly 93% of users within 6 months of quitting, while making NRT slaves of a substantial percentage of those who actually quit smokings. What quitting product and procedure salesmen will never tell you is that each year cold turkey generates more successful long-term ex-users than all other quitting methods combined. Why? Because they want your money. Remember, should all else fail, you always have you! OUR LIE: It's all Nicodemon's fault, not mine! THE TRUTH: There is no Nicodemon, no little monsters, no big monsters, no monsters at all. None! In fact, the title to this article, Nicodemon's Lies, is one of the biggest lies of all. They were never Nicodemon's lies but our lies. Nicotine is simply a chemical, a drug, an alkaloid known as C10H14N2. Its I.Q. is and always has been zero. It does not think, plan, inflict punishment, nor will it conspire to make you relapse or die addicted to it. The fact that it has zero intelligence has always been your greatest weapon. Everything you see, feel, and sense during nicotine withdrawal and recovery will be grounded in chemical dependency, conditioning, reason, logic, emotion or science. Any conspirators in any past attempts to make you relapse and destroy your recovery were always and only "you!" Never once did you relapse due to external circumstances. It was 100% internal, once again you introduced nicotine into your bloodstream. The good news is that while each defeat was yours, so too will be the victory. Should you end nicotine's control of your brain's reward pathways the victory will belong only to you!

Yes, every single person here and elsewhere can quit smoking and stay that way! Glad you're doing well.

Is your son, daughter or student hooked on e-cigarettes, vape pens or Juuls? This short video explains a critical insight that parents, or other adults responsible for a vaping child or teenager, need to understand in order to help these young people successfully quit vaping.

Mark L. Rubinstein, Kevin Delucchi, Neal L. Benowitz, Danielle E. Ramo http://pediatrics.aappublications.org/content/141/4/e20173557 Download the or view the PDF: e20173557.full.pdf Article Information Published online April 02, 2018 Pediatrics Vol. 141 No. 4 April 01, 2018 e20173557 doi: 10.1542/peds.2017-3557 PubMed 29507165 Published By American Academy of Pediatrics Print ISSN 0031-4005 Online ISSN 1098-4275

