Responding to, “but they are still *addicted*!!!”

by Carl V Phillips

Sorry for the blog absence.  I was spending that same niche of time and energy in a mass email conversation that consisted mainly of some of the “establishment” researchers and political operatives.  But most of them do not much care for we populists who try to represent the actual stakeholders, to say nothing of their feelings about the criticism and scrutiny that are considered necessary parts of science by those of us who come from real sciences, but are avoided in the cozy uncritical confines of “public health”.  So I was basically told to shut up.

That clear message of “we have the insider influence and your inconvenient observations are not welcome in our cozy little club” was a reminder that we (as in We The People) need to lead the fight for THR.  Even our closest allies among those in institutionalized tobacco policy are not really very close allies.  So I return to the series I started on how best to communicate our arguments to the vast majority of people (and, thus, lawmakers) who would be pro-THR if they heard and understood the truth.  (Click on the category “truths” in the sidebar to see the previous ones.)

Many anti-THR arguments are voiced exclusively by people with hidden agendas and who are just saying anything that comes to mind to try to muddy the waters.  But it is my impression that a lot of people who say “but this is just another addiction”, or something similar, are honestly concerned and thus can be honestly persuaded that they are drawing the wrong conclusions.

So how to respond?

This is an interesting one, because it is one of the few cases where I think the simplest response (that we need to use when the target audience is either not able to understand anything complicated, or when we only have a few seconds to make the point) is not a dumbed-down version of the complete and more precise response.  So, for example, the one-sentence answer to “how hazardous are e-cigarettes?” is a highly simplified version of the more complete and scientifically correct version of the answer.  But on the topic of “addiction”, the simple response is quite different from the more complete and correct discussion that I will come back to.

I will start with the simple response, because that is what most of us need to use most of the time.  If someone argues that THR should not be endorsed because it is just replacing one addiction with another, the one-sentences response should usually be:

If some people are addicted, then isn’t it better than they use a product with very low risk instead of smoking?

Boom!  This response, all by itself, is remarkably effective at winning over many people who have been tricked by anti-THR lies and have not really given the topic any serious thought.  Should this response steer the conversation in the direction of, “but it is better if they just quit entirely”, as it often does, then the next response is equally easy (though it does require a bit of scientific knowledge, which I presented in a previous post):

Smoking for just a couple of more months creates more health risk, on average, than a lifetime of using a smoke-free alternative.  Do you really think that everyone who would switch is going to quit entirely within two or three months?

This can also be supplemented with:

Once someone has switched, if you still think it is best for them to quit entirely, then you can try to get them to that point.  But shouldn’t we go ahead and almost eliminate the health risk in the meantime?

Admittedly, this is potentially slightly disingenuous depending on your beliefs, because it takes advantage of the other side’s rhetoric (making it fair and downright enjoyable, but also a bit cynical).  Many of us believe that if someone is using a low-risk product that makes their lives happier, then the powers that be have no business trying to push them to stop, but we can still quite legitimately say “go ahead and give abstinence promotion your best shot, but do so after the risk has been removed.”  However, we also know that — contrary to ANTZ rhetoric — most support for abstinence campaigns will probably collapse once most people are using low-risk products.

But, as I said, this is the simplified version.  Also that slight bit of disingenuity is a great legitimate way to corner the ANTZ and the lie-based disingenuous motive many of them have.  They pretend to care about health while actually trying to keep the risk high to support their abstinence-only approach.  Thus, their honest response to the previous argument is, “but most people are not going to want to quit once they have found they like a smoke-free alternative and they understand how low the risks are.”  But let us just see what happens when they offer that response.  We have a tough fight, so we deserve the joy that comes from seeing the anti-THR liars trapped by their own hidden motives.

There are some more complicated directions that this conversation can be taken, if it continues.  We can point out that the evidence shows that many smokers who never managed to just quit entirely seem to have an easier time quitting entirely once they have switched to an alternative product.  There is also the observation that long-term smoke-free use of tobacco/nicotine is so similar to long-term use of coffee that it is difficult to see much of a difference.  However, be aware that while the coffee argument seems to be persuasive to some people who are already sympathetic, but it does not seem to have much traction for changing people’s minds.

The last observation does bring up a question that leads us into the rather different response to this issue that can be pursued when we are not limited to soundbites:

What do you mean by “addiction”?

That is not a path to go down unless you have a bit of time and a receptive listener rather than a mob scene.  (It is way too easy for dishonest opponents to ridicule this very legitimate question.)  In the next post (and two after it), I will suggest some thoughts of how to travel that more complicated path if you so choose.

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18 responses to “Responding to, “but they are still *addicted*!!!”

  1. The ANTZ will say, “but most people are not going to want to quit once they have found they like a smoke-free alternative and they understand how low the risks are.”

    My response there would simply be:

    “So?”

    Because, what exactly IS the problem if they decide they are getting enough enjoyment/pleasure out of doing something that they feel makes their lives happier with very little risk involved?

    Even for younger people: which, on a rational/safety level, would you prefer your teenager to be doing: vaping/e-cigging? Or engaging in sports activities that can either quickly kill them outright or maim/paralyze them for life (surfing, horseback riding, football, soccer, rugby, motorcycling or even skateboarding — and that’s not even mentioning rock-climbing or skydiving!)?

    As far as the question of addiction goes, fulfilling an addiction is an enjoyable part of living. ANTZ ( I really DO prefer the term Antismokers in terms of welcoming “normal” people into our discussion sphere, but I realize it doesn’t apply so well to THR ) will say, “Well, smokers/vapers/chewers don’t *really* enjoy it, they’re just dampening the negative feedback of not fulfilling the addiction.” … but they’re wrong. We *do* enjoy the feeling we get from “dampening that negative feedback,” in much the same way that we enjoy sitting down to our turkey dinner at Thanksgiving after smelling it roasting beforehand. Sure, it’s nice to stuff our mouths whenever we want to, but there’s something particularly positive for our lives about eating when we are actually HUNGRY — even if part/all of that hunger has resulted from smells/anticipations/social-cues etc.

