• Nicotine Addiction

    (Tobacco Use Disorder; Smoking Addiction)

    Definition

    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
    Throat cancer
    Copyright © Nucleus Medical Media, Inc.
    Nicotine addition can be treated, often with a combination of therapies.

    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

    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

    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

    Diagnosis

    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.

    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:
    • 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

    Medication

    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.

    Prevention

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

    RESOURCES

    American Cancer Society http://www.cancer.org

    American Lung AssociationFreedom From Smoking http://www.ffsonline.org

    SmokefreeTelephone: 1-800-QUITNOW http://www.smokefree.gov

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca

    The Lung Association http://www.lung.ca

    References

    Kenfield SA, Stampfer MJ, Rosner BA, Colditz GA. Smoking and smoking cessation in relation to mortality in women. JAMA. 2008;299:2037-2047.

    Questions about smoking, tobacco, and health. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/002974-pdf.pdf. Updated January 17, 2013. Accessed March 11, 2013.

    Tobacco addiction. National Institute on Drug Abuse website. Available at: http://www.drugabuse.gov/publications/research-reports/tobacco/letter-director. Updated July 12, 2012. Accessed March 11, 2013..

    Tobacco use disorder. DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 16, 2013. Accessed February 24, 2014.

    Tobacco use disorder. PEMSoft at EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 19, 2013. Accessed March 11, 2013.

    2/27/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Etter JF, Stapleton JA. Nicotine replacement therapy for long-term smoking cessation: A meta-analysis. Tob Control. 2006;15(4):280-285.

    9/24/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: LF Stead, T Lancaster. Interventions to reduce harm from continued tobacco use. Cochrane Database of Syst Rev. 2007;(3):CD005231.

    3/25/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Parkes G, Greenhalgh T, et al. Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial. BMJ. 2008;336:598-600.

    10/14/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Shiffman S, Ferguson SG. Nicotine patch therapy prior to quitting smoking: a meta-analysis. Addiction. 2008;103:557-563.

    12/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Eisenberg MJ, Filion KB, et al. Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials. CMAJ. 2008;179:135-144.

    2/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Cochran CJ, Gallicchio L, et al. Cigarette smoking, androgen levels, and hot flushes in midlife women. Obstet Gynecol. 2008;112:1037-1044.

    2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2009;(1):CD001007.

    7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Myung SK, McDonnell DD, et al. Effects of web- and computer-based smoking cessation programs: Meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169:929-937.

    7/21/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Lancaster T, Stead L. Self-help interventions for smoking cessation. Cochrane Database Syst Rev. 2009;(2):CD001118.

    11/13/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Piper ME, Smith SS, et al. A randomized placebo-controlled clinical trial of 5 smoking cessation pharmacotherapies. Arch Gen Psychiatry. 2009;66(11):1253-1262.

    12/21/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Whittaker R, Borland R, et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2009;(4):CD006611.

    11/30/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Rusanen M, Kivipelto M, et al. Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. Arch Intern Med. 2011;171(4):333-339.

    4/29/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: A systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

    6/24/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Leonardi-Bee J, Britton J, et al. Secondhand smoke and adverse fetal outcomes in nonsmoking pregnant women: a meta-analysis. Pediatrics. 2011;127(4):734-741.

    9/9/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Bullen C, Howe C, et al. Electronic cigarettes for smoking cessation: A randomised controlled trial. Lancet. 2013;382(9905):1629-1637.

    3/19/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: McRobbie H, Bullen C, et al. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev. 2014;12:CD010216.

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