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Nicotine Addiction

(Tobacco Use Disorder; Smoking Addiction)

Definition  ^

Nicotine addiction is dependence on nicotine. Being dependent means there is a physical change in how your body reacts to a substance. Your body will also have a reaction when you stop using the substance. Nicotine can be found in tobacco products such as cigarettes, snuff, chewing tobacco, cigars, or pipes.

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

Throat Cancer
Throat cancer

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Nicotine addition can be treated, often with a combination of therapies.

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  ^

Anyone who uses nicotine products can become addicted to the substance.

The risk may increase with:

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

Symptoms  ^

Symptoms develop when nicotine is not being used, also known as withdrawal. Symptoms of withdrawal include:

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

Diagnosis  ^

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

Breathing tests may also be done to see how well your lungs are working.

Your doctor may monitor your nicotine use by checking a cotinine level in your saliva or blood.

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 misusing these products is low since NRT does not create "feel good" feelings.

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 that can be puffed. Some smokers have used e-cigarettes to help them quit. Right now, there is conflicting evidence on whether or not this is the case.

Currently, the US Food and Drug Administration (FDA), along with several major anti-smoking organizations, have determined that there has not been enough research on e-cigarettes to make any claims about their safety or effectiveness in helping people quit smoking. 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

Some antidepressants and nicotine partial agonists may help you quit. Other medications may help ease withdrawal symptoms or block the effects of nicotine if you start smoking again.

Prevention  ^

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

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.

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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: 3/19/2015

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