E-cigarettes are becoming popular among junior high students, so schools are educating them on health risks. By Brynn Twait http://www.newstrib.com/news/surprised-at-how-young-they-are-starting-to-vape/article_7fc2e768-1a68-11e9-9461-27b0307dd6a3.html At what age are kids starting to use e-cigarettes? Some users may be as young as 11. “We’re surprised at how young they are starting to vape,” said Jennifer Kelsey, a pediatrics nurse. “As early as fifth and sixth graders have tried it.” Kelsey works at OSF Medical Group in Ottawa and has been giving presentations at local junior high schools on the harmful health effects of e-cigarettes. She has noticed an increased use of e-cigarettes by her pediatric patients. “The word spread fast that vaping seems to be a problem in local schools,” Kelsey said. “I just wanted to take my message and spread it to the kids as well as my patients.” An e-cigarette is an electronic nicotine device that can look like a pen, computer memory stick, car key fob, or an inhaler. “E-cigarettes use inhaled vapor from the e-juice, which has been heated by a battery powered coil, and that’s where they get that term vaping,” Kelsey said. “The e-juice is flavored, which usually contains nicotine and other harmful chemicals. The juice comes in very tempting flavors like bubblegum and mango that are just more appealing to our youth.” Kelsey spoke last week to sixth and seventh graders at Washington Junior High in Oglesby. Principal Merritt Burns said there were several incidents involving e-cigarettes at the beginning of the school year, so the district has been teaching students about the devices. “E-cigarettes are designed to deliver nicotine into the blood, just like regular cigarettes, by smokers inhaling it into the lungs,” Kelsey said. “With e-cigarettes, the nicotine goes into your mouth, to your lungs, to your bloodstream and then it goes directly to your brain. It affects your whole body.” She said one e-cigarette refill pod has the same amount of nicotine as one pack of cigarettes. “With vaping, you’re not sure how much nicotine you’re actually getting, so you could actually be taking in more nicotine by vaping than you could by cigarettes,” Kelsey said. Kelsey also will give presentations at Trinity Catholic Academy in La Salle. Principal Deb Myers said she has not caught any students with e-cigarettes at school, but she wants to be proactive. “One of my main reasons for bringing in a program is to be able to give students as much information as possible to hopefully prevent students from using the products,” Myers said. “It does seem like it’s an increasing trend with junior high students, pre-teens and teenagers.” “We didn’t think that it would filter down to the junior high level as quickly as it has,” Burns said. “It’s the number one banned product right now that kids are exposed to, more so than alcohol or drugs, even regular tobacco,” Burns said. Kelsey said young people think e-cigarettes are safer than regular cigarettes because they taste good and don’t have a bad smell. However, both contain nicotine, a highly addictive drug. Michael Olson, Putnam County Junior High principal, said the school has been educating students about e-cigarettes in health class as a preventative measure. The school also signed up for the OSF presentation to reinforce students’ knowledge about the dangers of vaping. “We just want them to be fully aware that this isn’t just a cool fad,” Olson said. “There are some very harmful side effects, short term and long-term, with using these.” Burns said a lot of students he talked to at the beginning of the school year did not even realize that e-cigarettes contained banned substances. “Early on, kids were just not educated enough that they were doing it in a public manner,” Burns said. “Some of them were doing it on their walks to school.” Burns said there has been a lot of education over the years to inform people cigarettes are bad for our health, but not as much information has been relayed to the public about the negative health effects of e-cigarettes. “There are no extensive studies that have happened to really showcase the dangers of vaping,” Burns said. “When that knowledge isn’t there for students or adults, that’s where we kind of have to step in and begin that education process.” Toxic traces E-cigarettes contain a lot of toxic chemicals, including the ones listed below. Benzene — It is found in pesticides and gasoline. Short-term exposure of inhalation can cause drowsiness, dizziness, headaches, eye irritation and lung irritation. Long-term exposure can reduce the number of red blood cells that carry oxygen to your organs like your brain and your heart. Diethylene glycol — It is used in anti-freeze. It can cause eye irritation, lung irritation and long-term exposure can cause reproductive side effects. Isoprene — It is made up of natural rubber, and it’s a cancer-causing agent. Formaldehyde — It is used for preserving dead bodies. It’s been classified as a human carcinogen and it can cause nose and mouth cancers and even blood cancers. Nicotine — It is a naturally occurring toxic chemical found in tobacco. It affects the heart and brain. Propylene glycol — This is the ingredient that makes the vapor, or smoke. Long-term exposure may raise the child’s risk of developing asthma. Toluene — It is a poisonous, industrial solvent that is added to gasoline. The central nervous system is the primary target for that. Children that have been exposed during pregnancy can suffer from developmental side effects. They can have facial and limb abnormalities and then attention issues. Acetaldehyde — It is a poisonous solvent found in a paint stripper. Cadmium — It is a toxic heavy metal used in car batteries Lead — It is a naturally occurring element found in the Earth’s crust. It’s very toxic to humans and animals.

