Don’t Quit Smoking: Virtues of Nicotine and Caffeine

Some of the information below is in the book Don’t Quit Smoking, but this page is mainly for new items I’ve come across since the book was published. They might be included in an updated version in the future.

Don’t Quit Smoking is about controlling nicotine use for those who don’t want to quit – cutting down to a moderate level or, as recommended by the British Medical Journal, switching from the serious risks of cigarettes to the relative safety of cigars or pipes – and about the benefits of smoking and coffee.

More medical research telling us what we already know: coffee is good for you. A survey of 521 330 persons in ten European countries concluded: “Coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary by country.”
“Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study” Annals of Internal Medicine online 15/8/17

“An aircraft engineer who works for a large manufacturer of aircraft told me air quality has decreased since smoking was banned in planes. Seems when smoking was permitted they had to run AC systems flat out. Now they don’t and he said air quality had deteriorated. Sounds weird but that’s what he told me! Go figure.” (Guardian online comment 17/8/17)

According to WHO, tobacco use kills about 6 million people globally every year, including 480 000 in the USA alone.
“Nicotine addiction, reduction, and smoking cessation”
(Lancet 19/8/17 online)

July 1, 2017, marked the tenth anniversary of the entire UK becoming smoke free in indoor public places, an opportune moment for Cancer Research UK (CRUK) to provide an update on UK smoking prevalence. Compared with 2007, there are 1·9 million fewer smokers, a reduction from 21% to 16%.
“Where next for UK tobacco control?”  (Lancet online 8 July 2017)

“Cigarette smokers who have difficulty in giving up smoking altogether are better off changing to cigars or pipes than continuing to smoke cigarettes. Much of the effect is due to the reduction in the quantity of tobacco smoked, and some is due to inhaling less.”

The 1964 US Surgeon General’s report compares the standardized mortality ratio of cigarette, cigar and pipe smokers among men in 25 states. (“The standardized mortality ratio is the ratio of observed deaths in the study group to expected deaths in the general population.” – Wikipedia) If the ratio is 1.0, there is no difference between smokers and the general population. If it is more than 1.0, the smoker is more likely to die; if less, less likely.

Cigarettes only: 1.83
Cigars only: 0.97
Pipes only: 0.86

The Houston, Texas, suburb of Sugar Land hasn’t heard that news. A sign on the street in the shopping district advises:

“[A woman] who has now tried quitting six times said she measures her victories these days in smaller increments: cutting back to a pack every three days, holding out until after her morning cup of coffee to light up. ‘Do I ever think I’ll be able to quit?’ she said. ‘No. … But I’ll keep trying.’”

A pack every three days is seven cigarettes per day, an amount that some doctors say is not a serious risk. “In current smokers, the number of cigarettes smoked per day was the most important variable,” according to Lung Cancer International, Volume 2012 (2012), Article ID 790841.
A study of 185,855 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites aged 45 to 75 found:
“Compared with drinking no coffee, coffee consumption was associated with lower total mortality after adjustment for smoking and other potential confounders. … Trends were similar between caffeinated and decaffeinated coffee.”
Annals of Internal Medicine online 11/7/17
(“Hazard Ratio” is similar to “Relative Risk”. A score of 1.0 would mean that coffee drinkers are as likely to die as non-coffee drinkers; lower than that, less likely to die. In this study, the HR for one cup of coffee per day was 0.88, 2-4 or more cups 0.82.)
And as we all know, sitting is the new smoking. (Guardian online 29/6/17)
“Diet is the number-one issue. More than physical inactivity, smoking and alcohol, it contributes to more disease and death.” Doctor Aseem Malhotra, author of The Pioppi Diet: A 21-Day Lifestyle Plan.
“The associations of both overweight and obesity with higher all-cause mortality were broadly consistent in four continents. This finding supports strategies to combat the entire spectrum of excess adiposity in many populations.”
The Lancet, Volume 388, No. 10046, p776–786, 20 August 2016
Smoking depletes collagen

One of the most important components in the body, collagen is part of cartilage, which cushions the bones in joints, and the wearing of cartilage can lead to osteoarthritis.

