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(Tobacco Use Disorder; Smoking Addiction)
Nicotine addiction is a dependence on nicotine when it is used regularly. Nicotine can be found in tobacco products, such as:
- Chewing tobacco
|Chemical Release in Brain|
|Drugs stimulate unnecessary chemical release in the brain.|
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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.
Use of nicotine products is the main risk factor.
The risk of addiction increases with:
- Family history or exposure to smoking
Symptoms only happen when nicotine is not being used. This is known as withdrawal. Symptoms are:
- Increased hunger
- Thinking and attention problems
- Trouble sleeping
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.
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
- Nasal sprays
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:
Medicine that may help you quit include:
- 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.
The best prevention is to never use tobacco products. Try to avoid places where people are smoking as well.
American Cancer Society
Freedom From Smoking—American Lung Association
Canadian Cancer Society
The Lung Association
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 Surveillance https://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.
- Reviewer: EBSCO Medical Review Board Adrian Preda, MD
- Review Date: 03/2020
- Update Date: 02/19/2021