Posted 9:01 am, January 17, 2019, by CNN Wires https://fox2now.com/2019/01/17/why-vaping-is-so-dangerous-for-teens/ “We let this Frankenstein loose without knowing what was going to happen,” Levy said. Most of what we know about nicotine addiction in teens, we know from cigarettes. But experts say the technology and chemistry of vaping might pose an entirely different threat. “It turns out that e-cigarette use by kids doesn’t look the same at all,” said Dr. Sharon Levy, director of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital. “How you’re delivering [nicotine] and how much you’re delivering … everything you change really matters.” Levy said she’s seen vape-addicted kids in her program showing what appear to be psychiatric symptoms rarely seen with traditional cigarettes or among adults. Some have anxiety and cannot focus, for example. Meanwhile, vaping has become ubiquitous in many high schools, prompting the US Food and Drug Administration to tackle “epidemic” levels of use among minors. On Friday, the agency will hold a public hearing to discuss the role of smoking cessation drugs for kids in order to get them off vapes. There currently are no FDA-approved nicotine cessation products for e-cigarette users under 18. Despite early fanfare that e-cigarettes might offer a less harmful alternative to adult smokers, experts say youth are being hit hard by a combination of how vapes deliver nicotine, how kids’ brains are wired and developing, and the gadgets’ unique appeal to kids. Their long-term health effects are still unclear. “We let this Frankenstein loose without knowing what was going to happen,” Levy said. Teen vaping was a ‘predictable problem’ Experts say that one Juul pod — a cartridge of nicotine-rich liquid that users plug into the dominant e-cig brand — contains the same amount of nicotine as a pack of cigarettes. “That may be true, but that’s not the only consideration here,” said Levy, adding that it’s yet unclear “how high those peaks go and how quickly it gets into the bloodstream and into the brain.” Levy said that it’s not uncommon for kids to report symptoms that “sound a lot like nicotine toxicity,” including headaches and stomach aches. She suspects these devices cause nicotine levels in the blood to peak higher than they do with traditional cigarettes — but experts say more research is needed to better understand how vapes work on the body and brain. “These new generations of electronic cigarettes, like Juul … they actually deliver a really high dose of nicotine, probably even higher than tobacco cigarettes,” said Maciej Goniewicz, an associate professor of oncology and pharmacology at Roswell Park Comprehensive Cancer Center who specializes in toxicology. In a study last year, Goniewicz found higher levels of cotinine — a breakdown product of nicotine — in the urine of adolescent vapers than had been reported in prior research of teenage cigarette smokers. According to Goniewicz, vape manufacturers may be able to pack more nicotine into their products by creating “nicotine salts,” which may mask nicotine’s naturally unpleasant taste and lead the drug to be absorbed by the body quicker. The salt is created by combining nicotine — a base in its natural form — with an organic acid, he said. Experts worry that inhaling these and other added ingredients may cause other health problems down the line, but e-cigarettes haven’t been around long enough to know. Beyond the chemistry of the nicotine itself, e-cigarette companies have come under fire for adding pleasant, often sweet flavors to their “e-liquid” that are known to appeal to young people. And the absence of the harshness of inhaling combustible cigarettes may allow vapers to take deeper or more frequent puffs, Levy added. FDA commissioner Dr. Scott Gottlieb proposed in November to strengthen the agency’s policies against flavored e-cigarette products. These proposals could ultimately prompt their removal from shelves and websites that are accessible to minors. But the proposed changes do not include mint, menthol and tobacco flavors. Gottlieb said he wanted to leave the door open for adults who might use these products to quit smoking cigarettes, “but it can’t come at the expense of addicting a generation of kids on nicotine,” he previously told CNN. Leading e-cigarette company Juul, which holds about 75% of the market in the United States, has also maintained that flavors are a useful tool to help adult smokers to switch from combustible cigarettes. Ashley Gould, chief administrative officer at Juul Labs, told CNN last year, “We were completely surprised by the youth usage of the product.” The company has maintained that its product is intended to convert adult former smokers to what Juul describes as a less-harmful alternative, and it says it is taking steps to limit kids’ use of e-cigarettes. But Levy describes vapes’ popularity among teens as an “entirely predictable problem.” Teens’ brains might be more vulnerable to nicotine Levy said the impact of vapes on teens is changing the way people think about nicotine products. Smoking was largely seen as a “medical problem” that could lead to cancer and other physical ailments, she said. Now, vaping is increasingly being seen as a psychiatric problem over concerns that nicotine is cultivating addictive behaviors among kids and interfering with their brain development. “There’s concern that the adolescent brain may be more vulnerable to the addictive effects of nicotine,” said Adam Leventhal, director of the Health, Emotion, and Addiction Laboratory at the University of Southern California. “The circuits underlying pleasure and the pursuit of novel, enjoyable experiences develop much faster than the circuits that promote decision making, impulse control and rational thinking,” Leventhal said. We know from cigarette users that those who try nicotine products early in life are more likely to develop dependence to the drug, said Leventhal. This may also lead to the disruption of brain circuits that underlie attention and cognitive skills, he added. What makes kids uniquely vulnerable to vapes is not merely biological; it’s also psychosocial, according to Leventhal. This may come in the form of peer pressure or stress, which may increase the likelihood of addictive behaviors, he said. More broadly, the cultural and policy shifts that prevent many kids from picking up cigarettes — including FDA regulation and a “long history of prevention programs” — simply haven’t kept pace with the vaping boom, Leventhal added. Kids and adults also tend to vape for different reasons, Goniewicz said. Adults tend to be former smokers who can handle a high dose of nicotine and want to avoid withdrawal symptoms, such as the inability to sleep or focus on work. “They don’t really need nicotine to feel good,” he said. “They need nicotine not to feel bad — because they are already addicted.” But e-cigarettes may be kids’ first experience with nicotine. “Nicotine hits the brain,” he said, tinkering with molecules that affect mood and other pathways. And they aren’t used to it, he said. “Nicotine is a potent chemical that changes our brain.” It’s hard to get kids to quit Levy said that “nearly all” adolescents in her program have some experience with e-cigarettes, but “what’s new is that now, we’re seeing patients in the substance use program whose only substance is nicotine.” Health experts worry that getting hooked on nicotine early in life may be a gateway to cigarette smoking and other drugs, and there are few tried-and-true resources out there for teens. “Kids are often really struggling with this, and there are just not a lot of resources for them,” Levy said, adding that many addiction programs may not be equipped to deal with some of the younger, nicotine-addicted kids she’s seeing. Far better would be to ensure that primary care doctors are equipped to work with kids in their own communities, she said. Some parents have pursued nicotine gum and other cessation tools off-label for their children under doctors’ guidance. Levy said that can be tricky because some kids may use these products as a “bridge” between puffs of vapes and tobacco products. Medications can be important in some advanced cases, but they’re not enough, she said; kids also need “good, solid counseling.” “We end up needing to teach kids how they can deal with cravings, how they can identify high-risk situations, how they can actually deal with being surrounded by people who are using these things,” Levy said. “Because the reality is that, for most kids, we treat them and put them back in school, and then they go to the bathroom, and everybody’s Juuling.” Still, she said kids and their parents seem largely unaware of the potential dangers. “Even to this day, I have kids saying, ‘well, I thought it was safe’ or ‘I know it’s safer than cigarettes,’ ” Levy said. “And ‘safer than cigarettes’ is a really low bar.”

