Nicotine dependence — also called tobacco dependence — is an addiction to tobacco products caused by the drug nicotine. Nicotine dependence means you can't stop using the substance, even though it's causing you harm.
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.
While it's the nicotine in tobacco that causes nicotine dependence, the toxic effects of tobacco result from other substances in tobacco. Smokers have much higher rates of heart disease, stroke and cancer than nonsmokers do.
Regardless of how long you've smoked, stopping smoking can improve your health. 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 tobacco treatment specialist will significantly boost your chances of success.
Ask your doctor to help you develop a treatment plan that works for you or to advise you on where to get help to stop smoking.
Nicotine is the chemical in tobacco that keeps you smoking. Nicotine is very addictive when delivered to the lungs by inhaling tobacco smoke. It increases the release of brain chemicals called neurotransmitters, which help regulate mood and behavior. One of these neurotransmitters is dopamine, which may improve your mood and activate feelings of pleasure. Experiencing these effects from nicotine in tobacco is what makes tobacco so addictive.
Nicotine 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. Factors that influence nicotine dependence include:
Tobacco smoke contains more than 60 known cancer-causing chemicals and thousands of other harmful substances. Even "all natural" or herbal cigarettes have chemicals that are harmful to your health. When you inhale tobacco smoke, you take in these chemicals, which reach most of your body's vital organs.
Smoking harms almost every organ of your body, and more than 60 percent of people who keep smoking will die because of it. Women smokers are now at equal risk to men smokers of dying from diseases caused by using tobacco. The negative health effects include:
Lung function after quitting smoking
Lung function normally declines with age. Quitting smoking slows the rapid decline in lung function caused by continued smoking. ...
Preparing for your appointment
You're likely to start by seeing your primary care doctor or a general practitioner. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
For nicotine dependence, some basic questions to ask your doctor include:
Don't hesitate to ask questions during your appointment.
What to expect from your doctor
Tests and diagnosis
Your doctor may ask you questions or have you complete a questionnaire to get a sense of how dependent you are on nicotine. The more cigarettes you smoke each day and the sooner you smoke after awakening, the more dependent you are. Knowing your degree of dependence will help your doctor determine the best treatment plan for you.
In diagnosing nicotine dependence, your doctor may consider criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. This manual is used by mental health providers to help them diagnose conditions and by insurance companies to reimburse for treatment.
Treatments and drugs
Smoking is the single most preventable cause of death in the U.S. Your health will benefit almost immediately if you stop smoking. Younger smokers who stop can have a normal life expectancy, and even older smokers who stop add years and quality to their life expectancy.
According to a report of the Surgeon General, a year after quitting, your risk of a heart attack drops sharply. After two to five years, your stroke risk may be reduced to that of a nonsmoker. And at 10 years, your risk of cancer may be reduced to about half that of a smoker.
Like most smokers, you've probably made at least one serious attempt to stop. But it's rare to stop smoking on your first attempt — especially if you try to do it without help. You're much more likely to stop if you use medications and counseling, which have both been proved effective, especially in combination.
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
Nicotine replacement medications, including patches, gum, lozenges, nasal spray and inhaler, can help relieve difficult withdrawal symptoms and cravings. The best time to start using nicotine replacement medication is on the date you've set to stop smoking. Some smokers start earlier in order to reduce smoking on their way to stopping altogether.
Most nicotine replacement products are available over-the-counter:
These nicotine replacement products are available by prescription:
Counseling, support groups and other programs
Several types of counseling and support can help with stopping smoking:
Methods to avoid
Tobacco in any form is not safe. This includes the use of:
Lifestyle and home remedies
It's important to have a plan for managing nicotine 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's what you can do to help manage nicotine withdrawal symptoms:
Coping and support
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: 2013-06-04
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