Nicotine dependence is an addiction to tobacco products caused by the drug nicotine. Nicotine dependence — also referred to as tobacco dependence — means you can't stop using the substance, even though it's causing you harm. While it's the nicotine in tobacco that causes nicotine dependence, the toxic effects come mainly from other substances in tobacco. Smokers have much higher rates of heart disease, stroke and cancer than do nonsmokers.
Nicotine produces physical and mood-altering effects in your brain that are temporarily pleasing. These effects make you want to use tobacco and lead to dependence. At the same time, stopping tobacco use causes withdrawal symptoms, including irritability and anxiety.
Many effective treatments for nicotine dependence are available to help you manage withdrawal and stop smoking for good. Ask your doctor for help.
In some people, using any amount of tobacco can quickly lead to nicotine dependence. Signs that you may be addicted include:
When to see a doctor
You're more likely to stop for good if you follow a treatment plan that addresses both the physical and the behavioral aspects of nicotine dependence. Using medications and working with a stop-smoking counselor will significantly boost your chances of success.
Ask your doctor to help you create a treatment plan that works for you.
Nicotine is the chemical in tobacco that keeps you smoking. Nicotine is very addictive. It increases the release of brain chemicals called neurotransmitters, which help regulate mood and behavior. One of these neurotransmitters is dopamine, which makes you feel good. Getting that dopamine boost is part of the addiction process.
Nicotine dependence, also referred to as tobacco dependence, involves behavioral as well as physical factors. Behaviors and cues that you may associate with smoking include:
To overcome your dependence on tobacco, you need to deal with the behaviors and routines that you associate with smoking.
Anyone who smokes or uses other forms of tobacco is at risk of becoming dependent on tobacco and nicotine. Most people begin smoking during childhood or adolescence. The younger you begin smoking, the greater the chance that you'll become a heavy smoker as an adult.
Children who grow up with parents who smoke are more likely to become smokers. Children with friends who smoke also are more likely to try cigarettes.
Other factors that influence nicotine dependence include:
When you inhale tobacco smoke, you take in numerous chemicals that reach most of your body's vital organs. Tobacco smoke contains more than 60 known cancer-causing chemicals and more than 4,000 other harmful substances.
Smoking harms almost every organ of your body. More than half the people who keep smoking will die because of it. The negative health effects include:
Lung function after quitting smoking
Lung function normally declines with age. Smoking worsens that decline. Quitting smoking won't undo permanent damage, but it will slow the decline. ...
Preparing for your appointment
You're likely to start by seeing your primary care doctor or a general practitioner.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor:
Your time with your doctor is limited, so preparing a list of questions ahead of time will help you make the most of your time together. List your questions from most important to least important in case time runs out. For nicotine dependence, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Tests and diagnosis
There are no physical tests to determine the exact degree to which you're dependent on nicotine. Your doctor may ask you questions or have you complete a questionnaire to get a sense of how dependant you are on nicotine. The more cigarettes you smoke each day and the sooner you smoke after awakening, the more dependent you are.
In diagnosing nicotine dependence, your doctor likely will consider criteria detailed in a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to help them diagnose conditions and by insurance companies to reimburse for treatment.
DSM criteria for nicotine dependence include three or more of the following at any time in the same 12-month period:
Knowing your degree of dependence will help your doctor determine the best medication plan for you.
Treatments and drugs
Like most smokers, you've probably made at least one recent, serious attempt to stop. You may be feeling discouraged about trying again. But it's rare to succeed on your first attempt to stop smoking — especially if you try to do it without help. You're much more likely to succeed if you use treatments that have been proved effective. Medications and counseling both work. Combining these approaches makes it even more likely to work.
Although it may be tough to break your tobacco dependence, the benefits are well worth the effort. Smoking is the single most preventable cause of death in the U.S.
Your health will benefit almost immediately if you stop smoking. Just 20 minutes after your last cigarette, your heart rate goes down. Twelve hours later, levels of carbon monoxide, a toxic gas, in your blood return to normal. Your lung function improves and your circulation starts to get better within three months. After a year, your risk of having a heart attack drops by half. And after five to 15 years, your stroke risk will be the same as that of a nonsmoker.
Using more than one medication may help you get better results than if you use a single medication. You'll get better results by combining a longer acting medication — such as the nicotine patch or the drug bupropion (Zyban, Wellbutrin) or varenicline (Chantix) — with a short-acting nicotine replacement product, such as nicotine gum, lozenge, nasal spray or inhaler.
If you've tried a medication on your own but haven't been able to stop smoking, talk to your health care provider. He or she can help you move in the right direction by adjusting the dose of your medication, recommending a different medication or using a combination of medications.
Most people who want to stop smoking can benefit from a medication. But if you're pregnant or breast-feeding, you smoke fewer than 10 cigarettes a day or you're under age 18, talk to your doctor before taking any over-the-counter nicotine replacement products.
Nicotine replacement therapy
Most nicotine replacement products are available over-the-counter:
These nicotine replacement products are available by prescription:
Counseling, support groups and smoking cessation programs
Several types of counseling and support can help with stopping smoking:
Remember, it's common to lapse, and sometimes relapse. But your goal is no smoking at all — even light or occasional smoking is dangerous. You can learn from past experiences and what may have led to a lapse or relapse. Armed with that knowledge — you'll be stronger during your next attempt.
Lifestyle and home remedies
When you stop smoking, you'll likely experience some unpleasant or stressful symptoms of nicotine withdrawal. Medications will markedly reduce the difficulty of withdrawal. Even so, it's important to have a plan for managing withdrawal symptoms.
Withdrawal symptoms are usually the most intense during the first week after you stop smoking. They may continue for several weeks, with declining intensity. Although most nicotine withdrawal symptoms pass within a month, you may occasionally experience a strong urge or craving to smoke months after stopping. Triggers or cues that were associated with your smoking can provoke these urges or cravings.
Here are some things you can do to manage withdrawal symptoms:
Coping and support
How can you stay motivated? Start by thinking about the mixed feelings you may have about smoking. Then make a list of your reasons for stopping smoking.
Stopping smoking is a positive change for many reasons. Think of short-term benefits, such as breathing easier, saving money and having better smelling clothes. Long-term benefits include a lower risk of disease, increased chances for a longer life and a healthier environment for your family. Use these reasons to build your motivation. Look at your list often, especially when you feel your motivation is lagging.
To stay smoke-free over the long haul, consider these tips:
The best way to prevent tobacco dependence is to not smoke in the first place. The best way to prevent your children from smoking is to not smoke yourself. If you're a parent who smokes, the younger your children are when you quit, the less likely they are to become smokers themselves. Even if you don't smoke, here are some things you might try as a parent:
Last Updated: 2010-11-23
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