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A consumer group cited the need to focus on emerging scientific evidence to inform and shape the debates around safer nicotine products and tobacco harm reduction amid a lot of misinformation and misunderstanding about nicotine. 

“People should stop fear-mongering on nicotine and instead look at it through objective, science-informed eyes. It is not the nicotine that causes serious harms, but the tar and poisonous gases produced by combustible cigarettes,” said Antonio Israel president of the Nicotine Consumers Union of the Philippines.

According to Israel, smoking tobacco is the most harmful way of using nicotine. “But many people find it hard to stop smoking because it is very difficult for them to go without nicotine. Fortunately, less harmful nicotine products such as e-cigarettes and heated tobacco products have been developed to help people switch from smoking and thus avoid its many health risks.”

Israel cited a new French study entitled “A nicotinic hypothesis for COVID-19 with preventive and therapeutic implications”. It suggested a substance in tobacco, possibly nicotine, may be preventing patients who smoke from getting sick with COVID-19.

“Our cross-sectional study strongly suggests that those who smoke every day are much less likely to develop a symptomatic or severe infection with Sars-CoV-2 compared with the general population,” the researchers concluded. “The effect is significant. It divides the risk by five for ambulatory patients and by four for those admitted to hospital. We rarely see this in medicine.” They are awaiting approval from French health authorities to conduct further studies using nicotine patches on COVID-19 patients and health workers at Pitié-Salpêtrière Hospital.

The researchers from Assistance Publique-Hôpitaux de Paris and the Pasteur Institute questioned 480 patients at Pitié-Salpêtrière Hospital who tested positive for COVID-19, 350 of whom were hospitalized while the rest with less serious symptoms were allowed home. They found that of those admitted to hospital, whose median age was 65, only 4.4% were regular smokers. Among those released home, with a median age of 44, 5.3% smoked. The researchers stressed that they were not encouraging people to smoke, and pointed out that smokers who become sick with COVID-19 often develop more serious symptoms.

A renowned French neurobiologist, Dr. Jean-Pierre Changeux, reviewed the study and suggested that nicotine might stop the virus from reaching cells in the body thereby preventing its spread. He added that nicotine may also dampen the overreaction of the body’s immune system, which has been found in the most severe COVID-19 cases.

The findings of the French study and researchers’ plans to conduct follow-up studies underscore the rapidly developing science in relation to nicotine, according to Israel. “Scientific knowledge about nicotine has come a long way since 1976 when Professor Michael Russell, a pioneer in the study of tobacco dependence, famously said, ‘People smoke for nicotine but die from the tar.’”

Tar refers to the combustion products of cigarettes produced by the burning of organic matter, dried tobacco leaf. These combustion products are burned at a temperature of over 800ºC, which produces many toxins (carbon monoxide, formaldehyde, ammonia, hydrogen cyanide, arsenic, DDT, etc.) that are subsequently inhaled by the smoker.

Israel urged the DOH and local policymakers to “keep an open mind” on tobacco harm reduction and the role of safer nicotine products such as e-cigarettes and heated tobacco products, which can help people switch from smoking. “Making lower-risk nicotine products available can help the estimated 16 million Filipino smokers switch and eventually quit smoking. This can help reduce serious sickness and premature death linked to tobacco smoking.” 

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