Penn State News https://news.psu.edu/story/527326/2018/07/03/impact/medical-minute-hazards-juuling-or-vaping HERSHEY, Pa. — Mango, mint, fruit medley — these flavors are delicious in a smoothie but dangerous when they introduce youth and young adults to nicotine. A 2009 federal law outlawed the use of flavorings other than menthol in cigarettes, but electronic cigarettes — or e-cigarettes — are unregulated and exploit the flavors to attract young consumers. E-cigarettes are battery-powered devices that allow users to inhale or “vape” into their lungs aerosolized liquid that contains nicotine, and many vaping devices also can be used to vaporize marijuana. These devices often look like pens, USB flash drives and other everyday items. The term "juuling" comes from Juul, a company that markets e-cigarettes that look like USB devices and plug into a computer to charge. The e-liquid in vaping cartridges contains nicotine mixed with a base (usually propylene glycol) and may also include flavorings, colorings and other chemicals. Dr. Shwetha Gurram, a family medicine physician with Penn State Health in State College, said teens are particularly attracted to “juuling” because of the device’s sleek design and fruity or perfume-like odor. “This makes it easy to hide from adults because of the added flavors such as cool cucumber or crème brulee,” she said. In 2017, a Minnesota Department of Health survey reported that almost one in five of the state’s high school students had used e-cigarettes in the past 30 days, and a 2016 report by the U.S. Surgeon General found e-cigarettes to be the most popular tobacco product among American teens. Because vaping can be a gateway to smoking cigarettes, experts are concerned that the increasing popularity of vaping could reverse the longstanding U.S. decline in smoking. “Parents should make sure their kids understand what juuling really is and have an honest discussion about why it’s dangerous in an effort to counteract the messages delivered by attractive advertising, social media posts and peer pressure,” said Gurram. The U.S. Food and Drug Administration does not regulate e-cigarettes, so packaging does not feature warning labels about health risks. Last year, the FDA announced that it would delay until 2022 a pending requirement that e-cigarette companies submit their products for review. Although e-cigarettes are marketed as a safer alternative to smoking, they are still dangerous: Most e-cigarettes contain nicotine, an addictive substance that can negatively impact adolescent brain development. One Juul pod contains as much nicotine as a pack of cigarettes. Side effects include increased heart rate and blood pressure, lung disease, chronic bronchitis and insulin resistance leading to type 2 diabetes. Some e-cigarettes that claim to be nicotine-free do contain the harmful substance. Studies have found toxic chemicals such as formaldehyde and an antifreeze ingredient in e-cigarettes. Almost 60 percent of people who use e-cigarettes also currently smoke conventional cigarettes, according to the U.S. Centers for Disease Control and Prevention. The vapor exhaled by e-cigarette users contains carcinogens and is a risk to nearby nonusers, just like secondhand tobacco smoke. “Most importantly, parents should serve as positive role models by being tobacco-free,” Gurram said. “Give kids a clear message that nicotine in any form is bad for their health.”

