Nicotine Addiction
(Tobacco Use Disorder; Smoking Addiction)
Definition
Nicotine addiction is a dependence on nicotine when it is used regularly. Nicotine can be found in tobacco products, such as:
- Cigarettes
- Snuff
- Chewing tobacco
- Cigars
- Pipes
Drugs stimulate unnecessary chemical release in the brain.
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Causes
Nicotine acts on the brain's chemistry. It creates feelings of pleasure. These feelings go away within a few minutes. People will need to keep using nicotine to feel this way again. 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
- Bullying
Symptoms
Symptoms only happen when nicotine is not being used. This is known as withdrawal. Symptoms are:
- Increased hunger
- Craving
- Headache
- Irritability
- Nervousness
- Thinking and attention problems
- Trouble sleeping
Diagnosis
You will be asked about your symptoms and health history. You will also be asked about your history of using tobacco products. 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 1 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:
Benowitz NL. Nicotine addiction. N Engl J Med. 2010 Jun 17;362(24):2295-2303.
Tobacco and cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer.html. Accessed September 2, 2020.
Tobacco, nicotine, and e-cigarettes research report. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/tobacco-nicotine-e-cigarettes/introduction. Accessed September 2, 2020.
Tobacco use. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/tobacco-use-22. Accessed September 2, 2020.
9/29/2016 EBSCO DynaMed Systematic Literature Surveillancehttps://www.dynamed.com/management/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 2020 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 2/19/2021