Why does smoking lead to cancer and heart disease? It is not because of nicotine

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In a new study, researchers found that most doctors mistakenly believe that nicotine leads to cancer and heart and respiratory diseases.

But in fact, the toxic substances in cigarette smoke and not nicotine cause the primary health risk.

The research was conducted by a team at Rutgers University.

In the United States, an estimated 34 million people smoke cigarettes, according to the Centers for Disease Control.

Nicotine replacement therapies include over-the-counter products like patches, gum, and lozenges, as well as prescription medications.

The team surveyed more than 1,000 doctors from several specialties between September 2018 and February 2019 about their knowledge of tobacco use and found that 80% of those surveyed believe it is the nicotine that directly causes cancer.

The survey asked physicians in specialties that included family medicine, internal medicine, obstetrics and gynecology, cardiology, pulmonary and critical care, and hematology and oncology about their understanding of tobacco treatment practices, harm reduction beliefs, and tobacco and e-cigarette use.

Although nicotine’s primary risk is addiction or dependence on tobacco products, researchers found that 83% of doctors strongly believe that it directly contributes to heart disease.

In comparison, 81% thought it contributes to chronic obstructive pulmonary disease (COPD). Pulmonologists, who focus on the respiratory system, were less likely than other specialties to misperceive nicotine as a direct contributor to COPD.

Family doctors were more likely than oncologists to misunderstand nicotine as a cancer-causing substance.

Less than one-third of the doctors surveyed correctly agreed that nicotine directly contributes to birth defects, while 30% did not answer the question, indicating they did not know the answer.

Younger and female doctors were more likely than males to perceive correct risks causing birth defects, while OB/GYNs surprisingly misidentified them more than other specialties.

The team says doctors must understand the actual risk of nicotine use as they are critical in the prescription and recommendation of FDA-approved nicotine replacement therapy products to help patients who use other dangerous forms of tobacco.

Doctors should be able to accurately communicate these risks, which may include low-nicotine cigarettes, which are not safer than traditional cigarettes.

Researchers recommend brief communication interventions that can effectively correct such nicotine misperceptions among doctors and the general public.

One author of the study is Michael B. Steinberg, the medical director of the Rutgers Center for Tobacco Studies.

The study is published in the Journal of General Internal Medicine.

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