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Nicotine Addiction

(Tobacco Use Disorder; Smoking Addiction)

Animation Movie Available Related Media: Choosing a Quitting Method

Definition

Nictotine addiction is when a person becomes dependent 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:

Chronic obstructive pulmonary disease

Chronic bronchitis

Emphysema

Cancer, like cancers of the larynx (voice box), oral cavity, throat, esophagus, lung, and colon

Heart disease

Stroke

Dementia

Increased risk of stillbirth, infant death, low birth weight, miscarriage, premature delivery, or sudden infant death syndrome

Shorter life span

Problems if you have surgery

Throat Cancer

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

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.

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.

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:

Nicotine gum

Lozenges

Nasal sprays

Patches

Inhalers

The chance of abusing 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

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

http://www.cancer.org

American Lung Association

Freedom From Smoking

http://www.ffsonline.org

Smokefree

Telephone: 1-800-QUITNOW

http://www.smokefree.gov

CANADIAN RESOURCES:

Canadian Cancer Society

http://www.cancer.ca

The Lung Association

http://www.lung.ca

References:

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

Questions about smoking, tobacco, and health. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/002974-pdf.pdf. Updated January 17, 2013. Accessed March 11, 2013.

Tobacco addiction. National Institute on Drug Abuse website. Available at: http://www.drugabuse.gov/publications/research-reports/tobacco-addiction. Updated July 12, 2012. Accessed March 11, 2013..

Tobacco use disorder. PEMSoft at EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated February 19, 2013. Accessed March 11, 2013.

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3/25/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Parkes G, Greenhalgh T, Griffin M, Dent R. Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial. BMJ. 2008;336:598-600.

10/14/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Shiffman S, Ferguson SG. Nicotine patch therapy prior to quitting smoking: a meta-analysis. Addiction. 2008;103:557-563.

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2/5/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Cochran CJ, Gallicchio L, Miller SR, Zacur H, Flaws JA. Cigarette smoking, androgen levels, and hot flushes in midlife women. Obstet Gynecol. 2008;112:1037-1044.

2/17/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2009;(1):CD001007.

7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: 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;169:929-937.

7/21/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Lancaster T, Stead L. Self-help interventions for smoking cessation. Cochrane Database Syst Rev. 2009;(2):CD001118.

11/13/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Piper ME, Smith SS, Schlam TR, et al. A randomized placebo-controlled clinical trial of 5 smoking cessation pharmacotherapies. Arch Gen Psychiatry. 2009;66(11):1253-1262.

12/21/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Whittaker R, Borland R, Bullen C, et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2009;(4):CD006611.

11/30/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Rusanen M, Kivipelto M, Quesenberry CP Jr, Zhou J, Whitmer RA. Heavy smoking in midlife and long-term risk of alzheimer disease and vascular dementia. Arch Intern Med. 2010 Oct 25. [Epub ahead of print]

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6/24/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Leonardi-Bee J, Britton J, Venn A. Secondhand smoke and adverse fetal outcomes in nonsmoking pregnant women: a meta-analysis. Pediatrics. 2011;127(4):734-741.

Last reviewed February 2013 by Brain Randall, 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.