Nicotine Addiction

(Tobacco Use Disorder; Smoking Addiction)

Definition ^

Dependence is a physical change in how your body reacts to a substance. In this case, nicotine. Your body will also have a reaction when you stop using it. Nicotine can be found in tobacco products such as:

  • Cigarettes
  • Snuff
  • Chewing tobacco
  • Cigars
  • Pipes

Throat Cancer
Throat cancer

Copyright © Nucleus Medical Media, Inc.

Causes ^

Nicotine acts on the brain's chemistry. It creates feelings of pleasure. However, the effects go away within a few minutes. Users will need to continue using nicotine to keep the good feelings going. This cycle can lead to addiction.

Risk Factors ^

Use of nicotine products is the main risk factor.

The risk of addiction increases with:

  • Family history or exposure to smoking
  • Depression
  • Victims of bullying

Symptoms ^

Symptoms only develop when nicotine is not being used. This is known as withdrawal. Symptoms of withdrawal include:

  • Irritability
  • Craving
  • Nervousness
  • Headache
  • Thinking and attention problems
  • Trouble sleeping
  • Increased appetite

Tobacco use is also associated with several serious health conditions such as:

Diagnosis ^

Your doctor will ask about your symptoms, medical, and smoking history. A physical exam will be done.

A blood test can check cotinine level in your saliva or blood. This will show changes in nicotine use. The doctor may use it to check your progress.

Treatment ^

Talk with your doctor about the best treatment plan for you. Treatment may involve one or more therapies. Options include:

Nicotine Replacement Therapy (NRT)

NRT relieves withdrawal symptoms. NRT products include:

  • Nicotine gum
  • Lozenges
  • Nasal sprays
  • Patches
  • Inhalers

The chance of becoming dependent on these products is low. NRT does not create the same "feel good" feelings as nicotine.

NRT may help you to:

  • Avoid smoking
  • Reduce the amount of tobacco you use
  • Quit and stay smoke-free

Electronic Cigarettes

Electronic cigarettes (e-cigarettes) turn liquid nicotine into a vapor. There is conflicting evidence on whether or not they may help you quit. In addition, the long-term effects of e-cigarette use are not known.

Behavioral Therapy

Behavioral therapies include:

  • Counseling
  • Group behavior therapy
  • Telephone quit lines, cell phone programs, and text messaging programs
  • Internet and computer-based programs
  • Self-help classes and manuals
  • Cognitive-behavioral therapy

Medication

Medicine that may help you quit include:

  • Antidepressants
  • Nicotine partial agonists—mimics effect of nicotine to ease withdrawal

Other medicine may help ease withdrawal symptoms. A third type may be used if you start smoking again. It blocks the pleasure feeling when you use nicotine.

Prevention ^

The best prevention is to never use tobacco products. Try to avoid places where people are smoking as well.

RESOURCES:

American Cancer Society
https://www.cancer.org

Freedom From Smoking—American Lung Association
http://www.freedomfromsmoking.org

CANADIAN RESOURCES:

Canadian Cancer Society
https://www.cancer.ca

The Lung Association
https://www.lung.ca

REFERENCES:

Kenfield SA, Stampfer MJ, Rosner BA, Colditz GA. Smoking and smoking cessation in relation to mortality in women. JAMA. 2008;299(17):2037-2047.

Tobacco, nicotine, and e-cigarettes. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/tobacco-nicotine-e-cigarettes/introduction. Updated January 2018. Accessed April 18, 2018.

Tobacco and cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer.html. Updated April 18, 2018.

Tobacco use. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114788/Tobacco-use. Updated March 8, 2018. Accessed April 18, 2018.

2/27/2007 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Etter JF, Stapleton JA. Nicotine replacement therapy for long-term smoking cessation: A meta-analysis. Tob Control. 2006;15(4):280-285.

9/24/2007 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T361003/Nicotine-replacement-therapy-for-tobacco-cessation: LF Stead, T Lancaster. Interventions to reduce harm from continued tobacco use. Cochrane Database of Syst Rev. 2007;(3):CD005231.

10/14/2008 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T361003/Nicotine-replacement-therapy-for-tobacco-cessation: Shiffman S, Ferguson SG. Nicotine patch therapy prior to quitting smoking: a meta-analysis. Addiction. 2008;103(4):557-563.

12/16/2008 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T361003/Nicotine-replacement-therapy-for-tobacco-cessation: Eisenberg MJ, Filion KB, Yavin D, et al. Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials. CMAJ. 2008;179(2):135-144.

2/5/2009 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114788/Tobacco-use: Cochran CJ, Gallicchio L, Miller SR, Zacur H, Flaws JA. Cigarette smoking, androgen levels, and hot flushes in midlife women. Obstet Gynecol. 2008;112(5)1037-1044.

2/17/2009 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T576484/Counseling-for-tobacco-cessation: Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2009;(1):CD001007.

7/6/2009 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114788/Tobacco-use: Myung SK, McDonnell DD, Kazinets G, Seo HG, Moskowitz JM. Effects of web- and computer-based smoking cessation programs: meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169(10):929-937.

7/21/2009 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T576484/Counseling-for-tobacco-cessation: Lancaster T, Stead L. Self-help interventions for smoking cessation. Cochrane Database Syst Rev. 2009;(2):CD001118.

12/21/2009 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T576484/Counseling-for-tobacco-cessation: Whittaker R, Borland R, et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2009;(4):CD006611.

11/30/2010 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114788/Tobacco-use: Rusanen M, Kivipelto M, et al. Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. Arch Intern Med. 2011;171(4):333-339.

6/2/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

9/9/2013 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T361003/Nicotine-replacement-therapy-for-tobacco-cessation: Bullen C, Howe C, et al. Electronic cigarettes for smoking cessation: A randomised controlled trial. Lancet. 2013;382(9905):1629-1637.

3/19/2015 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T361003/Nicotine-replacement-therapy-for-tobacco-cessation: McRobbie H, Bullen C, et al. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev. 2014;12:CD010216.

9/29/2016 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T361003/Nicotine-replacement-therapy-for-tobacco-cessation: Kalkhoran S, Glantz SA. E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. Lancet Respir Med. 2016;4(2):116-128.

Last reviewed March 2018 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 7/12/2018