Tuesday 16 July 2024

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 

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