Comparing "Nicorette QuickMist" to Vaping

I found a post on Facebook (thanks to Paula P.) which had an image that seemed interesting (see photo right).  Paula was clever enough to compare the ingredients of Nicorette QuickMist to those of a standard vape.  (This is available in the US, Canada, Australia, and others.  Its unclear whether the FDA has cleared this for US customers but you can buy it none-the-less.)

These ingredients are confirmed from this Australian document (from the Australian Register of Therapeutic Goods - this is what you find on their site.)

With apologies to Paula I believe that "Cooling flavour" and "Sucralose" are also vape "Flavoring."

So at least in the rest of the western world Nicorette Mist products would appear to have been cleared by their respective government health organizations for regular use, i.e., no prescription required.

Under the heading in the Australian document we see Pharmacodynamics.  There we see "Clinical studies have shown that nicotine replacement from nicotine containing products can help people give up smoking by relief of abstinence symptoms associated with smoking cessation."

Okay good - this does help with smoking cessation.

So what does this say for "nicotine mist?"

"Compared to nicotine gum or nicotine lozenge, the absorption of nicotine from the mouth spray is more rapid and based on prior experience with nicotine replacement therapy, this will result in a faster onset of relief of cravings and other symptoms. A single dose study in 200 healthy smokers demonstrated that two sprays of 1mg reduced urges to smoke one minute after administration and to a significantly greater extent than nicotine lozenge 4mg during the first 1, 3, 5, and 10 minutes."

Seems pretty clear that nicotine mist works better than lozenges.

Nicorette makes both of these types of products so it seems clear that they think the spray is better than the lozenge.

Next we see "The pharmacokinetics of the mouth spray has been studied in 4 studies. The studies enrolled a total of 141 subjects. "

Wow.  A total of 141 people tested.

There are probably five to six million vapers world-wide.  Most vaping every day.

Gee, so far its safe...

You can read the rest of this section yourself.  If you know anything about what's know of the science of vaping you'll see that the spray users end up with reasonable blood nicotine levels that work to stop their urges to smoke - just like vaping.

Next you can read about the clinical trials - not much interesting there other than to say it must work well enough against a placebo to allow the various government agencies to approve it for sale in their respective countries.

Now let's look at the PRECAUTIONS section...

"In stable cardiovascular disease NICORETTE® QuickMist presents a lesser hazard than continuing to smoke."

That's reasonable...

But this one is interesting: "Transferred dependence  Transferred dependence can occur but is both less harmful and easier to break than smoking dependence."

So if you transfer your dependence over to this mist it is "less harmful and easier to break than smoking dependence."

Well that's kind of interesting.

Not exactly what you hear from the CA department of public health on vaping.

Now we get into "Continued smoking while using NRT" - this is the FDA and CDC feared "dual use" scenario.

Here's what this Australian document says.  First: "NICORETTE QuickMist can be safely used while smoking."

Hmmm... Contradicts what you hear about vaping and smoking...

Then: "The adverse event profile (incidence and severity of events) of intermittent NRT products in studies to reduce smoking did not differ markedly from that in smoking cessation studies."

This means that bad things that happen when you quite smoking are not made worse by this spray.

So is "dual use safe:" "Intermittent use of intermittent dosing NRT products and cigarettes does not appear to produce more side effects than use of NRT alone."

I added the underline - so mixing mist and cigarettes is not a problem.

And finally: "Most regular smokers are adept at self-titration of their nicotine in order to maintain their plasma nicotine levels within a narrow range."

So with dual use most regular smokers (and of course vapers) are able to control their consumption of nicotine and reasonably regulate it on their own.

The rest of the document provides a lot of general information on how to use and misuse the product.

Apparently no one thinks this mist is dangerous (save for the section on nicotine poisoning when addresses overdoses in both adults and children).  One imagines that if a child drank this it would be like drinking eliquids.

Apparently not enough people use this (or it tastes bad) hence there are no poisoning statistics that I have seen.

What's the difference between this and vaping?

Probably a several things:

1) Its an aerosol spray (pumper with air and a bottle of liquid) as opposed to an atomizer.  Obviously atomizers heat the liquid to create the mist as compared to blowing air across the surface of the liquid.  It seems like that at low temperatures vaping would be quite similar.

2) There is less nicotine in the mist.  Perhaps this explains why its not a popular product?

3) Its expensive.  A small kit with two sprayers costs around $30 USD on Amazon (link above).

It would seem, at least in my opinion, that there's no real difference here.

So, Mr. CDC and FDA, why the fuss?