More or less Addicted or Dependent?

 This tweet from Dr Jonathan Foulds , has prompted this blog 

This is the study in question https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905831/  

Using Dr Foulds Penn State dependence score gives 

No or low dependence accounted for in excess of 60% of respondents, this would tally with my own personal experience of Vaping/use of e-cigs. 

Previously when I was a person who had smoked(45 years at upwards of 40 cigs/day) there was rarely a time in the day where 30-60 minutes would pass without me lighting up yet another cigarette. This was only ever tempered when I was unable to do so, usually work related, the most extreme was when I worked for 20 years as a Mining Engineer in coal mining. Due to the nature of coal mining, explosive methane was an inherent danger underground and consequently smoking was an impossibility, strangely, even though I considered myself very strongly dependent or indeed addicted, my mind unconsciously rationalised this such that I never missed smoking for my underground time. 

Nowadays as an 11 year Vaper, I have a number of workarounds if my device malfunctions, loses charge,runs out of juice ie that I am simply unable to vape......it becomes a nuisance, irritation would be an exaggeration,nothing like that same 'manic' feeling when I was a person who smoked who was incapable of concentration or performing anything much until that cigarette was smoked. 

Lastly, dependence or addiction? 

Whether or not this distinction matters .....I think it does 

Dependence : the dictionary definition 

a situation in which you need something or someone and are unable to continue normally without them 

I don't think this describes what my 'condition' is exactly. It may describe some users who use nicotine to modify/mollify their behaviour eg ADHD 

In my case and hopefully not simply trying to fool myself, I genuinely derive pleasure from nicotine, it helps to stabilise my mood and believe rightly or wrongly it isn't doing me any obvious harm, or harms to anyone around me. 

Addiction 

Dependence + harm to self and/or to those around me 

I really think many of these terms are used in a stigmatising, pejorative manner by opponents who wish to see the elimination of nicotine (an impossible pipe-dream) and of course has been seized upon by populist politicians and a gullible unquestioning press/media. Many definitions of dependence and addiction are used, maybe it's my layman reasoning, but no clear universally accepted definitions exist for nicotine, possibly due to the various methods of consumption. Of course I am well aware of the Fagerstrom Test  and a minor addition  

For example I object to this type of definition in Substance Use Disorder  there is no disorder in my personal circumstances afaik. I freely choose to use nicotine and believe that it's use is pleasurable and benign. 

A very interesting recent piece of research from Principal Research Fellow Sharon Cox from UCL TARG is well worthy of a read 

Safer Nicotine Wiki gives a multitude of entries < take out of that what you wish!! 

*If* you ploughed through to the end of this blog, might I suggest a read of another vaguely similar one 

Better still, a topical blog/article by Chris Snowdon features much of what I have written about in this 24th August 2024 entry, I found it an excellent read and highly commend here 

ASH ORG UK :- Policy Leaders or Followers re Safer Nicotine Products 2012-2024 ?

 This blog is my attempt to make some sense out of ASH actions/inaction over the the previous decade or so,regarding safer nicotine products. This could go back even further in time,but I will leave it to the period 2012- 2024 and deliberately confine my commentary to e-cigarettes/Vaping. 

ASH is a government funded campaigning charity who has a primary aim of reducing Smoking rates to at most 5%, which would be considered as 'Smokefree'. However, a government sponsored campaigning organisation that campaigns that same government has been described as a 'sock-puppet' from some quarters.

Run up to TPD (2013) 

UK Health Secretary Jeremy Hunt who was very anti e-cigs circulated a letter to all UK MEP prior to EU Parliamentary debate and vote, regarding making ecigs a medicinal product with a minimal nicotine strength of 4mg/ml. Fortunately consumers were very active across the EU in contacting their MEP to get the Commission proposals somewhat watered down. This quote comes via Clive Bates''Looking back to the last TPD, we should recall that the Commission, the Council, the scrutinising committee in the European Parliament (ENVI), and nearly all tobacco control NGOs all agreed on medicalising vapes in June 2013''.

 - this was also outwardly the position of ASH at that time .

Which came 1st, was ASH guiding or following? 

Nudge Unit circa 2013-14 

This unit took a far more pragmatic approach to e-cigs and managed to persuade the UK PM David Cameron of the virtues of advancing safer nicotine products as an alternative for folks who smoked. Jeremy Hunt the self-same Health Secretary also adopted this pragmatic approach culminating in the Public Health England Report of 2015, further supplemented by the Royal College of Physicians report of 2016 . All credible Public Health bodies in the UK welcomed both reports. ASH were outwardly supportive of this new found approach.

