In the last month, the Centers for Disease Control and Prevention has warned the public of severe lung-damage and pneumonia-like symptoms linked to vaping. At least seven vaping-related deaths have been reported, with hundreds more people requiring hospitalization— The New England Journal of Medicine, not known for hyperbole, proclaimed “there is clearly an epidemic that begs for an urgent response.”
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Thus far, though, investigators haven’t uncovered what’s making people sick. Some patients vaped THC, while others vaped only nicotine, and still others were using a combination of the two, making it harder to pinpoint a culprit. In the absence of a definitive cause, doctors are strongly encouraging people not to vape—which is good advice even absent the risk of life-threatening lung damage.If you vape regularly, you’re almost definitely addicted to nicotine. It’s worth understanding that whether you vape or smoke tobacco, the underlying chemical effect is the same. Every time you take a hit of a vape or a cig, you’re bringing nicotine into your bloodstream. Nicotine makes you feel good—which is why people keep smoking, even when they intellectually know it’s doing them harm. “Nicotine is as addictive as cocaine and heroin. It has the same effect on the brain and changes the brain,” said Deborah Buckles, program director of the Tobacco Treatment Program at the Indiana University Melvin and Bren Simon Cancer Center.That means vaping—often marketed as a way to quit smoking, though the Food and Drug Administration has never approved them for that—produces the same addiction as cigarettes do, centered around deliberately getting a hit. And quitting means going through withdrawal: Symptoms include anxiety, irritability, cravings, over-eating, and the like. So: If you want to quit vaping without turning to cigarettes, as many people are doing—how do you actually get off nicotine altogether? (Because, just for the record: Quitting “cold turkey”—abruptly stopping with no support, whether physical or psychological—is generally a terrible approach, according to experts. One study showed that a mere three to five percent of smokers succeeded at quitting cold turkey.)
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Ask for help and find counseling.
With the help of a doctor, look into nicotine replacement therapy.
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NRT has been around for a long time, with decades of research proving its safety and efficacy. That said, there can be side-effects, including dizziness, nausea, hiccups, racing heartbeat, and others. Nicotine gum may irritate your jaw or leave a bad aftertaste; lozenges may provoke coughing; and patches can cause skin irritation. Nicotine overdose is a rare side effect (you should be receiving less nicotine than vaping), but if you start having a fast heartbeat, dizziness, cold sweats, or nausea, see a doctor. And, of course, if you’re pregnant, you’ll want to look at other options. All of these minor and well-known side effects pale next to the uncertainty around vaping, where people are suffering permanent lung damage due to causes currently unknown.Prescription smoking cessation drugs, on the other hand, are options that don’t include nicotine, but can address its effects. Varenicline (sold under the brand name Chantix), Jani explained, is a nicotinic receptor partial agonist. That’s a concise way of saying it bonds to the same neuro receptors as nicotine, so if a nicotine addict uses a nicotine product while taking the medicationthe hit doesn’t have nearly the same rewarding effect. Without that reward—the rush of the puff—it’s easier to quit. “The most effective and safest medication on the market today is Varenicline,” said Buckles. (It, too, can have side effects, including nausea, sleep problems, constipation, gas, and vomiting.)The antidepressant Bupropion (sold as Wellbutrin) is also FDA-approved for quitting. Like varenicline, it contains no nicotine, but its mood-elevating effects may help blunt some of the side-effects of nicotine withdrawal, such as irritability and, yes, depression. Dulling those symptoms can make it easier to stick with quitting. (Bupropion’s potential side effects probably sound familiar by now: nausea, dizziness, constipation, insomnia, and others.)
If you and a doctor determine they're right for you, look into prescription drugs to cut out nicotine entirely.
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