“Collagen is most commonly found in the skin, bones and connective tissue within the body, providing structural support, strength and a degree of elasticity (in combination with elastin). … Collagen production declines with age (as part of intrinsic aging), and is reduced by exposure to ultraviolet light and other environmental factors (extrinsic aging). … By the age of 60 there is typically a considerable decline in collagen production. … Controllable factors that damage the production of collagen include sunlight, smoking and high sugar consumption.”
Coffee reduces the risk of liver cancer.

“Primary liver cancer is the sixth most commonly diagnosed cancer worldwide, and because of its poor prognosis the second leading cause of cancer death. … Coffee is a popular drink in most countries, with approximately 2.25 billion cups consumed daily. It is a complex mixture of biologically active molecules, including caffeine, chlorogenic acid and diterpenes. These compounds possess antioxidant, anti-inflammatory, antifibrotic and anticarcinogenic properties, which may explain the observational data that coffee drinkers have lower rates of chronic liver disease (CLD), including fibrosis, cirrhosis and HCC [Hepatocellular carcinoma]. … Increased consumption of caffeinated coffee and, to a lesser extent, decaffeinated coffee are associated with reduced risk of HCC, including in pre-existing liver disease. … In summary, this study has shown that an extra two cups of coffee per day is associated with a one-third reduction in the RR [Relative Risk] of HCC.”

The article repeatedly refers to “an extra two cups of coffee per day” without indicating how that relates to the total number of cups per day. A cup is 150ml in this study.

“Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis”
BMJ Open, Volume 7, Issue 5, May 2017
In an article in the Sunday Times (Australia) on 10 November 2016 – “Quitting smoking? 10 common myths busted” – one of the “common beliefs and misconceptions about smoking” is “Quitting smoking means gaining weight.” But the text contradicts that: “On average, female quitters will gain 2.8kg and men will gain 3.2kg.” Smokers who quit or cut down should be aware that they will have to take measures to prevent weight gain.

Another “myth” is that “Smoking helps calm you down and reduce stress. On the contrary, smoking is a mental stimulant. Nicotine is like a soft version of cocaine. It has no psychotropic effects but it keeps you alert and awake.” Misinformation: a psychoactive or psychotropic substance is one that affects mental processes, and nicotine is the main psychoactive ingredient in tobacco, according to the World Health Organization’s “Lexicon of Alcohol and Drug Terms” – “it has both stimulant and relaxing effects.”

Another “myth”: “Smoking 20 cigarettes is twice as bad as smoking 10. The biggest risk factor isn’t the number of cigarettes you smoke per day, but the duration of your exposure.” Both are risk factors, but, “In current smokers, the number of cigarettes smoked per day was the most important variable,” according to Lung Cancer International, Volume 2012 (2012), Article ID 790841.
[Prof Dr Marewa Glover, an associate professor at Massey University] said, “Smoker hatred is so bad in New Zealand that people feel justified giving smokers dirty looks on the street, or telling them to stop and being aggressive.”
The Guardian 31/5/16

That is a good example of WHO’s definition of “Unsanctioned use”: “Use of a substance that is not approved by a society or by a group within that society. The term implies that disapproval is accepted as a fact in its own right, without the need to determine or justify the basis of the disapproval.”
“Lexicon of Alcohol and Drug Terms”, World Health Organization, 1994
“Alzheimer’s is now acknowledged as the leading cause of death in the UK, responsible for more than 61,000 fatalities, according to the Office for National Statistics – a staggering 11.6 per cent of deaths.” (Sunday Telegraph 21/5/17)

“Cognitive improvement is one of the best-established therapeutic effects of nicotine. In human studies, nicotine improves performance in smokers on cognitively demanding attentional tasks.”
Neurology, 2012 Jan 10; 78(2): 91–101
“I smoke a pipe abroad, because
To all cigars I much prefer it,
And as I scorn your social laws,
My choice has nothing to deter it.”
Robert Louis Stevenson

“Pipe-smokers spend so much time cleaning, filling and fooling with their pipes, they don’t have time to get into mischief.” – Bill Vaughan, American author and columnist, died aged 61 of lung cancer.