The UK medicines regulator MHRA who previously were quite dogmatic in what they would allow, introduced a registration and yellow card scheme that in effect licensed existing registered products even if not approved as medicines. To date, this has worked well, unlike it's US counterpart the FDA that has left virtually all Vaping products either in limbo or simply unapproved or worse. 

Which came 1st, was ASH guiding or following? 

2015-2022 

Various Ministers of Health throughout this period and the supportive, pragmatic position adopted post 2015 was maintained if not particularly reinforced. Of note the Health Dept spokespersons attended various COP meetings of the WHO #FCTC and never once outwardly voiced opinions or objections to draconian proposals or communiques issued by this opaque organisation. ASH attended as observers 

What part did ASH play throughout this period? 

It must be noted here though that ASH does produce invaluable information that has been v. useful for all users of that information, whether from government running through to interested private citizens, sometimes the assessment/analysis could be lacking balance but overall is generally very good .

2022- present 

A marked shift from both Ministers and ASH, ostensibly due to a large uptake by youth, this has been exacerbated by a number of factors, eg Covid, boredom of youth unable to attend school or college due to Covid, cheap disposables, poor to non-existent enforcement, start of a grey market with illicits .....an endless list . This has meant that 'Something must be done' approach has replaced the previous pragmatic one. This is a genuine issue, but one that has been stoked up in the media, maybe with malicious outside intent from anti-THR groups .  

The UK Government introduced the Smoking and Vaping Bill in the Spring of 2014 following pitiful scrutiny from various hand-picked committee members and a clearly biased Minister of Public Health(Andrea Leadsom) who has made a series of illogical non-factual comments towards Vaping in general. The Vaping part of the bill was designed to limit marketing and appearance, restricted flavours, along with a disposable ban, throughout the period a Treasury 'consultation' (from the Chancellor Jeremy Hunt...yes,him again!) was in place to get the opinions from everyone regarding punitive increases in vape fluid graduated from low to high nicotine content . 

Interestingly, D.Arnott was involved as a co-author of this research paper  , which recommends no differential taxation, interesting quotes are in this Guardian article . Paper here 

This above research collaboration featuring an ASH presence is far from unique 

So the government was/is proposing quite a drastic change overall, this is reinforced with support from all of the other traditional political parties, with Labour Party Shadow Health Minister(Wes Streeting) saying that the Australian Prescription model was under investigation (made a few months ago, prior to the recent terrible incidents of firebombing and deaths that have resulted from the gravely flawed policy,hopefully this madcap prescription model gets ditched asap)

I was given this quote regarding ASH 

'Internally they want to see consumer vaping banned by 2026, and prescribed vapes with plain packaging, minimal flavour'' I won't attribute this to anyone

Hopefully this is spurious nonsense, but even if a genuine quote, I would hope and expect that this ASH 'wish' is rapidly ditched, the unintended consequences would be catastrophic and wouldn't be simple to reverse the nonsense once set in motion.

But are ASH once again leading or following what the current (past tense) or future expected Labour Govt Health Ministers thoughts and proposals?

Recent published research(referred to above) from respected UK researchers seemingly challenges the Vaping aspects of the bill especially the disposable ban, along with the differential strength nicotine e-liquid taxation.

Internal and external pronouncements seemingly don't always tally, this is one area where the accusation of mixed ASH messaging comes from.

This blog was not intended to be an anti-ASH diatribe, simply a collection of thoughts of where and what their true position is on this contentious issue. There have been some glorious highlights eg where ASH CEO Deborah Arnott and Martin McKee were involved in a C4. TV interview, this again was an outward manifestation .......'What do they really think behind the scenes though? or is it a case of action speaks louder than words, how many times do we see media reports or demonstrably false information plastered across social platforms where there is little or no response forthcoming from ASH. I can understand that they cannot counter all mis or disinformation, but for it to be so sparse to non-existent isn't helpful.

Will anything be any different with the upcoming change of CEO from D.Arnott to Hazel Cheeseman?

Does ASH lead(advise) or follow Govt policy .........this of course is totally unknown to outsiders, known only to the participants.

From a consumer point of view it would be greatly appreciated if a consistent long-term tone was advanced towards THR, I can count at least 4 distinct changes in approach since 2007 , this report featuring Prof John Britton et al and received ASH support .

 

A complete move to the Darkside on the cards

 A little Background

The last time I owned an MX-5 it was circa 2005, when I purchased an NA (ie the 1st generation) reg /year ? I cannot recall now, but it was pretty ropey, with a roof that blew from shut to open at 70 mph on a Spanish Autoroute, mediocre handling from probable tired suspension, lastly, a terminal issue, when the coolant disappeared, rapid overheating ensued, the car towed to a Spanish garage never to re-appear! 