By Flint Duxfield Updated 11 Jun 2018, 8:19pm https://www.abc.net.au/news/2018-06-12/not-all-e-juices-are-as-nicotine-free-as-they-claim/9857540 Nicotine, the addictive agent found in tobacco cigarettes, has been discovered in a number of e-cigarette liquids claiming to be free of it. Key points: The sale of liquid nicotine in e-cigarettes is illegal across Australia Six varieties of "nicotine-free" e-liquids have been found to contain nicotine Health experts say the findings highlight the lack of regulation of vaping products in Australia Australian researchers investigating the potential health impacts of e-cigarettes tested 10 varieties of "nicotine-free" e-liquids and found six to contain nicotine. The e-liquid samples, purchased online and over the counter from Australian suppliers, were also found to contain a substance known as 2-chlorophenol, an "acutely toxic" chemical typically found in insecticides and disinfectants. Lead researcher Alex Larcombe of the Telethon Kids Institute said the findings highlighted the risks of "little to no regulation" of vaping products in Australia. "In a lot of cases, people who are using e-cigarettes are unaware of what they're breathing in," Associate Professor Larcombe said." The sale of liquid nicotine is illegal in Australia, meaning vape stores are restricted to e-cigarette devices and "nicotine-free" e-liquids. But inaccurate labeling means vape users may "unwittingly inhale this addictive substance" or retailers may sell incorrectly-labelled nicotine-containing e-liquids to willing customers, according to the study published today in the Medical Journal of Australia. "There is little to no regulation of their manufacture, and potentially dangerous ingredients and incorrect nicotine levels have been identified," the authors wrote. The nicotine found in three of the samples was at levels comparable to those found in low-dose nicotine e-liquids, and at trace levels in the other three samples in which it was present. Potentially harmful ingredients identified Associate Professor Larcombe said he was "surprised" by the discovery of 2-chlorophenol, a known respiratory and dermal irritant. "It was only in there in small amounts, but it was found in all of the liquids that we looked at," he said. "We also found other things — by-products of animal or human bodily functions — which indicates the process of making the e-liquids might not be as clean as you might hope." The samples were also found to contain "relatively benign" chemicals commonly used in foodstuffs, soaps and detergents, as well as common e-liquid ingredients such as flavours and solvents. "Most of these sorts of things are food additives qualified as 'safe to eat', but … it's unknown what the heating process does to the chemical composition of these ingredients, especially when it's being breathed into the lungs," Associate Professor Larcombe said. A 'regulatory no-man's land' Simon Chapman, emeritus professor of public health at Sydney University, said Australia was operating in a "regulatory no-man's land" when it came to e-cigarettes. "Vaping retailing in Australia is a real cowboy … they say they can sell the juice without nicotine, but there's no specification about what can and can't be in it," said Professor Chapman, who was not involved in the study. In Australia, nicotine is classified as a "schedule 7 dangerous poison", with exemptions made for certain nicotine replacement therapies and for tobacco used in smoking. People who want nicotine in their e-cigarettes must order it in liquid form from overseas and add it to the devices themselves. But Professor Chapman, who has been at the forefront of tobacco control in Australia, said it was an "open secret" that you could buy e-liquid containing nicotine, despite it being illegal. "I've also been told there's a fair amount of amateur, backyard lab production of e-juices which are being sold," he said. Last year, health inspectors from the New South Wales Department of Health visited 227 retailers selling e-liquids and found 63 per cent of e-liquids labelled "nicotine-free" actually contained nicotine. Professor Chapman said the lack of regulation and mislabeling of nicotine was a particular concern when it came the use of e-cigarettes among young people. "In the United States, the Food and Drug Administration is currently considering what they're going to do about the regulation of nicotine products … because they've seen an incredible spike in teenagers using e-cigarettes," he said. "We hope that e-cigarettes are less harmful than smoking because they don't contain combusted material ... but there is no long-term evidence about the risks or the benefits of vaping." Vaping as a harm reduction measure Colin Mendelsohn, associate professor of public health at the University of New South Wales, said although more stringent vaping regulations were required, the findings of the research were "relatively unimportant" as a health issue. "The labels are definitely misleading, and these products should certainly be legalised and regulated," he said. "But the average dose of nicotine they found was trivial … and I doubt very much it would be addictive in any way" Associate Professor Mendelsohn, who has long campaigned for the use of electronic cigarettes as a harm reduction measure, said the discovery of other potentially harmful chemicals was "not in itself a concern". "There are chemicals everywhere — we are exposed to them all day long. The harm depends on the level of the chemical and the toxicity of that chemical," he said. "Lots of studies have looked at the chemicals in vaping, and they're way below occupational health standards. I suspect these products would be down at that level." Associate Professor Mendelsohn said the majority of regular vapers were smokers and ex-smokers, and that the health impacts of e-cigarettes should always be compared to those of smoking. "We know vaping is dramatically less harmful than smoking," he said. "I think nicotine liquids should be available for sale for smokers who are unable to quit, because the alternative for these people is to keep smoking — and two out of three will die from that." Professor Chapman, however, said the evidence for people quitting smoking using e-cigarettes was "very poor". "For every person who has a positive outcome, there are more than two people who have a negative one — meaning they switch back exclusively to cigarettes," he said. "It will take decades before we know whether or not vaping is less dangerous than smoking, and by how much, if it all."

