Definition
Dependence is a physical change in how your body reacts to a substance. In this case, nicotine. Your body will also have a reaction when you stop using it. Nicotine can be found in tobacco products such as:
- Cigarettes
- Snuff
- Chewing tobacco
- Cigars
- Pipes

Causes
Nicotine acts on the brain's chemistry. It creates feelings of pleasure. However, the effects go away within a few minutes. Users will need to continue using nicotine to keep the good feelings going. This cycle can lead to addiction.
Risk Factors
Use of nicotine products is the main risk factor.
The risk of addiction increases with:
- Family history or exposure to smoking
- Depression
- Victims of bullying
Symptoms
Symptoms only develop when nicotine is not being used. This is known as withdrawal. Symptoms of withdrawal include:
- Irritability
- Craving
- Nervousness
- Headache
- Thinking and attention problems
- Trouble sleeping
- Increased appetite
Tobacco use is also associated with several serious health conditions such as:
- Chronic obstructive pulmonary disease (COPD)
- Chronic bronchitis
- Emphysema
- Cancers of the larynx (voice box), oral cavity, throat, esophagus, lung, colon, and others
- Coronary artery disease (CAD)
- Stroke
- Increased risk of stillbirth, infant death, low birth weight, miscarriage, premature delivery, or sudden infant death syndrome
- Alcohol or drug use disorders
- Depression, bipolar disorder, anxiety, personality disorders, and attention deficit hyperactivity disorder
- Shorter life span
- Complications during surgery and recovery
Diagnosis
Your doctor will ask about your symptoms, medical, and smoking history. A physical exam will be done.
A blood test can check cotinine level in your saliva or blood. This will show changes in nicotine use. The doctor may use it to check your progress.
Treatment
Talk with your doctor about the best treatment plan for you. Treatment may involve one or more therapies. Options include:
Nicotine Replacement Therapy (NRT)
NRT relieves withdrawal symptoms. NRT products include:
- Nicotine gum
- Lozenges
- Nasal sprays
- Patches
- Inhalers
The chance of becoming dependent on these products is low. NRT does not create the same "feel good" feelings as nicotine.
NRT may help you to:
- Avoid smoking
- Reduce the amount of tobacco you use
- Quit and stay smoke-free
Electronic Cigarettes
Electronic cigarettes (e-cigarettes) turn liquid nicotine into a vapor. There is conflicting evidence on whether or not they may help you quit. In addition, the long-term effects of e-cigarette use are not known.
Behavioral Therapy
Behavioral therapies include:
- Counseling
- Group behavior therapy
- Telephone quit lines, cell phone programs, and text messaging programs
- Internet and computer-based programs
- Self-help classes and manuals
- Cognitive-behavioral therapy
Medication
Medicine that may help you quit include:
- Antidepressants
- Nicotine partial agonists—mimics effect of nicotine to ease withdrawal
Other medicine may help ease withdrawal symptoms. A third type may be used if you start smoking again. It blocks the pleasure feeling when you use nicotine.
Prevention
The best prevention is to never use tobacco products. Try to avoid places where people are smoking as well.
Revision Information
- Reviewer: EBSCO Medical Review Board Adrian Preda, MD
- Review Date: 03/2018 -
- Update Date: 07/12/2018 -