An all too brief experience with two Honda CRX(Del Sol) circa 1994 age of cars, happened just afterwards :- a CRX Vti and a heavily modified B-18  engine converted Trans-top, both were excellent cars for where we were living at the time :- Costa Brava, Spain. A major forest fire put paid to the Vti, whilst the missus hated the other one, which had overly firm suspension and thus was sold on. 

Story Continuation 

Following the miserable experience with the MX-5, a few years elapsed until circa 2016, when I decided to have another go at buying an affordable convertible. This time I avoided MX-5, so the 'affordable' Roadster/Convertible category consisted of Fiat X1-9, Fiat Barchetta, BMW Z3 and Z4 , and finally my choice, a Toyota MR2 mk3 .

This Toyota had only 12k miles, silver with a hardtop, located in a different part of the country :- Edinburgh, whereas I live in Mid-Wales.3 train journeys later, taking at least 6 hours, I was met by the seller at a train station, after a few hours of checking the car out, I was happily driving home with the hardtop on, at a steady 75-80 mph. 

The MR2 was a source of great joy, but 2 factors combined to take away from the driving experience, namely I always ended up with quite severe headaches after a 1-2 hour drive. This turned out to be down to 2 factors :- cold on the forehead, when driving with the roof off, secondly,a lack of good sunglasses to reduce the glare. BUT I only discovered these were factors after I had sold the MR2. I didn't replace the convertible until maybe a further year, then an Audi TT convertible was bought.

The higher screen of the Audi took away any wind blast onto my forehead, also the wearing of headgear helped.  Quite a few Audi TT later of various guises of fwd/awd, and from 160-300bhp varieties were bought. However I decided that although the cabin quality, general ambience, paintwork were excellent, it really couldn't overcome the lack of joy and fun that the TT gave to the driver ie Dull but worthy in it's own way......just not a drivers car!

So I decided to go back to MR2 mk3 , this time suitably attired to avoid the headache issue, I owned maybe 6-7 for various periods of time, indeed I was that besotted with how very good a mid-engined rwd could be, I ended up with four at once :- madness!! but it must be said at this point that each one was a source of great joy and really couldn't contemplate ever not owning at least one in future years.

Story Conclusion

Full circle and back to the MX- 5 story (this was written on 19/3/24)

Today, I bought an Orange 30th Edition with 15k miles on the clock, crucially it also came with a raft of BBR kit(s) 

220 bhp engine kit

Big Brake kit with cf pads 

Exhaust + manifold kit 

Ohlins suspension kit 

Great geo done by the previous owner 

This is just what I can recall 'off the cuff' . The upshot is though, its a wonderful relaxed cruiser , 6th gear at 70mph = ~ 2800 rpm and very economical at those speeds , maybe high 40's-low 50's mpg . 

But the car transforms into a supremely planted, very rapid sports car, when the revs rise over ~ 5500rpm , I did see 7500rpm today , with a delicious accompanying howl . 

The car has exceeded all expectations with it's multi-faceted character , I travelled on a few well-known to me back-roads today, at a far higher speed than with any other vehicle I have owned previously,all achieved without any fuss or drama, such was the excellence of the chassis/ride and roadholding . 

So what will I do with my existing MR2 mk3 (2 off) ? 

I'm very strongly considering selling both, as their virtues and strong points are at least matched by this MX-5

The MR-2 is a less common sight on UK roads, and just maybe the driving position is a tad more generous than the MX-5, but these would be the only area where my existing cars have any very slight advantage.

Maybe a Final Twist in This Saga though 

A friend who was a previous MR-2 owner, purchased a well sorted, great service history, but ancient 05 reg Porsche Boxster 987 2.7 engined car, in mid Summer last year. I drove the car, and was suitably impressed with the very solid nature of it in terms of the car controls eg pedals,switches,levers , maybe overly heavy in fact, but the overall driving impression was very positive. Little did I imagine less than 9 months later, that the car now belongs to me. So, as I was driving the Boxster along today,I'm thinking ''did I need to also have the newly bought MX-5 as well'?  The previous owner of the MX-5 did indicate that he would like to have 1st refusal if ever I wanted to sell. So.....what to do? enjoy all of my crop of cars over the Summer and then see what to do for the best, or start to have a much needed cull of a 5 car stable, where I am the only driver in the family.  

