Addiction: Tobacco & Nicotine

Written by Mara Tyler | Published on July 3, 2014
Medically Reviewed by George Krucik, MD, MBA on July 3, 2014

Addiction: Tobacco & Nicotine

Tobacco is one of the most widely abused substances in the world. It is highly addictive. Although tobacco use appears to be on the decline in the United States, the Centers for Disease Control and Prevention (CDC) estimates that nearly 20 percent of adults still smoke. This is despite nearly 70 percent of smokers wanting to quit.

Nicotine, the main addictive chemical in tobacco, causes a rush of adrenaline when absorbed in the bloodstream or inhaled via cigarette smoke. Nicotine also triggers an increase in dopamine—the brain’s “happy” chemical. This stimulates the area of the brain associated with pleasure and reward. Like any other drug, use of tobacco over time can cause a physical and psychological addiction. This is also true for smokeless forms of tobacco such as snuff and chewing tobacco.

What Is the Prevalence of Tobacco & Nicotine Addiction?

Federal and state governments spend billions fighting tobacco addiction each year. This is because smoking costs the country billions every year. The CDC reports that cigarette smoking costs more than $193 billion annually in lost productivity and health care costs.

While tobacco use has declined in recent decades, it is still one of the most common addictions. The CDC estimates that about 45.3 million adults were smokers in 2010. This accounts for 19.3 percent of adults.

According to the CDC, approximately 3.5 percent of the U.S. adult population uses smokeless tobacco, which poses similarly dangerous health risks.

What Are Symptoms of Tobacco & Nicotine Addiction?

A tobacco addiction is harder to hide than other addictions. This is largely because tobacco is legal, easily obtained, and can be consumed in public. Also, the smell of the addiction follows the smoker in their hair and clothing.

While some individuals can smoke socially or occasionally, others become addicted. An addiction may be present if the person:

  • cannot stop smoking or chewing, despite attempts to quit
  • has withdrawal symptoms when he or she tries to quit ( shaky hands, sweating, irritability, or rapid heart rate
  • must smoke or chew after every meal or after long periods of time without using, like after a movie or work meeting
  • needs tobacco products to feel “normal” or turns to them during times of stress
  • gives up activities or won’t attend events where smoking or tobacco use is not allowed
  • continues to smoke despite health problems

What Are Treatments for Tobacco & Nicotine Addiction?

A tobacco addiction can be one of the most difficult addictions to manage, despite the wealth of available treatment options. Many users find that even after nicotine cravings have passed, the ritual of smoking can lead to a relapse.

There are several different treatment options for those battling a tobacco addiction.

The Patch

The patch is known as a nicotine replacement therapy (NRT). It is a small, bandage-like sticker that the user applies to the arm or back. The patch delivers low levels of nicotine to the body. This helps wean the body gradually.

Nicotine Gum

Another form of NRT, nicotine gum can help users who need the oral fixation of smoking or chewing. This is common, as the addict may have the urge to put something into his or her mouth. The gum also delivers small doses of nicotine to help the user manage cravings.

Spray or Inhaler

Nicotine sprays and inhalers can also help by giving low doses of nicotine without tobacco use. These are sold over the counter and are widely available. The spray is inhaled, sending nicotine into the lungs.

Medications

Some doctors recommend the use of medication to help with tobacco addictions. Certain antidepressants or high blood pressure drugs might be able to help manage cravings.

Psychological and Behavioral Treatments

Some tobacco users have success with methods like hypnotherapy, cognitive-behavioral therapy, or neuro-linguistic programming (NLP). These help the user change their thoughts about addiction and work to alter feelings or behaviors the brain associates with tobacco use.

In most cases, treatment for tobacco addition requires a combination of methods and will vary from one person to the next. Individuals should talk to their doctor when considering NRT methods or medication to ensure the safety and effectiveness of treatment. Your doctor may also have good treatment advice.

What Is the Outlook for Tobacco & Nicotine Addiction?

With proper treatment, tobacco addiction can be managed. Like other drugs, addiction to tobacco is never really “cured.” In other words, it is something that a person may battle for the rest of his or her life.

Tobacco users tend to have high relapse rates. The National Institute on Drug Abuse (NIDA) estimates that about three-quarters of individuals who try to end chronic tobacco use end up relapsing within six months. A longer treatment period or change in approach may prevent a future relapse. Research has also shown that altering lifestyle habits, such as avoiding situations where there will be other tobacco users or implementing a positive behavior (like exercising) when cravings start can help improve chances for recovery.

Without treatment, tobacco addiction can have fatal consequences. According to the CDC, every year in the United States, one in five of all deaths are related to tobacco use. Tobacco use can cause:

Any one of these conditions can be fatal. Quitting smoking or tobacco use can significantly reduce the risk of death due to these diseases. Even once the disease has been diagnosed, stopping tobacco use can improve treatment efforts.

What Are Resources for Tobacco & Nicotine Addiction?

Many resources are available to individuals with tobacco addiction. The following organizations can provide further information about tobacco addiction and possible treatment options:

  • Nicotine Anonymous
  • National Institute on Drug Abuse
  • Substance Abuse and Mental Health Services Administration
  • DrugFree.org
  • Smokefree.gov
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