Nicotine Addiction

(Tobacco Use Disorder; Smoking Addiction)




Nicotine addiction is when a person becomes dependent on nicotine. Being dependent means there is a physical change in how your body reacts to a substance. Your body will also have a reaction when you stop using the substance. Nicotine can be found in tobacco products such as cigarettes, snuff, chewing tobacco, cigars, or pipes.

Tobacco use is also associated with several serious health conditions, such as:

Throat Cancer

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Nicotine addition can be treated, often with a combination of therapies.



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

Risk Factors

Anyone who uses nicotine products can become addicted to the substance.

The risk may increased with:

  • Family history or exposure to smoking
  • Exposure to smoking in movies
  • Depression
  • Victims of bullying



Symptoms develop when nicotine is not being used, also known as withdrawal. Symptoms of withdrawal include:

  • Irritability
  • Craving
  • Nervousness
  • Headache
  • Thinking and attention problems
  • Trouble sleeping
  • Increased appetite



Your doctor will ask about your symptoms, medical and smoking history. A physical exam will be done.

Breathing tests may also be done to see how well your lungs are working.

Your doctor may monitor your nicotine use by checking a cotinine level in your saliva or blood.



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:

  • Nicotine gum
  • Lozenges
  • Nasal sprays
  • Patches
  • Inhalers

The chance of abusing these products is low since NRT does not create “feel good” feelings.

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 that can be puffed. Some smokers have used e-cigarettes to help them quit. Right now, there is conflicting evidence on whether or not this is the case.

However, one promising review of two studies showed the six-month quit rate for e-cigarettes was higher than a non-nicotine placebo. In one of the studies, e-cigarettes were as effective as nicotine patches after six months. Currently, the US Food and Drug Administration (FDA), along with several major anti-smoking organizations, have determined that there has not been enough research on e-cigarettes to make any claims about their safety or effectiveness in helping people quit smoking.

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


Some antidepressants and nicotine partial agonists may help you quit. Other medications may help ease withdrawal symptoms or block the effects of nicotine if you start smoking again.



The best prevention is to never use tobacco products. Try to avoid places where people are smoking.


American Cancer Society

American Lung Association Freedom From Smoking

Smokefree Telephone: 1-800-QUITNOW


Canadian Cancer Society

The Lung Association


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Last reviewed January 2015 by Michael Woods, MD
Last Updated: 3/19/2015

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