Nicotine addiction: Questions and Answers

What is Nicotine?

Nicotine is one of the many poisonous chemicals found in tobacco smoke and smokeless tobacco products. It is the main chemical ingredient in tobacco that adversely affects the brain and many body functions. Nicotine is considered one of the most addictive drugs, even more addictive than cocaine, amphetamine and such “hard” drugs as heroin.

How is Nicotine Absorbed?

When you inhale tobacco smoke, the nicotine in the smoke is absorbed rapidly from your lungs into your blood stream and distributed throughout your body. Peak nicotine levels in the brain are reached within seconds of puffing on a cigarette. The smoker is able to control the exact amount of nicotine delivered to the brain by how often during the day the smoker lights up a cigarette. Nicotine and other toxic chemicals in tobacco also can be absorbed into the body through the skin and the tissue lining the nose and the mouth, but at a much slower rate than from the lungs.

What is Nicotine Addiction?

It is now generally recognized that the “need” to smoke cigarettes or use smokeless tobacco products like snuff and chewing tobacco results from addiction to the nicotine. You smoke because you are addicted to the nicotine in the smoke. Nicotine addiction makes it very difficult to give up smoking. Addiction starts very early in the use of tobacco, no matter if you smoke a cigarette, cigar, pipe or chew tobacco. Nicotine addiction happens so fast, sometimes after only a few cigarettes, that you don’t realize you are addicted until it is too late. The craving of addiction is so serious that you may have to try many times before you are able completely to stop smoking.

How Does Nicotine Cause Addiction?

Nicotine acts by releasing the brain dopamine, a neurochemical substance involved, amongst other activities, in the addiction process in which dopamine, in turn, stimulates a specialized “reward” centre in the brain that is responsible for the “feeling of pleasure”. Thus, nicotine in cigarette smoke, by increasing the level of dopamine in the brain’s reward and pleasure pathways, increases the desire to smoke. Nicotine also influences the levels and activity of other neurochemicals involved with mood, learning, memory, dopamine regulation and the excitatory response to nicotine.

Who Becomes Addicted?

Smokers usually start at a young age because of peer pressure, parental rebellion or mimicking the behaviour of adults (self-image appeal). Other risk factors leading to smoking and addiction include low self-esteem, family problems, low economic status, depression or having been victim to abuse. Nearly 50% of high school students smoke and the percentage of adult women who smoke is approaching that of men. While recent studies indicate that genetic factors play a role in addiction, all smokers can be considered nicotine addicts.

What are the Symptoms of Nicotine Addiction?

Craving (for a cigarette or other tobacco products) is one of the main symptoms of nicotine addiction. The body’s (brain’s) “need” for nicotine is satisfied by continued and regulated use of tobacco. However, when deprived of cigarettes (as when you try to stop smoking), brain nicotine levels rapidly decrease, lowering dopamine brain levels thereby decreasing the desired “feeling of pleasure”. In addition to the intense craving when you stop smoking, you also experience other nicotine withdrawal symptoms that include intense craving (for a cigarette), depression or sadness, irritability, anxiety, restlessness, insomnia, inability to concentrate and increased appetite. The return to smoking (nicotine) immediately restores the “feeling of pleasure” you crave and also terminates the very unpleasant withdrawal symptoms, both certain signs of nicotine addiction. The intensity of both the craving and other withdrawal symptoms is considered the major obstacle to successful smoking cessation.

What are the Other Effects of Nicotine?

Continued intake of nicotine results in the development of tolerance to some effects of nicotine. Nicotine increases the blood pressure, pulse rate and hand tremor even in a chronic smoker, particularly after smoking the very first cigarette of the day. However, the chronic smoker does not experience the dizziness, nausea and vomiting that nicotine induces in a non-smoker who smokes one or two cigarettes. The chronic smoker has developed a tolerance to these acute effects of nicotine. Chronic smokers overall find many nicotine effects to be pleasant whilst non-smokers report the effects to be mostly unpleasant.

How Does Nicotine Addiction Affect Your Health and Life Span?

A chronic smoker is addicted to nicotine and thus must continue to smoke to maintain that addiction. Smokers have a 30-50% higher risk of getting life-threatening diseases, particularly lung cancer, heart disease and chronic obstructive pulmonary disease. Smoking also significantly increases the risk for developing many other types of cancer and other disease conditions, which result in the loss of 12 healthy years and reduce life span by 8 years. Each cigarette smoked costs the smoker 8 minutes of life. Half of all smokers will die of some disease related to smoking. Thus, smoking is considered to be the most preventable disease causing premature death in the world.

What are the Disadvantages to Quitting Smoking?

Quitting smoking means wrestling with the many problems of withdrawing from nicotine addiction. You may find yourself preoccupied with your smoking problem. It may be difficult for you to concentrate as you feel anxious or depressed trying to battle the host of nicotine withdrawal symptoms, the intensity of which varies from smoker to smoker. Some smokers develop more common cold-like symptoms as coughs, sore throats and sneezes, probably another manifestation of nicotine withdrawal. Most people complain about the increase in appetite and weight gain. Perhaps the biggest problem is the intense craving that leads to a return to smoking.

What Other Treatments are Available to Help People Stop Smoking

Approved treatments that provide some help in getting you to stop smoking include a), nicotine replacement therapy in the form of nicotine gum, transdermal patches, nasal spray or nasal inhaler; b), non-nicotine based therapy as the antidepressant bupropion (Zyban). The nicotine replacement products prevent the nicotine withdrawal symptoms by maintaining your addiction to nicotine. The antidepressant drug Zyban may cause adverse effects, the most serious of which is seizures. More common side effects include dry mouth, insomnia, skin rash, itching and hypersensitivity.
Counseling and/or some support group intervention also can help you live your life as a may help you stop smoking. Non-smoker and an exercise program also may help in the smoke cessation process.
Treatments considered ineffective or that may be harmful include acupuncture, hypnosis, anti-anxiety drugs, herbal concoctions and other alternative approaches.