Nicotine dependence

Overview

Nicotine dependence happens when your body craves nicotine and you can't stop using it. Nicotine is the chemical in smoked tobacco that causes the urge to smoke. The chemical brings on pleasant feelings, but these effects are short-lived. So you have another cigarette, cigar or pipe bowl.

The more you use smoked tobacco, the more nicotine you need to feel good. When you try to stop, you go through mental and physical changes that aren't pleasant. These are symptoms of nicotine withdrawal.

For some people, using any amount of smoked tobacco can quickly lead to nicotine dependence. But no matter how long you've used nicotine, stopping can improve your health. It isn't easy, but you can break your dependence on nicotine. There are treatment options. Ask your healthcare professional for help.

Symptoms

Symptoms of nicotine dependence can include the following:

• You can't stop smoking. You've made one or more serious attempts to stop without long-term success.
• You smoke within 30 minutes of waking up. The sooner you start smoking after waking and the more cigarettes you smoke during the day, the more dependent on nicotine you are.
• You have nicotine withdrawal symptoms when you try to stop. Your attempts at stopping have caused physical and mood-related symptoms. Withdrawal symptoms can include strong cravings, anxiety, irritable mood, restlessness, trouble focusing or sleeping, depression, frustration, anger, increased hunger, and constipation.
• You keep smoking despite health conditions. Even though you've developed health conditions linked to smoking, you haven't been able to stop.
• You give up social activities. You may stop going to smoke-free restaurants or stop socializing with family or friends because you can't smoke in these situations.

When to see a doctor

Talk with your healthcare professional if you've tried to stop smoking but haven't been able to stop for good. Most people who smoke make many attempts to stop smoking before they're able to quit long-term.

A treatment plan that includes medicine and counseling with a tobacco treatment specialist can boost your chances of success. Ask your healthcare team for a treatment plan that works for you. Or ask where to get help with stopping smoking.

Causes

Nicotine is the chemical in tobacco that keeps you smoking tobacco. Nicotine reaches the brain within seconds of taking a puff. In the brain, nicotine increases the release of brain chemicals called neurotransmitters. These brain chemicals help control mood and behavior.

When you're using nicotine, the reward center in your brain releases a neurotransmitter called dopamine. Dopamine causes feelings of pleasure and improved mood.

The more you smoke, the more nicotine you need to feel good. Nicotine quickly becomes part of your daily routine and affects your habits and feelings.

Common situations that trigger the urge to smoke include:

• Drinking coffee or taking breaks at work.
• Talking on the phone.
• Drinking alcohol.
• Driving your car.
• Spending time with friends.

To overcome your nicotine dependence, you need to become aware of your triggers and make a plan for dealing with them.

Risk factors

Anyone who smokes or uses other forms of tobacco is at risk of becoming dependent. Factors that influence who is likely to use tobacco include:

• Age. Most people begin smoking during childhood or the teen years. The younger you are when you begin smoking, the greater the chance of nicotine dependence.
• Genetics. The genes passed from parents to children may play a role in the chance of a person becoming dependent on nicotine.
• Parents and peers. Children who grow up with parents who smoke are more likely to smoke. Children with friends who smoke also are more likely to try it.
• Depression or anxiety. Some people who have mental health conditions such as depression and anxiety try to get relief by smoking. But smoking cigarettes doesn't help relieve symptoms of these conditions.
• Substance use. People who use alcohol and illicit drugs are more likely to smoke.

Complications

Tobacco smoke has hundreds of harmful chemicals in it. At least 69 of those chemicals can cause cancer. Even "all-natural" or herbal cigarettes have harmful chemicals.

People who smoke cigarettes are much more likely to develop and die of certain diseases than are people who don't smoke. But smoking can cause many different health issues, including:

• Lung cancer and lung disease. Smoking is the leading cause of lung cancer deaths in countries such as the United States. Smoking also causes lung diseases such as emphysema and chronic bronchitis. Smoking makes asthma worse too.
• Other cancers. Smoking raises the risk of many types of cancer. Some examples include cancer of the mouth, throat, also called the pharynx, esophagus, larynx, bladder, pancreas, kidney and cervix and some types of leukemia. Overall, smoking causes 30% of all cancer deaths in the United States.
• Heart and blood vessel conditions. Smoking raises the risk of dying of heart and blood vessel diseases including heart attack and stroke. If you have a heart or blood vessel disease, smoking makes it worse.
• Diabetes. Smoking raises the risk of type 2 diabetes. If you have diabetes, smoking can lead to other health concerns such as kidney disease and eye conditions.
• Eye conditions. Smoking can raise the risk of serious eye issues such as cataracts and loss of eyesight from macular degeneration.
• Infertility. Smoking can make it harder to start a pregnancy.
• Complications during pregnancy. Pregnant people who smoke have a higher risk of miscarriages and preterm deliveries. Their babies have a higher risk of having medical conditions present at birth and lower birth weights.
• Cold, flu and other illnesses. People who smoke are more prone to respiratory infections such as colds, the flu and bronchitis.
• Tooth and gum disease. Smoking is linked to a higher risk of gum disease and tooth loss.

Smoking also poses health risks to those around you. Partners of people who smoke have a higher risk of lung cancer and heart disease compared with people who don't live with someone who smokes. Children whose parents smoke are more likely to get bronchitis, pneumonia, ear infections and colds. And if a child has asthma, secondhand smoke can make it worse.

Prevention

The best way to prevent nicotine dependence is to not start using tobacco.

The best way to keep children from smoking is to not smoke yourself. Children whose parents do not smoke or who successfully quit smoking are much less likely to take up smoking.