Another French Study Looks Into The Use of Nicotine Against Covid-19
vapingpost.comPure guess, but I wouldn't be surprised if fewer smokers went to the hospital for minor cases. Most of the common symptoms for the illness are things smokers regularly deal with like a loss of taste and smell, congestion, coughing, and breathing difficulties. So unless things are pretty bad, being sick might seem better than getting hospitalized and going through withdrawal.
I hope whatever wide scale antibody test they do ask if the person smokes as well.
That doesn't really make sense. Whatever are a person's current indicators on the symptoms you just listed, if they were to worsen during this pandemic, people would probably consider going to the hospital.
Apart from perhaps coughing, smokers don't "regularly deal" with any of that. Smokers don't have a "sudden loss of sense of smell".
> Smokers don't have a "sudden loss of sense of smell".
Right. They have a _persistent_ loss of sense of smell. Regaining sense of smell is one of the major changes that ex-smokers notice after quitting. This is very widely known.
> Apart from perhaps coughing, smokers don't "regularly deal" with any of that.
Google "smoker sense of smell" and "smoker sense of taste" and "smoker shortness of breath".
I never heard about that and definitely did not noticed anything like that when I stopped smoking.
How long and heavy you smoked probably matters, and if you aren't expecting it you may not notice your sense of smell and taste slowly getting sharper over a few months.
Personally, quitting smoking led me to eat far less fast food, as I noticed how terrible much of it tasted.
Parent claimed this: Regaining sense of smell is one of the major changes that ex-smokers notice after quitting.
Slow change over course of moths that you don't notice unless you know about it is hardly that.
Major changes that happen gradually are incredibly hard to notice if you aren't expecting them, and even if you did notice you might just think it's because you got over a cold or spring is here or similar.
"ajor changes that ex-smokers notice after quitting" is something completely different then "Major changes [...] incredibly hard to notice".
If it is hard to notice, then it can't be major thing ex-smokers notice.
Or many ex-smokers were expecting them so did notice the change. I can't tell if you just think the poster should have qualified that not every smoker notices it or if you think it doesn't exist because you didn't notice it.
No I think the parent is making up "plenty smokers" and "commonly known" to describe something that exists only in minority of cases.
"Health benefits of quitting smoking...Within 48 hours, nerve endings and sense of smell and taste both start recovering."
https://en.wikipedia.org/wiki/Smoking_cessation#Health_benef...
Think about how the smell longer on your clothes. That smell lingering in your mouth is going to mess with your smell and taste. And that's ignoring the damage inhaling burning air does to your mouth.
Which is far cry from "major change smokers notice".
It's the start of the major change smokers notice, if you want more detail find it yourself. Your baseless certainty astounds me.
People don’t get hospitalised because of just a loss of smell.
I do not understand why you think my post said they did.
There are oral nicotine products that are widely available. You can get smoking cessation lozenges at drug stores, but there are also nicotine pouches sold alongside cigarettes and snus. Some use tobacco nicotine, but many are derived from nightshade vegetables such as tomatoes. If you were considering adding nicotine into your life, this would probably be the safest choice for the throat and lungs. Receding gums and nicotine addiction are very likely consequences as well as risk to the cardiovascular system; proceed with caution.
As a Covid-19 therapy oral nicotine would be easy to scale up and distribute. It doesn't take long to turn around a crop of eggplant or tomatoes, and the processing seems simple enough. Effective dosing, safety and the political difficulties of advocating for safe and limited use nicotine seem to be something that would make any public health professional's head spin.
Smoking cessation lozenges are kinda gross, they mimic the taste of smoking.
The point is to be unappealing otherwise there will be no cessation.
Right, but it would be bad to use lozenges if you didn't smoke before, which was the parent's point.
> The study in question will be randomized, national and multi-center, carried out double-blind, and should involve teams from Assistance Publique – Hôpitaux de Paris, Sorbonne University and Inserm. It is expected to include approximately 1,633 medical and non-medical caregivers, working in a health establishment, non-smokers (or former smokers who have quit smoking for more than 12 months), without a history of infection with COVID-19, and working with patients (with or without the virus).
> The researchers will administer nicotine patches to some of the participants for a period of 4 to 5 months, and then carry out a follow-up for 6 to 7 months. Of course, it is still too early to conclude exactly how nicotine interacts with the coronavirus. However, if nicotine is indeed confirmed as a protective factor, NRTs including e-cigarettes could play a pivotal role in controlling this pandemic.
Very curious to see how this goes. I would also love to see information as to why nicotine works this way, and if there are any non-nicotine options that have similar effects? Interesting stuff none the less.
Another interesting thing to find out: Is it just nicotine that has an effect? Or nicotine delivered via the respiratory system?
