By Chris Holmes
The Non-Smoker Tries a Cigarette
Remember your first cigarette? Or to be more precise, do you remember the first time you inhaled tobacco smoke properly and experienced the effect on the way you felt, physically and mentally?
If there was no alcohol in your system already at the time – or any other recreational drug like cocaine, amphetamine or cannabis – if you were – like myself – eight years old and hiding at the bottom of your friend Ian’s garden having helped him steal a (now rather crumpled) Embassy No.1 from his Mam’s packet, and a single match… after a few puffs on that, you may have felt like this:
Nauseous… head fuzzy… feel rather sick and faint… got that uncomfortable feeling like I don’t know where to put myself… feel really unwell… don’t feel safe… bowels churning… feel rotten, very definitely ill. Poisoned. Really want to feel normal again, regret trying this…
So I lay down on the grass and waited, feeling stunned and very sick. It would be four whole years before I tried tobacco again.
Now of course, there are a lot of chemicals in tobacco smoke, not just nicotine. But nicotine was certainly in there, and according to the British Medical Association’s Illustrated Medical Dictionary (Dorling Kindersley, 2002 – I have it open in front of me)… nicotine “stimulates the central nervous system, thereby reducing fatigue, increasing alertness, and improving concentration.”
Really? Then how come I was lying there like a stuck pig watching the sky whirl round? Also, why does the same medical dictionary include amongst the side effects of nicotine replacement therapy “nausea, headache, palpitations, cold or flu-like symptoms”?
After The Sly Smoke at School
As we headed back into the main building Stuart said, as he often did: “You know lads, I really feel ready for Double Physics now! I feel energised, alert… the only problem is that my noticeably-increased powers of concentration might give me away this afternoon! Better stash these cigs somewhere…”
It was a hazard of which we were all too keenly aware. Anyone who works in a school will be able to spot the smokers – full of life, really alert, always concentratin’… come to think of it we had a bit of an unfair advantage, didn’t we? No wonder we all did so well.
The Non-Smoker Tries A Nicotine Patch
Many years later, long after I had ditched tobacco I found myself putting the finishing touches to a book about nicotine and smoking (working title: Whose Stupid Idea Was All That Then?) when it suddenly occurred to me that although I had tried tobacco when I was a non-smoker and found it stunningly nauseating… experienced tobacco smoke as a regular smoker and grown accustomed to it but it never seemed beneficial… and also tried Nicotine Replacement Poisoning as a regular smoker and found it slightly weird and pointless, I had never tried nicotine alone as a non-smoker. What would it be like? Perhaps, all those years ago in Ian’s garden I had been overwhelmed by all the other poisons in the smoke. Maybe, if I just tried “therapeutic nicotine” all by itself, nicotine would indeed “stimulate the central nervous system, thereby reducing fatigue, increasing alertness, and improving concentration.” After all, that’s what the British Medical Association say it does.
So I obtained a single nicotine patch, a NiQuitin CQ 21mg 24-hour patch. I also put by a pen and some paper upon which to make notes of the experience as I went along. I didn’t really intend to leave it on for the full 24 hours but I did aim to leave it on for most of the day, just to monitor the experience. As it turned out, it didn’t quite happen that way. What follows is directly quoted from Nicotine: The Drug That Never Was:
“This was at 10.15 on a Sunday morning, April 22nd 2007. We were planning to take the kids to the park at about eleven, which I was looking forward to because it was a nice day. This is an exact transcript of the notes I made at the time.
10.15 am. Stuck patch on inside upper left arm.
10.20 am. Tingling in both hands, mild tightening feeling in the throat.
10.25 am. Feel nauseous, patch burning skin a bit.
10.30 am. Feel like blood pressure is up, not a pleasant feeling. Tense. Uncomfortable, want to take it off actually. More nauseous, feel a bit ill. Patch really burning. Bowels upset a bit.
10.35 am. Head fuzzy. Feel rather sick. Got that feeling like I don’t know where to put myself. Feel really uncomfortable and irritable now.
10.37 am. Took patch off. Don’t feel safe. Big red mark on arm. Hands/wrists aching. Feel sick and faint, balance and even speech abnormal. Wrists and hands quite red. Bowels churning. Feel rotten, very definitely ill. Poisoned. Really want to feel normal again, regret trying this.
10.50 am. Still feel just as rotten, but feeling of real alarm that made me take it off now subsiding. Just feel ill.
“The patch was only in contact with my skin for 22 minutes. Before I began the experiment I felt fine – healthy and in good spirits. Now I felt absolutely terrible, really unwell and although I don’t usually scare easy…” [as a former intravenous drug user over many years, I’ve done some pretty mad and dangerous things] “…actually afraid to leave the patch on any longer. But here’s the thing – according to the B.M.A., nicotine:
“stimulates the central nervous system, thereby reducing fatigue, increasing alertness, and improving concentration.”