Two MR2 for Sale

MR-S 

MR2 (now sold) 

Updated situation in late July 

As per usual in my car-owning history, nothing was straightforward. A friend who I have known for many moons, offered me yet another MR2 in May, but this one was an unusual solar yellow Facelift in great condition, with a low mileage of 46.8k(now bought) so couldn't pass up the opportunity. This had followed me swapping the black MR2 mentioned above (that was For Sale) for a Honda CRZ, but the Honda has subsequently been donated to my son who 'blew-up' his only car:- a battered MX-5. So, once again all change, but at least I am at 4 cars now! The MR-S that I also mentioned for sale above, generated some initial interest, but I must confess that I haven't strongly pushed to sell it as it is such a delightful relatively cheap (not quite valueless) car. However it doesn't make much sense to have 4 cabriolets however much I like each of them. So, over the next few weeks/months it's the intention to replace the MR-S with a winter-runabout, and probably trade in the recently bought yellow MR2 along with with the manual Boxster to get a PDK paddle-shift 987 Gen 2 Boxster .....this would bring the stable to a far more manageable 3 cars 

The Planned 'Fleet'

MX-5 

Boxster 

A cheap runabout eg Audi A2, Ford Fiesta ...... 

Tangible Benefits of Social Drugs?

 A simplistic and relatively shallow series of muses here,  prompted by repeated commentary from naysayers, particularly in reference to nicotine.

Social Drugs I shall confine to just three varieties, although many more exist. I shall discuss  Caffeine, Alcohol, Nicotine but not include another very popular Social Drug :-Cannabis, for whatever reasoning. 

Caffeine 

A straight rip from Google yields this commentary 

''Low to moderate doses of caffeine (50–300 mg) may cause increased alertness, energy, and ability to concentrate, while higher doses may have negative effects such as anxiety, restlessness, insomnia, and increased heart rate. [2] Still, the cumulative research on coffee points in the direction of a health benefit.''  < via this 

So just maybe some Health benefits here! 

Alcohol 

again a Google rip 

''Moderate amounts of alcohol raise levels of high-density lipoprotein (HDL, or “good” cholesterol), [37] and higher HDL levels are associated with greater protection against heart disease. '' via here  see Nutt et al here to put into context with other social drugs.

Nicotine 

Interestingly no Google rip is available here to post 

but a multitude of entries are shown via this link 

So can I make any conclusions whatsoever here, other than Google and hence TC Chan who provided the commentary on caffeine and alcohol are not predisposed to writing or recording anything positive about nicotine <Why is this??

I can still recall a commentary from a now retired researcher:- Robert West who I have admired for his published works and Tobacco Harm Reduction conference speeches, however he startled me when he stated there are no benefits associated with nicotine. 

I have no intention of regurgitating the Google link above, but simply refer any long suffering reader of this, to Safer Nicotine Wiki  namely this section here and from New Nicotine Alliance especially this entry  a recent entry by Brad Rodu is well worth a read another via Carrie Wade also a good read .Lynne Dawkins 2019 address at GFN entitled Beneficial effects of nicotine.  Finally the GFN'2022 Day #2 Conference on Benefits of nicotine . Yet another very readable entry from Jim McDonald is this . Further detailed research with pros and cons of nicotine use 

Positive benefits of nicotine exist, but seemingly well hidden (ie deliberately ignored by the media) from the vast majority of the general public, who have been consistently and continually brainwashed for many years  largely because of the association with combustible Smoking. 

Nicotine has been researched for very many years,but the overwhelming number of research papers is associated with combustible use, comparatively recently this has changed to research of safer forms. However,funding models especially in the US are frequently designed to find problems and harms, as opposed to benefits. To justify that last comment see Charles Gardner via Regwatch (12:00 onwards)

It could certainly be strongly argued that alcohol is way more dangerous than any of the safer forms of nicotine consumption, similarly are safer forms of nicotine equally as benign as caffeine? and arguably offer more tangible benefits?

But of course the obvious must be stated that both Caffeine and Alcohol have far greater public 'acceptance' than nicotine, this is unjustifiable, from a risk or benefit perspective, but changing public perception will certainly not happen quickly, if at all. This probably because caffeine and alcohol is used by significantly higher numbers in many Western and non-Muslim societies, compared to nicotine(exceptions exist of course). 

Finally, even if Robert West was correct in his assessment that there are no benefits from using nicotine, how does one measure pleasure in any context, not just in the case of nicotine? To this nicotine user who just happens to be a Vaper, there are very many pleasurable flavours that collectively are unique to my palate, how can these possibly be quantified or assessed ?