The nicotine patch trial will hopefully shed light on that as well.
In the meantime, it would be nice to see data comparing the hospitalization rates of smokeless tobacco users* vs. smokers and non-tobacco users.
* i.e. Chew, dip, and snus.
A quick literature search shows ample evidence of both immune suppressing and immune promoting effects of nicotine.
I didn’t see something that was a clear consensus, but it seemed like nicotine decidedly modulates the immune system. It seems whatever effects it has might do good things for covid.
Nicotine isn’t evil, and even not particularly addictive when not delivered via burning leaves. (components in smoke change how much enters the brain)
"even not particularly addictive when not delivered via burning leaves"
My personal experience is that it is even more addictive. First, with NRT (gum, lozenge) you can use nicotine much more frequently - e.g. even going to bed with lozenge in your mouth. Second, you can easily increase your dosage. 2mg piece of gum not doing it for you? Pop in a few more or move up to 4mg. Switch to mini-lozenge and you can suck on say 5 * 4mg lozenges at one time.
I've been wondering about this anyway. Isn't the covid that requires hospitalization due to an overreaction of the immune system? Maybe suppressing the immune system slightly is what helps here.
One of the primary treatments is a big dose of powerful steroids to suppress the immune response.
Hydroxychloroquine has been very controversial for some reason, but it is an immunosuppressant that's been used for years to treat sarcoidosis, and severe covid is a very similar inflammatory disease.
Some ideas from May soon after this was first observed: https://www.cebm.net/covid-19/nicotine-replacement-therapy/
> > The researchers will administer nicotine patches to some of the participants for a period of 4 to 5 months, and then carry out a follow-up for 6 to 7 months.
By that time, I'd expect widespread vaccinations particularly among older and at-risk people. Is this going to be anything more than a curiosity at that time? Maybe something to keep on the shelf for the next pandemic? Or a hedge in case the vaccine immunity is short-lived?
Lol, I've been saying this since July. Severe covid is due to organ inflammation from overaggressive immune system response, and nicotine is an immune system suppressant. The one episode of Dr. House where is was actually sarcoidosis (a systemic inflammatory disease), the patient didn't have any symptoms because of his use of chewing tobacco to manage his weight for wrestling.
You'd probably be interested in
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9...
This paper points out that patients on infliximab (trade name Remicade: immune system modulator used by people with chronic autoimmune diseases, particularly IBD and rheumatoid arthritis) don't seem to be at elevated risk of severe COVID – which is surprising because these are powerful immune system suppressants.
I had to start taking immunosuppressants earlier this year, and after reading up on it I've convinced myself that it's an effective treatment for severe covid. As it happened, I essentially had a severe covid experience, but for auto-immune/ideopathic reasons. It's like my body had 2020 FOMO.
All diseases cause inflammation, it's the bodies basic response to everything, like cuts and whatnot. That said, this may also be why they figured out certain steroids helped COVID patients by reducing this hyper reaction. I rememebr reading some steroids became a frontline treatment at some point mid way through the year at certain medical centers.
But any pathologist would have known immediately about the risks of inflammation and that being the auto-response. It would have been evaluated is what I'm assuming.
I have colitis which similarly causes artificial immune response in the digestive tract and they used steroids to help reduce the inflammation which was causing other serious problems in my body. But only during a very serious episode. Other lighter approaches are available to keep it under control.
Note: I'm not a medical expert at all and could be talking out of my ass. Just basing this on personal experience and some personal reading into pathology.
For sure, but severe covid seems to involve a disproportionate amount of inflammation that itself causes organ damage. I think the medical term is a cytokine storm?
Indeed. It appears Cytokine Storms [1] are a big threat with Covid-19.
Do we currently have no medications that can stop that inflammation from occurring?
Corticosteroids, hydroxychloroquine, methotrexate, and I'm sure dozens of others. Immune system suppression isn't something one should do without supervision of a doctor, though. Notably, most effective drugs have non-trivial side effects or cause their own long term damage.
I am not the right sort of doctor, and you should ask a medical professional. My knowledge comes from very out-of-date experience working in a computational drug discovery lab, which gives one a very narrow view of a very small number of things.
Seriously, ask a doctor, but these might give you starting points for the discussion:
This is a very high-value part of pharma research, because inflammation is at the root of a lot of lifelong chronic disease and is basically only manageable rather than curable. But because inflammation is a systemic response, all drugs which modulate the immune system are serious business.
For short-term use: corticosteroids (eg prednisone), and I think best-current acute Covid pneumonia protocols involve quite a lot of these, particularly dexamethasone (https://www.covid19treatmentguidelines.nih.gov/immune-based-...). Corticosteroids are extremely powerful drugs. Some of them are used topically for acute local inflammation (hydrocortisone is the best known of those and is available OTC from pharmacists for rashes), but that's basically the only context you're likely to encounter them taken as lightly as, eg, aspirin or acetaminophen.
