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.

2/27/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Etter JF, Stapleton JA. Nicotine replacement therapy for long-term smoking cessation: a meta-analysis. Tob Control. 2006;280-285.

9/24/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: LF Stead, T Lancaster. Interventions to reduce harm from continued tobacco use [review]. Cochrane Database of Systematic Reviews. 2007;3.

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.

12/16/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Eisenberg MJ, Filion KB, Yavin D, et al. Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials. CMAJ . 2008;179:135-144.

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]

4/29/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: 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.e8.

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.

Revision Information

Reviewer: Brain Randall, MD
Review Date: 02/2013
Update Date: 03/11/2013

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.