    Some addictions (alcohol, heroin, barbituates) involve such strong negative feedback when they’re unfulfilled that the possibility of experiencing that feedback adds quite significantly to the “costs” of whatever risks and other negatives are involved in the addiction. Addictions to caffeine and nicotine generally don’t seem to be in the same range. If a pack of cigarettes suddenly shot up to $50/$100, it’s unlikely we’d see mass muggings/killings/prostituting as desperate smokers destroyed their lives in order to get money for their next “fix.” If a smoker is denied a dozen of their usual “fixes” on a long airplane flight or a weekend at the local constabulary they’re likely to be a far better next-seat/cell-mate than a heroin addict or alcoholic denied a dozen of THEIR usual “fixes” over whatever regular period of time they’re accustomed to for indulging.

    We’ve assigned an “evil” to the idea of addiction that I don’t think really belongs there. Its negatives come purely from two sources: (1) when the side effects are highly destructive — which is how, traditionally, the word was applied, and (2) when it destroys the development of one’s life (e.g. constantly walking around in an alcoholic/heroin/barbituate “haze” or dancing around on a methamphetamine “high”).

    In and of themselves, are mild addictions necessarily an evil or bad thing in life? Or does the fulfillment of them add overall to the positive side of living?

    – MJM

  2. Jonathan Bagley

    When the anti tobacco industry resorts to a moral argument against “addiction”, they lose a lot of credibility. People note the vast distance they have travelled from the supposed dangers of passive smoking to the private use of harmless ecigs. And what is the problem with daily nicotine intake? I’m sort of “addicted” to exercise, but that’s regarded as morally sound. Are sleeping pills and happy pills morally dubious? People get irritable when the person responsible for morning coffee hasn’t shown up, but they don’t think of themselves as “addicts”. I’d say like caffeine, nicotine is a dependence, for want of a better word; or maybe just a habit, like biting your nails or continually checking your i-phone. If you try and stop, you may find it very difficult, but there are no serious physical consequences, unlike with alcoholism or co-codamol addction, for example.

    • Fr. Jack Kearney

      Well said, Jonathan and Dr. Phillips!
      In the addiction treatment world we have to distinguish between “dependence” and “addiction” all the time. You can be addicted to a drug witihout being dependent on it (e.g. meth and marijuana), and you can also be dependent on a drug without being addicted to it (e.g. caffeine, unless you are robbing Starbucks to get your supply). I was addicted to smoking, not nicotine….otherwise the patch would have worked for me. I am dependent on caffeine and nicotine (thru ecigs), but not addicted because there are no negative consequences. No serious negative consequences = no addiction. Or another way to put it: I have treated my addiction by reducing it to a dependency. When done properly we treat heroin addiction quite well by using methadone as a harm reduction strategy; the physical dependency may remain, but the risks for HIV, Hep C and liquor-store robbery stuff goes away, and a fairly normal life can be led. When I help a smoker with ecigs I am doing much the same, just on a different scale and different negative consequences.

      • Carl V Phillips

        I would be interested in hearing what you mean by “addiction” after you read the rest of my posts in this series (or at least the next one)

  3. Less addicted (nicotine is dramatically/significantly less addictive than smoking according to studies). And arguably tobacco smoking addiction is persistant to some degree regardless of nicotine intake or behaviour – quitters are known to commonly relapse within 20 months, and up to twenty years after quitting….

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  8. Jonathan Bagley

    Interesting Fr Jack saying he was addicted to smoking, rather than nicotine. I’d never thought of that before, but it explains why people switch to ecigs so easily, as they mimic the act of smoking. It might also turn out that ecigs are huge help in then giving up nicotine altogether, for those who so wish – not me, at the moment I’m enjoying my ecig nicotine habit. I think that smoking itself is so addictive because in middle age we associate it with good times when we were young: laughing, drinking and smoking in bars, a reward upon reaching the top of a mountain, lighting a pretty girl’s cigarette, etc. Ecigs are one step removed from cigarettes – sufficiently different that they don’t have those associations. Maybe I could now give up nicotine, but not yet. I’m savouring my new, cheap, harmless habit – perhaps trying a different real cigar occasionally, and content I have reached smokers’ nirvana – able to enjoy real tobacco very occasionally and then forget about it for weeks..

  9. There was a researcher back around 75? years ago who experimented with nicotine as an addictive drug, injecting himself with it. I think he was unable to find any addictive effect. Recent experiments with mice self-administering nicotine water etc seem to show an effect though. Overall, it’s clearly the combination of things: e.g. Alcohol is clearly addictive, but if it was only available by injection, flavorless gum, or “A Patch” you’d probably see a lot less alcohol use.

    – MJM

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  15. The issues of ‘addiction’ and ‘dependence’ are entirely red herrings. MANY activities, from gambling to womanising to watching TVor computer-gaming can be argued to be a ‘dependency’ or an ‘addiction’, depending on what definition one chooses (there are many options) – and yet all these activities involve no exogenous chemical.
    The SIMPLE fact is that an e-cigarette has massively fewer risks to the individuals health than a ‘real’, tobacco cigarette. It also has zero risk to those in the near vicinity of the person smoking it (unlike the tobacco cigarette).
    There is NO argument that I can conceive of, legal, medical or moral, that justifies banning a safer activity in preference to a much more dangerous one.

  16. Pingback: Extracting from ‘Nicotine’ Moments | Alan Beard:- Musings

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