Long-term use; there are some small molecules, eg methotrexate, which modulate the immune system – hydroxychloroquine is one of these used in lupus treatment, but there is plenty of evidence that it harms rather than helps in the Covid case.
That leaves you some of the second-line treatments used for chronic immune system diseases like rheumatoid arthritis, Crohn's disease, and ulcerative colitis, and there the Lancet paper I linked up-thread suggests these may have some utility/protective value against Covid, found by studying correlations in patients undergoing these therapies for pre-existing conditions.
But: these are not easy options. They're "biologics" (big proteins). You've had or know people who've had some of these. The ones you've probably encountered are vaccines and insulin, but the big growth area has been monoclonal antibodies. Some of these can directly modulate specific signalling pathways, particularly inflammation pathways, which is why they are effective against the diseases of systemic inflammation above. But: these drugs are extremely expensive to develop (so the US prices are ungodly high), difficult to transport, store and deliver - often requiring IV infusion (I think Humira has a self-injectable formulation, but none of them are oral medications) - and have systemic side effects basically by design.
Two new monoclonal antibody therapies of this class have US EUAs (emergency use authorizations) for Covid; https://www.fiercepharma.com/pharma/regeneron-following-lill.... One of them (the Regeneron one) is the one Donald Trump had.
> The daily smokers rate amongst COVID-19 patients was at 5.3%, whilst amongst the general population, the daily smokers rate was at 25.4%.
Not to be macabre, but could it potentially be that more smokers die before reaching the older age range of most COVID hospitalizations?
The first paragraph says:
> The researchers had estimated the rates of daily current smokers among COVID-19-infected patients and compared them to the rates of daily current smokers within the general French population, after controlling the data for sex and age.
So, assuming they correctly controlled for age, then no, it’s not “anti-survivorship” bias. (“Casualty bias”?)
There could still be survivorship bias, e.g. the people who don't die from smoking have stronger lungs, and aren't affected as much by covid.
This would be true if the outcome of smoking was binary and quick (i.e. unless you have strong lungs you die from smoking soon, otherwise your lungs remain stronger than the rest of population until natural death).
That’s not a pattern with smoking.
Ah, missed that, thanks. Even more interesting then!
As someone who has been wearing nicotine patches every day for several years, the thought of the general population buying up my life source is terrifying. I now have a 400 day supply arriving tomorrow.
> As someone who has been wearing nicotine patches every day for several years
I think you're the first person I've encountered who desires to use nicotine patches indefinitely. Isn't the idea usually to gradually wean off of them instead of just continuing to use them forever?
To be fair, he didn't say he desires to use them. Just that he does. There can be many reasons why it is not a good time to discontinue nicotine. For example, if one is at a risk of returning to cigarettes. In that case, it is a much safer alternative.
Myself, I vaporise moderate amounts of nicotine. It is not part of my identity, it just got me off cigarettes. I have no plans to reduce or discontinue my usage at this time. A stable mental state and staying off cigarettes is more important right now.
Abstinence is a noble goal, but it is not always practical. In those cases, reducing the harm is desirable.
That’s certainly an interesting hobby.
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Typo in the headline you wrote: it's "preventative", not "preventiative".
When “Blowing Smoke Up Your Ass” Was Much More Than Just A Saying https://allthatsinteresting.com/blowing-smoke-up-your-ass
> The researchers will administer nicotine patches to some of the participants for a period of 4 to 5 months,
Wow. Hooking participants on nicotine for research seems like an extreme measure to research this. I know that nicotine-patches cannot be compared to cigarette-hits in addictiveness. But still, I take it as given that a few participants will start to smoke tobacco after this.
Since the effect promises to be really big though, I'll accept the argument that it's worth to study it. I just wonder how we'll deal with a positive result. Will the at-risk population actually be advised to take nicotine preventatively?
Same with meth. Anecdotally, apparently users are resistant to respiratory viruses. The expected covid outbreak on the Downtown Eastside of Vancouver never materialized, despite widespread lack of masks and social distancing .
I can't imagine anyone is too eager to do that study. If I was covid health care worker, I'd probably be on a low dose of amphetamines right now. Purely as prophylaxis, of course.
Great, but meth isn't the drug of choice for the DTES so how is this relevant?
smokers more effectively social distance, because people can smell when they’re too close
OTOH, smokers offer cigarettes and lights to each other, and arguably congregate for consumption and have small-talks more than non-smokers given smoking starts with peer group pressure effects, etc.