Nicotine dependence is an addiction to tobacco products caused by the drug nicotine. Nicotine dependence — also referred to as tobacco dependence — means you can’t stop using the substance, even though it’s causing you harm. While it’s the nicotine in tobacco that causes nicotine dependence, the toxic effects come mainly from other substances in tobacco. Smokers have much higher rates of heart disease, stroke and cancer than do nonsmokers.
Nicotine produces physical and mood-altering effects in your brain that are temporarily pleasing. These effects make you want to use tobacco and lead to dependence. At the same time, stopping tobacco use causes withdrawal symptoms, including irritability and anxiety.
Cigarettes and other forms of tobacco—including cigars, pipe tobacco, snuff, and chewing tobacco—contain the addictive drug nicotine. Nicotine is readily absorbed into the bloodstream when a tobacco product is chewed, inhaled, or smoked.
Upon entering the bloodstream, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, respiration, and heart rate. Glucose is released into the blood while nicotine suppresses insulin output from the pancreas, which means that smokers have chronically elevated blood sugar levels.
Like cocaine, heroin, and marijuana, nicotine increases levels of the neurotransmitter dopamine, which affects the brain pathways that control reward and pleasure. For many tobacco users, long-term brain changes induced by continued nicotine exposure result in addiction—a condition of compulsive drug seeking and use, even in the face of negative consequences. Studies suggest that additional compounds in tobacco smoke, such as acetaldehyde, may enhance nicotine’s effects on the brain. A number of studies indicate that adolescents are especially vulnerable to these effects and may be more likely than adults to develop an addiction to tobacco
Foremost among the cancers caused by tobacco use is lung cancer. In fact, cigarette smoking has been linked to about 90 percent of all lung cancer cases, the number-one cancer killer of both men and women. Tobacco abuse is also associated with cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, ureter, and bladder.
Tobacco abuse harms every organ in the body. It has been conclusively linked to leukemia, cataracts, and pneumonia, and accounts for about one-third of all cancer deaths.
One out of every five people in the United States are addicted to cigarettes, or about 61 million people. Even more millions use smokeless tobacco and cigars.
The Centers for Disease Control lists tobacco use as the single most important preventable risk to human health. Tobacco is used by smoking or chewing it to get the pleasurable ,but ultimately addicting effects of nicotine. Tobacco use has been proven to cause heart disease, strokes, emphysema, chronic obstructive lung disease, and cancer of the lungs, bladder, throat, mouth, and pancreas.
Quitting smoking is difficult, but doing so immediately allows the body to cut the health risks associated with tobacco use. Some people can just go ‘cold turkey’ and quit immediately, but many more have success by using nicotine replacement products, such as gums, lozenges, or patches, which allow the person to gradually wean themselves off nicotine while avoiding the toxic byproducts of smoking and helping them resist the urge to smoke or chew.
If someone you know is smoking or using tobacco in another way, encourage him or her to talk to a parent, school guidance counselor, or other trusted adult. A national toll-free number, 1-800-QUIT-NOW (1-800-784-8669), can help people get the information they need to quit smoking. Callers to the number are routed to their state’s smoking cessation quitline or, in states that have not established quitlines, to one maintained by the National Cancer Institute. In addition, a Web site—www.smokefree.gov—from the U.S. Department of Health and Human Services offers online advice and downloadable information to make stopping easier.
The bottom line: People who quit smoking can have immediate health benefits. Believe it or not, within 24 hours of quitting, a person’s blood pressure decreases and they have less of a chance of having a heart attack. Over the long haul, quitting means less chance of stroke, lung and other cancers, and coronary heart disease, and more chance for a long and healthy life.
Smoking doesn’t just affect the person who smokes. People who do not smoke are exposed to “secondhand smoke,” which comes from both the exhaled smoke and from the smoke floating from the end of a cigarette, cigar, or pipe. Inhaling secondhand smoke increases a person’s risk of developing heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent. In fact, secondhand smoke is estimated to contribute to as many as 40,000 deaths related to heart disease and about 3,000 lung cancer deaths per year among people who do not smoke. Secondhand smoke also causes respiratory problems in people who do not smoke, like coughing, phlegm, and reduced lung function.
Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome, acute respiratory infections, ear problems, and more severe asthma. And, believe it or not, dropped cigarettes are the leading cause of residential fire fatalities, leading to more than 700 such deaths each year.
Each year, almost half a million Americans die from tobacco use. One of every five deaths in the United States is a result of tobacco use, making tobacco more lethal than all other addictive drugs combined.
Tobacco abuse harms every organ in the body. It has been conclusively linked to leukemia, cataracts, and pneumonia, and accounts for about one-third of all cancer deaths. The overall rates of death from cancer are twice as high among people who smoke as those who don’t, with people who smoke heavily having rates that are four times greater than those of people who don’t smoke.
People who smoke also lose some of their sense of smell and taste, don’t have the same stamina for exercise and sports they once did, and may smell of smoke. After smoking for a long time, people find that their skin ages faster and their teeth discolor or turn brown.
When nicotine addicts stop smoking they may suffer from restlessness, hunger, depression, headaches, and other uncomfortable feelings. These are called “withdrawal symptoms” because they happen when nicotine is withdrawn from the body.
The good news is that treatments for tobacco addiction do work. Although some people who smoke can quit without help, many people need help. Behavioral treatment programs help people learn about and change their behaviors using self-help materials, counselor-staffed telephone “quitlines,” and individual therapy. Over-the-counter medications, such as the nicotine patch, gum, inhalers, and lozenges, replace nicotine and relieve the symptoms of withdrawal.
Medications
It is important to know that nicotine replacement medicines can be safely used as a medication when taken properly. They have lower overall nicotine levels than tobacco and they have little abuse potential since they do not produce the pleasurable effects of tobacco products. They also don’t contain the carcinogens and gases found in tobacco smoke, making them a good treatment approach for quitting.
There are also prescription medications now available for smoking cessation, such as bupropion (Zyban) and varenicline tartrate (Chantix), that have been shown to help people quit. But research shows that the most effective way to quit smoking is to use both medications and behavioral treatment programs.
Therapies
Behavioral interventions play an integral role in smoking cessation treatment, either in conjunction with medication or alone. A variety of methods can assist smokers with quitting, ranging from self-help materials to individual cognitive-behavioral therapy. These interventions teach individuals to recognize high-risk smoking situations, develop alternative coping strategies, manage stress, improve problem solving skills, and increase social support. Research has also shown that the more therapy is tailored to a person’s situation, the greater the chances are for success.
Traditionally, behavioral approaches were developed and delivered through formal settings, such as smoking cessation clinics and community and public health settings. Over the past decade, however, researchers have been adapting these approaches for mail, telephone, and Internet formats, which can be more acceptable and accessible to smokers who are trying to quit.