Video discusses how e-cigarettes are an ineffective tool at helping most smokers to be able to quit and discusses the Implications of smokers who use e-cigarettes to supplement their nicotine delivery needs at times when they are not permitted to smoke regular cigarettes.

Why users of electronic cigarettes may be having a harder time emotionally with their quits over the longer-term.

There is a real concerted effort out there trying to make vaping seem relatively harmless. This poses a big risk to kids and is leading to the epidemic rates of use that we are seeing now in teens, but also poses a risk to all former smokers who can easily be influenced by these campaigns to experiment with what is being presented as a harmless alternative that is going to cause them to lose their quits. Do not underestimate how many people are seeing these resources. Here is the link to the Public Health England video referred to: https://www.youtube.com/watch?v=RisBe5sLGPc A December 2018 cotton ball comparison video experiment produced by Public Health England will likely leave many viewers believing that vaping is relatively harmless because it doesn’t discolor the lungs the way smoking tobacco cigarettes do. This video explains that when it comes to dangers posed by nicotine delivery systems, it’s often what you don’t see that can still end up harming and possibly killing you. https://whyquit.com/joels-videos/vaping-what-you-cannot-see-can-still-hurt-you/

Video discusses how parents who write off their children's use of nicotine containing products as a minor problem are sending a message that put their children's long-term health and lives at risk. On top of that, by minimizing the dangers of taking up nicotine, they are increasing the risk of their children taking up other drugs that the parents are often more worried about.

