What It Is

Tobacco is one of the most widely-abused and addictive substances in the world. Although tobacco use appears to be on the decline in the U.S., researchers estimate that about 40 percent of Americans still smoke up to 20 cigarettes per day. Nicotine, the main addictive chemical in tobacco, causes a temporary 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—and stimulates the area of the brain associated with pleasure and reward. Like any other drug, repeated use of tobacco over time, whether in cigarette or chew-form, can cause a physical and psychological addiction.

Symptoms and Signs

A tobacco addiction is typically more difficult to hide than other substance abuse problems. While some individuals can smoke recreationally or occasionally, an addiction may be present if the person:

  • Cannot stop smoking or chewing, despite repeated attempts to quit
  • Experiences withdrawal symptoms at cessation of using, such as shaky hands, sweating, irritability, or rapid heart rate
  • Must smoke or chew after every meal or after long periods of time without using, like a movie or work meeting
  • Needs tobacco products to feel “normal” or turns to them during times of emotional stress or irritability
  • Gives up activities or wont attend social events where smoking or tobacco use is not allowed
  • Continues to smoke despite health problems

Treatment Options

A tobacco addiction can be one of the most difficult addictions to manage, despite the ease and accessibility of treatment options. Many users find that even after nicotine cravings have passed, the tactile pleasure and ritual associated with smoking are factors that can lead to relapse. However, there are several different treatment options for those battling a tobacco addiction:

The Patch

A nicotine replacement therapy (NRT), the nicotine patch 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 to help wean the body off of the substance gradually.

Nicotine Gum

Another form of NRT, nicotine gum can help users who need the oral fixation associated with smoking or chewing. It also delivers small doses of nicotine to help the user manage cravings.

Spray or Inhaler

Tobacco addiction can also be managed with nicotine nasal spray or a nicotine inhaler.


Some doctors recommend the use of medication to help with tobacco addictions. Certain antidepressants or antihypertensive drugs might be effective in helping the brain manage cravings.

Psychological and Behavioral Treatments

Some tobacco users have success with methods like hypnotherapy, cognitive-behavioral therapy, or neuro-linguistic programming (NLP).

In most cases, the process of treating tobacco addition will require a combination of different methods and will vary from one person to the next. Individuals should seek professional medical advice when considering NRT methods or medication therapies to ensure the safety and effectiveness of treatment.


With proper treatment and lifestyle changes, tobacco addiction can be managed. Unfortunately, users tend to have high relapse rates. The National Institute on Drug Abuse 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 variation of methods may be necessary if a user continues to 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.


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