Nicotine replacement therapy

Yeah.

And it's, and so I guess if we're having the NRT talk,

right.

So if

It's often forgotten that there is a cliff, a massive drop-off in the harm.

Once you move away from cigarettes and cigars, as you move to vaping and heated tobacco and oral nicotine pouches, we at gin certainly view positively that oral nicotine pouches are an NRT-adjacent product.

Right.

And there even are now nicotine inhalers, which are comparable to an asthma inhaler.

Yeah.

So at the Vermont conference, you presented results from two pilot studies of NRT with a particular focus on dual users, which I think had really been an understudied group in this space up till then.

Can you talk us through the key points and findings from those? Sure.

So the first pilot study I did when I was a postdoctoral fellow, I wanted to look at the potential for nicotine replacement therapy as an option for quitting e-cigarette use.

But what we've found is that for people who are engaging in heavier smoking, for example, so people may be smoking alcohol, two or three packs a day that are, you know, sort of smoking a lot.

There's a lot of evidence to show that wearing more than one patch or using more lozenges is actually helpful for them because they've got higher nicotine dependence and that extra nicotine replacement therapy can help mitigate some of the side effects from quitting.

And so I drew from that literature in thinking about how can we apply high dose NRT to individuals who are engaging in dual use.

people engaging in dual use are self-reporting that they feel more addicted.

And ideally, that would always be a combination of access to pharmacotherapies to help people quit smoking.

So combined forms of NRT, nicotine receptor partial agonist, possibly bupropion.

But also making sure that that's combined with some sort of support.

And that support is to help people on this journey.

Resulting in an unintended pregnancy.

We see similar protocol gates with nicotine replacement therapy, too.

With NRT, the gating is psychological rather than pharmacological.

We rely on Prochaska's trans-theoretical model of change.

The stages of change.

Right.

And what's the main difference between these products and nicotine replacement therapy or NRT designed for cessation?

Yeah, well, like I mentioned earlier, these products were created by the tobacco industry.

So obviously we've done an excellent job over the last few decades of bringing down smoking rates.

I mean, the HSE recommends against using vaping as, as a way of stopping smoking.

They do, but they also say, um, [laughs] that NRT doesn't work.

Like, you know, if you look at, at the Department of Health's own information, that, that I've seen, N- NRT doesn't work.

And if you look at-

That's nicotine replacement therapy

And some of those reasons may be why recent research shows Uh, that e-cigarettes can actually be even better than those traditional medication, um, oriented, uh, uh, products.

There was a review published, uh, just a few months ago, uh, that said that the quit rates with, uh, e-cigarettes are, are 60% better than with NRT.

Now, uh, let's be clear, e-cigarettes are not approved or authorized as, uh, as treatments.

Um, a- and they're not a complete treatment either.