Friday, 14 November 2014

Nicotine addiction: When and why it all started

My post on nicotine addiction last week (Nicotine - a supersheep in wolf's clothing?) ended in a lot of questions. Now of course I wouldn't have done that without intending to give some answers, or at least attempt to do so. It appears that there is some consensus among quite a few scientists today that nicotine by itself is not very addictive. It needs some of the other chemicals in cigarette smoke to create that powerful addiction that keeps people smoking even though they are well aware that it might kill them. As professor Killeen says: the chemical addiction to cigarette smoke is indeed very real and very powerful, and nicotine plays an important role in that equation. But if you take the rest chemicals in cigarette smoke out of the equation, nicotine seems to be pretty harmless and not very addictive at all, so why is it then that nicotine has gotten all the blame?

I got an anonymous comment on one of my previous posts with a couple of links to Danish online newspaper 180grader and the excellent blog by Danish journalist Klaus K. The topic: Anti-smoking experts paid by Big Pharma. The article is written in Danish but the blog-post has been translated by Frank Davis:

In July this year a D.C. District Court documented the massive conflicts of interests of three prominent anti-tobacco experts, who, while appointed by the US government to be scientific editors for the official “Surgeon General”-reports on tobacco, received payment from pharmaceutical companies Pfizer and GlaxoSmithKlein. The three experts in question are Neal Benowitz, Jack Henningfield and Jonathan Samet, and the court ordered that the FDA needed to remove them from TPSAC (FDA Tobacco Products Scientific Advisory Committee) and it also barred FDA from using a scientific report on menthol in cigarettes from 2010, that the three "experts" were responsible for. The judge said that the advice of the three experts and their reports would benefit the pharmaceutical companies by giving a huge boost to the NRT market. You can read more about the court order here, here and here.

Benowitz, Henningfield and Samet were also responsible for another report, the "Surgeon General"-report of 2006 on The health consequences of involuntary exposure to tobacco smoke (2nd hand smoking), and Benowitz and Henninfield was also responsible for the "Surgeon General"-report of 1988. And guess what this one was about... Nicotine Addiction (!). It's not difficult to see how these two reports would benefit Pfizer and GlaxoSmithKlein and their nicotine replacement products hugely now is it? Have a look at the cover of the two reports by the way... see any logos you recognize?

The conclusion that Benowitz and Henningfield presented in the 1988 report was this: Nicotine is addictive, and that it is stronger than the addiction of heroin and cocaine. Having this report to back up their newly released nicotine-replacement product, Nicorette, was of course a huge advantage for Pfizer at the time. Klaus K sums this up pretty neatly:
There is no doubt that Benowitz ‘and Henningfield’s report on nicotine addiction was valuable for Nicorette producers. Apart from a few critical sections the report appears unilaterally as a kind of scientific advertising publication for Nicorette and other pharmaceutical nicotine products – endorsed by the US government Surgeon General.
In my previous post I mentioned several scientists saying that nicotine by itself is not very addictive. It requires the "help" of other chemicals in tobacco to cause the chemical addiction. There has been quite a lot of research done on the subject, and the scientist making this claim has new, good scientific reports supporting their claims. But on the other side, according to Israeli nicotine researchers Hanan Frenk and Reuven Dar, the Benowitz and Henningfield report seems to be virtually the only reference used when academics and journalists write about nicotine. Klaus K gives us even more indications that nicotine is not very addictive on by itself:
The addiction theory of nicotine has been laid to rest by virtually every nicotine researcher since it was demonstrated that smokers prefer nicotine-free cigarettes over Nicorette in trials. Mice and rats have never been interested in nicotine, and the researcher who originally had his name linked to the nicotine addiction theory – the Swedish medical researcher Karl Fagerström – today recognizes that nicotine is not an addictive factor in smoking.
The French smoking cessation specialist, Robert Molimard, wrote in the 2013 article, “The Myth of Nicotine Addiction” on the nicotine report that there has never been any proof that one can become addicted to nicotine, and the report therefore does not demonstrate that, contrary to the claim in the title – yet the chapter “Treatment” is dedicated to the companies’ Nicorette gum, which had just come on the market:
“In this huge book with 3,200 references, we would look in vain for a single article showing that man can be dependent on nicotine only. On the other hand, the “Treatment” chapter focuses immediately on the “Nicotine replacement therapy”. But then we did not have any hindsight about the efficiency of this new treatment, because the FDA had just approved the marketing of the 2 mg gum.”
To sum up a bit:
  • There is lots of pretty new and convincing research showing that nicotine by itself, is not very addictive.
  • The one report that is usually referenced as proof that nicotine is addictive, is written in 1988 by Benowitz and Henningfield who was (and still is, I believe) on the payroll of pharmaceutical giants that had just released a product that would benefit hugely from this.
  • The FDA is ordered by a federal court to remove these so-called experts from the TPSAC for writing reports that they and their employers would benefit financially from. Judge Richard Leon had this to say about the matter: 
“The presence of conflicted members on [FDA Tobacco Products Scientific Advisory Committee, TPSAC] irrevocably tainted its very composition and its work product”
“the Committee’s findings and recommendations…are, at a minimum, suspect, and, at worst, untrustworthy.”
It very much looks like nicotine addiction was a lie that Benowitz and Henningfield created back in 1988 on assignment from Pfizer and GlaxoSmithKlein, for their own financial benefit. Smokers were mislead into believing they were addicted to nicotine, and that the solution was Nicorette. Pfizer and GlaxoSmithKlein needed something their new Nicorette could be a solution for, so they ordered it from Benowitz and Henningfield. But surely, these well respected companies could not do such a thing you say? Well, this is what Dr. Peter Rost, former vice CEO and whistleblower from Pfizer, has to say about the matter:
“You give them grants, you establish friendships, you make sure they become beholden to you, you start programs with them, which they can make a profit from. But they are not going to continue to get money, unless they are saying what you want them to say.
Everybody knows that this is how things work. They know it and you know it – it’s only maybe the public that does not know it.
That’s how you influence the medical establishment. Simply, with money.”
Still wondering why so many "medical experts" are part of campaigns against e-cigarettes?



  1. Another one from Klaus K:

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