Politics over science: unprecedented distortion of evidence by a prestigious medical journal


By Dr Farsalinos

A paper published in New England Journal of Medicine by researchers including a Nobel Prize winner (Eric R. Kandel), accompanied by a press release, supports that there is a biological link between nicotine and cocaine addiction. In particular, they evaluated a specially-developed mouse model and found that mice became more addicted to cocaine if they were previously given nicotine for several days. Researchers detected several changes in the brain which justified the increased addictiveness to cocaine induced by nicotine administration. Based on these findings, they propose that e-cigarettes (not any other nicotine product?) are a gateway to illicit drug use.

This argument contradicts not only science but also common sense. First of all, the statement that nicotine is a gateway to cocaine means that people taking nicotine are more prone to try and use cocaine. Even if we accept that everything observed in mice is perfectly applicable to humans (which obviously is not; in reality it is not even applicable to different mouse strains-that is why the authors developed a specific mouse model), how can you reach to the conclusion that e-cigarettes are a gateway to illicit drugs? Will the e-cigarette force anyone (or make him more prone) to try cocaine? Obviously it will not. The vast majority of smokers have never tried cocaine, therefore, they will never become addicted to it. Of course most cocaine users may indeed be smokers. This is easily explained: these are people liable to recreational substance and drug use in general. They start with cigarettes which are legal, easy and cheap to buy, and then progress to illicit drug use. This is just a behavioral issue, which has nothing to do with brain chemistry or genetics. The authors of the paper present this explanation themselves: "An alternative to the gateway hypothesis has been proposed on the basis of the idea that the use of multiple drugs reflects a common liability for drug use and that addiction, rather than the use of a particular drug, increases the risk of progressing to the use of another drug."

The only information drawn from this study is that if you use nicotine and you try cocaine you have more chance of becoming addicted to cocaine. For this to be true, we must assume that the mouse model examined by the researchers is perfectly applicable to humans. But most probably it is not. In any case, the authors did not prove any gateway effect because their theory requires someone to voluntarily start using cocaine. They did not prove that nicotine use forces anyone to try cocaine (or any other drug). Therefore, the study conclusion should be expressed in this way: if you use nicotine, we advise you not to try cocaine because you may be prone to be addicted. If you don’t use nicotine, we still advise you not to try cocaine, for the same reason (maybe less prone than when using nicotine, but still you may become addicted to cocaine). Concerning e-cigarettes, there is no relevance between the study and any adverse effects coming from e-cigarette use (in fact, the authors did not even evaluate e-cigarette use in their experiments and did not give nicotine through inhalation).


It is sad to see prestigious journals and scientists engage in a political game by distorting and mispresenting science. It seems that there is an effort to create confusion, manipulate public opinion and influence regulators into making completely inappropriate decisions. It is our duty to restore the truth and resist to these efforts, based strictly on evidence and science.


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