“For my part, I consider that tobacco, in moderation, is a sweetener and equalizer of the temper.” – Thomas Henry Huxley

“I believe that pipe smoking contributes to a somewhat calm and objective judgement in all human affairs.” – Albert Einstein, 1950

“A pipe is the fountain of contemplation, the source of pleasure, the companion of the wise; and the man who smokes, thinks like a philosopher and acts like a Samaritan.” –  Edward George Bulwer-Lytton, 1st Baron Lytton, Night and Morning

“If I had taken my doctor’s advice and quit smoking when he advised me to, I wouldn’t have lived to go to his funeral.” – George Burns, who died aged 100. He also said: “Happiness? A good cigar, a good meal, a good cigar and a good woman – or a bad woman; it depends on how much happiness you can handle.”

In a short story by Charles Dickens, the Baron of Grogzwig is on the point of committing suicide. (Spoiler: he doesn’t do it.) The story ends: “And my advice to all men is, that if ever they become hipped and melancholy from similar causes (as very many men do), they look at both sides of the question, applying a magnifying glass to the best one; and if they still feel tempted to retire without leave, that they smoke a large pipe and drink a full bottle first, and profit by the laudable example of the baron of Grogzwig.”

The full story is at:

Vincent Van Gogh was a fan of Dickens. In a letter to his sister Willemien, he wrote: “Every day I take the remedy that the incomparable Dickens prescribes against suicide. It consists of a glass of wine, a piece of bread and cheese and a pipe of tobacco.” Although this tactic may have postponed the act, he killed himself at the age of 37.

Most of the above quotes are from:

Smoking – even cigarettes – has been found to be a protection against the “non-smokers disease”, ulcerative colitis, and sarcoidosis. Also, several studies have reported a reduced risk of Parkinson’s Disease and Mild Cognitive Impairment (a precursor to Alzheimer’s Disease) among cigarette smokers and coffee drinkers: “… the risk of PD was found to be 60% lower among current cigarette smokers than among never smokers, and 30% lower among coffee drinkers than among non-drinkers.”

In 48 studies from 20 countries, results showed that for Parkinson’s current smokers had a Likelihood Ratio (LR) of 0.45 and a Relative Risk (RR) of 0.4. The LR for ever (former: minimum one pack/year) smokers was 0.8, with an RR of 0.75. Never users of tobacco had an LR of 1.25 and an RR of 1.25

For people diagnosed with Mild Cognitive Impairment, a precursor of Alzheimer’s Disease, “Cognitive improvement is one of the best-established therapeutic effects of nicotine. In human studies, nicotine improves performance in smokers on cognitively demanding attentional tasks.”

Apart from personal narrative and anecdotal evidence, the information is based mainly on the results of research published in prestigious medical journals about my psychoactive substances of choice: nicotine and caffeine. Caffeine, beneficial in itself, is included because for many of us it is a trigger for smoking. Most citations are online and hyperlinked, so you can consult the full articles.

Caffeine has many health benefits. Coffee drinkers have lower rates of heart disease, stroke, diabetes, Parkinson’s disease, hepatitis C virus, hepatocellular carcinoma (HCC), nonalcoholic fatty liver disease and infection.

“Reduced risks were seen for cancers of the liver and uterine endometrium [the inner lining of the womb].”

“Cognitively normal older individuals who habitually consumed moderate amount of coffee (from 1 to 2 cups of coffee/day) had a lower rate of the incidence of MCI [Mild Cognitive Impairment] than those who never or rarely consumed coffee.”

However: “The amount of caffeine contained in energy drinks can range from 50 mg to 505 mg. Therefore, these beverages allow consumers to drink large quantities of caffeine in a relatively small number of servings. Research suggests that this level of consumption can produce Caffeine Intoxication, resulting in serious adverse health consequences and, in rare cases, death.”

A 16-year-old boy in the US died after drinking a latte, a caffeinated soft drink and an energy drink containing a total of 470mg of caffeine in less than two hours.

This is a short Kindle ebook – 15,000 words, the equivalent of a long magazine article or a very short novel.

Available for $3.00 or local equivalent from:
Amazon US
Amazon UK
Amazon Germany
Just change the country code following the word “amazon” to the one that fits your country – “com/” – and so on.

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