Health Information

Nicotine Addiction

(Tobacco Use Disorder; Smoking Addiction)

En Español (Spanish Version)

Definition

Animation Movie Available Related Media: Choosing a Method to Quit Smoking

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

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:

Chronic obstructive pulmonary disease (COPD)
Chronic bronchitis
Emphysema
Cancers of the larynx (voice box), oral cavity, throat, esophagus, lung, colon, and others
Coronary artery disease (CAD)
Stroke
Increased risk of stillbirth, infant death, low birth weight, miscarriage, premature delivery, or sudden infant death syndrome
Alcohol or drug use disorders
Depression, bipolar disorder, anxiety, personality disorders, and attention deficit hyperactivity disorder
Shorter life span
Complications during surgery and recovery

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:

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 (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 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

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.

American Cancer Society

https://www.cancer.org

Freedom From Smoking—American Lung Association

http://www.freedomfromsmoking.org

Canadian Cancer Society

https://www.cancer.ca

The Lung Association

https://www.lung.ca

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 Surveillance https://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 Surveillance https://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 Surveillance https://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 Surveillance https://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 Surveillance http://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 Surveillance https://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 Surveillance http://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 Surveillance https://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 Surveillance https://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 Surveillance http://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 Surveillance http://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 Surveillance https://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 Surveillance https://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 Surveillance https://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

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.