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The sole motivation for smoking doesn't have to be nicotine

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The medical community are fond of pronouncing on all things smoking while most of their number have probably never been smokers themselves. Their beliefs about this have become almost religious doctrine that must never be questioned.

In this regard they have firmly settled on a craving for nicotine as the sole motivation for smoking and will routinely refer to smoking as an addiction. Some of their number will even claim that nicotine is more difficult to quit than heroin. However true addiction has five pillars of definition and tobacco/nicotine fail on two of them. First, there are more ex-smokers than smokers and this simply is not true of any other actual addiction. Second, the true addict to any substance quickly requires larger doses to achieve the same effect and this is not true of smokers. Variously, people have settled on ten-a-day or twenty with some settling for more and this and then the "habit" tends to remain the same for years.

So smoking is not a true addiction but it is a very strong habit, among other things. Like all habits it has its ritual and its habitual behaviors, particularly in social situations. Smokers generously offer one another a cigarette and this is normally the signal to strike up conversation. Lighting someone else's cigarette is a semi-intimate action requiring close quarters. Once done, the actual cigarettes themselves ensure you remain together for five minutes of impromptu chat at least. It is the unspoken etiquette of smoking.

Each individual smoker develops their own style of smoking. Different brands and flavors are often the topic of conversation with strangers and also the best smoke in any given day. Is it the first one in the morning or the last one at night? The post-coital cigarette is often mentioned as is the one after a fine dinner. I would suggest that every person's smoking habit is as individual as their personality which is why we have such a huge range of brands, roll-your-owns, cigars and pipe tobacco. No two smokers are exactly alike.

But as the wise old saying goes, "When the only tool you have is a hammer, then every problem must look like a nail." For the medical community, nicotine addiction is the sole problem to be addressed and chemicals are their only tool. The whole psychology behind smoking is ignored in favour of a nicotine delivery system. There is a guy who goes to my local pub and he gave smoking three years ago after 30 years. He did so using an e-cigarette but what amazed me as I watched him puff away on it one night was that he'd stopped the nicotine additive two years before. His chosen e-cig used fruit flavors without nicotine present and yet he swore he would go nowhere unless he had his e-cig with him fully charged and a spare refill as well.

In the Irish Times we read of a new device to help smokers quit ('Fountain Healthcare invests in $47.6m stop smoking device'). This wonderous thing is described as "a device that delivers nicotine through the skin in set doses at set intervals timed to coincide with the peak of the craving cycle". How are you supposed to socialize with that? Indeed, like the best cigarette in any day, when should it give you the required bang? It has no ritual to it. There is no habitual behavior involved in any of it. You can't share it and you don't actually have to do anything. Even worse, you are not in control of the device because it decides when you get your nicotine. Worse again, what happens if you don't want or require nicotine like the guy in the pub?

The big pharmaceuticals have already made this mistake with their gums, patches and sprays. None of these ever had anything to do with the art of smoking and that is why they have all failed miserably. Fountain Healthcare will find this out to their cost in time when all $47.6m is gone and their device is not being bought. The e-cig has some chance but this physical medication approach does not work simply because the underlying nicotine diagnosis is wrong. A smoking habit is about far more than nicotine. It is a life-style prop in its own right.

Perhaps in their infinite wisdom the big companies might actually begin talking to smokers rather than talking at them because they have much to learn about us.


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