By MATTHEW PERRONE - 1/16/19 3:53 PM http://www.tribtown.com/2019/01/16/us-teen-vaping-addiction/ WASHINGTON — The nation’s top health authorities agree: Teen vaping is an epidemic that now affects some 3.6 million underage users of Juul and other e-cigarettes. But no one seems to know the best way to help teenagers who may be addicted to nicotine. E-cigarettes are now the top high-risk substance used by teenagers, according to the latest U.S. figures , which show that Juul and similar products have quickly outpaced cigarettes, alcohol, marijuana and other substances that have been tracked over more than four decades. The handheld devices heat a liquid solution that usually contains nicotine into an inhalable vapor. Federal law prohibits sales to those under 18, though many high schoolers report getting them from older students or online. In recent months, government officials have rolled out a series of proposals aimed at keeping the products away from youngsters, including tightening sales in convenience stores and online. In November, vaping giant Juul voluntarily shut down its Facebook and Instagram accounts and pulled several flavors out of retail stores. But there’s been little discussion of how to treat nicotine addiction in children as young as 11 years old. While some adolescents should be able to quit unaided, experts say many will be hampered by withdrawal symptoms, including anxiety, irritability, difficulty concentrating and loss of appetite. Physicians who treat young people now face a series of dilemmas: The anti-smoking therapies on the market — such as nicotine patches and gums — are not approved for children, due to lack of testing or ineffective results. And young people view the habit as far less risky, which poses another hurdle to quitting. The harshness of cigarette smoke often limits how much teenagers inhale, sometimes discouraging them from picking up the habit altogether. That deterrent doesn’t exist with e-cigarette vapor, which is typically much smoother, according to experts. Kicking any addiction requires discipline, patience and a willingness to follow a treatment plan — something that doesn’t come easily to many young people, experts said. “Teenagers have their own ideas of what might work for them, and they’re going to do what they do,” said Susanne Tanski, a tobacco prevention expert with the American Academy of Pediatrics. “But we desperately need studies to figure out what’s going to work with this population.” Since debuting in the U.S. in 2007, e-cigarettes and other vaping devices have grown into a $6.6 billion business. Driving the recent surge in underage use are small, easy-to-conceal devices like Juul, which vaporizes a high-nicotine solution sold in flavors such as creme, mango and cucumber. Despite industry worries of a crackdown on flavors, the FDA has taken no steps to ban the array of candy and fruit varieties that companies use to differentiate their offerings. E-cigarettes have become a scourge in U.S. schools, with students often vaping in the bathroom or between classes. One in 5 five high schoolers reported vaping in the last month, according to 2018 federal survey figures. Juul and other brands are pitched to adult smokers as a way to quit smoking, but there’s been little research on that claim or their long-term health effects, particularly in young people. Nicotine can affect learning, memory and attention in the teenage brain, but there’s virtually no research on how e-cigarette vapor affects lungs, which do not fully mature until the 20s. “It’s frightening for me as a pediatrician because I really feel like there’s this uncontrolled experiment happening with our young people,” Tanski said. “They don’t perceive the harm, and we can’t show them what it’s going to be.” Tanski and other experts will meet this Friday at the Food and Drug Administration to discuss the potential role for pharmaceutical therapies and non-prescription medications such as nicotine gums and patches. Regulators acknowledge they are starting from square one: The FDA “is not aware of any research examining either drug or behavioral interventions” to help e-cigarette users quit, the agency noted in its announcement. The FDA will also hear from researchers, vaping executives, parents and teenagers. “We want to make sure our voices are heard and that — most importantly — our kids’ voices are heard,” said Meredith Berkman, who plans to speak at the meeting with her 10th-grade son. Berkman said she first realized her son and his friends were “Juuling” last year when she heard them repeatedly opening and closing his bedroom window. With two other New York City mothers, she formed the group Parents Against Vaping E-cigarettes, which is asking the FDA to ban all e-cigarette flavors. “Unless the flavors are off the market, kids are going to continue to be seduced by these highly addictive nicotine-delivery systems like Juul,” Berkman said. Quitting smoking is notoriously difficult, even for adults with access to various aids and programs. More than 55 percent of adult smokers try to quit each year, yet only about 7 percent succeed, according to government figures. Nicotine gums, patches and lozenges are available over-the-counter for those 18 and older, and are occasionally prescribed “off-label” for younger patients. They provide low levels of nicotine to help control cravings. Prescription drugs include Zyban, an antidepressant, and Chantix, which blocks the effects of nicotine on the brain. But neither has shown positive results in teenagers, and both carry worrisome side effects, including suicidal thinking for Zyban and nausea and abnormal dreams for Chantix. That leaves counseling as the go-to option for teenagers trying to quit cigarettes. In November, Colorado dropped the minimum eligibility age for its quit-smoking hotline from 15 to 12, in response to the explosion in vaping among students as low as 6th grade. The state’s underage vaping rate is the highest in the U.S., with 1 in 4 high school students reportedly using the products, according to federal data. The state’s over-the-phone and online programs provide free coaching to help users create a quit plan, manage cravings and avoid relapse. But even counseling has shown only “limited evidence” in helping teenagers, according to an exhaustive review of the medical literature published in 2017. Still, addiction specialists see growing demand for such programs, particularly group sessions that often have the most promising results. Addiction psychiatrist Jonathan Avery says he gets four to five calls a week from pediatricians referring patients or asking about treatment options. One of the biggest problems is an education gap — many doctors haven’t heard of Juul and don’t even recognize the vaping devices brought in by parents. On the other side, teenagers are often “suspicious” when he informs them that they are inhaling a highly addictive substance, said Avery, of New York-Presbyterian Hospital. About two-thirds of U.S. teenagers do not realize that Juul contains nicotine, according to a recent survey by the Truth Initiative, an anti-smoking advocacy group. The U.S. Surgeon General, Jerome Adams, hammered that point home in a rare public advisory last month. He said even his 14-year-old son believed that e-cigarette vapor was essentially harmless. “Youth like my son have no clue what’s in these products most of the time,” he said.

Coming.. tobaccoexplained.pdf