“So, did “therapeutic nicotine” make me feel more alert, able to concentrate better, as the B.M.A. described? Well, by the time I took the patch off I was very nauseous, anxious, irritable and no longer able or willing to hold a normal conversation – so I would have to say no, it certainly did not. Well, why not? If that is what nicotine does, that is what it does. I would have noticed. It just made me feel poisoned, and actually it did remind me of the first cigarette I ever tried, when I was eight. My pal Ian Coates stole a single Embassy No.1 from his mum, and we hid at the bottom of his garden and smoked it. It left me feeling pretty much like the experience I described above, but with a foul taste in my mouth as well. It was years before I tried one again, and even then it wasn’t because I liked it the first time. It was just because I wasn’t allowed to, and because smoking makes you look grown-up and cool, despite being twelve and pimply with awful hair and silly clothes. And feeling very queasy, if not actually vomiting.
“At eleven o’clock, we all left for the park. Sure enough I felt very queasy, delicate and anxious that I might suddenly need the toilet – that IBS feeling. I really didn’t want to go out at all now, I felt more like going for a lie down, which I hardly ever feel like doing even when I am ill. Of course, some fool might suggest that the dose was too high for a non-smoker, or that I was irresponsible to try that without medical advice, as if that were the reason it made me ill. But that’s ridiculous: none of us took medical advice before we tried our first cigarette, did we? And very few kids start with a low-nicotine cigarette – certainly not my generation anyway, or the previous one. So it was, in fact, an experiment that roughly replicated many initial, real smoking experiences but this time focussing entirely on nicotine itself – and guess what? Nicotine just makes you feel ill, because it is nothing but a poison. I’m not saying you can’t get used to it – professional boxers get used to being slammed in the face with a fist to the point where they hardly notice it, and I’m sure that stimulates the central nervous system too, but that don’t make it medicinal, baby.”
Talking of Crazy Experiments That Aren’t Exactly Scientific…
Who discovered penicillin? That’s right, Fleming. Who invented the hypodermic syringe? Louis Pasteur, correct. Both well known names in the history of medicine because the things they gave us are used by millions of people all over the world. So: who invented nicotine replacement therapy?
You don’t know, do you?
Well, he was also the man who insisted that tobacco smoking was not just a filthy habit, as everyone had been quite happy to regard it for several centuries. He insisted it was a drug addiction, and he claimed in a letter to The Lancet that he had ‘proven’ this by gathering together a group of 35 habitual smokers and – with their permission – injected them with 1mg of nicotine whenever they felt like they wanted a cigarette. He insisted that because the impulse to reach for a cigarette then subsided, this proved that the reason they smoked was because they were addicted to nicotine.
The man was a Glaswegian GP called Dr. Lennox Johnston (1899-1986) and the main reason you have never heard of him is because everyone thought he was loopy. He isn’t credited with inventing Nicotine Replacement Poisoning because he wasn’t suggesting using nicotine to get people OFF smoking. In fact, that would be an insane suggestion from anyone who was insisting that the smoking problem was a result of addiction to that very poison. No, he simply used that method to try to demonstrate his theory that smokers’ cravings are in fact a physical “need” for nicotine itself – but the experiment doesn’t even do that in reality. If I had still been a smoker when I tried that patch experiment, I certainly wouldn’t have wanted to smoke for quite some time after that, just as I never wanted one when I had a hangover or felt under par for any other reason. Lennox Johnston’s 35 volunteers were habitual smokers so they were more used to being poisoned than I was, but if they didn’t feel much inclined to smoke for a bit after an injection of a lethal insecticide (nicotine) then we shouldn’t be surprised.
Short-term reactions to interventions of that sort are no proof of anything. This is why the Advertising Standards Agency recently blocked an advert by the NHS Stop Smoking Services which tried to use reported cessation rates at four weeks as if they were real success rates. They said it was misleading, and I have already shown in the Evidence section of this site how the difference between those short-term results and the real outcomes at a one-year interval can be as great as 90% short-term, falling to 8% by the end of the year we have to conclude that the ASA are right to object.
Since I started this Campaign in March 2008, I have often heard it suggested that NRT products have been ‘properly’ tested in scientific trials, so I must be talking nonsense when I say they are utterly bogus and have no long-term effectiveness to speak of at all. Did any of those people suggesting that know that in the original trials that got NRT passed as if it were a medication in the first place, it was passed on the basis of it’s performance at SIX WEEKS. In smoking cessation that is NOT proof of efficacy and it should never have happened at all.