Nicotine & Addiction

Nicotine is one of the more than 7,000 chemicals contained in tobacco products like cigarettes and cigars. It is the primary addictive component in these products. 

Nicotine is responsible for 480,000 deaths each year in the United States due to its reinforcing effects. Nicotine does not create the same high as other illicit drug abuse does, but it does impact the brain’s reward system, and this reinforces repeated use, leading to addiction. 

There are more than 1 billion tobacco users in the world. Nicotine addiction leads to half of all tobacco users’ deaths. 

Nicotine addiction is treatable. There are a number of approaches and treatments that can help you stop smoking or using nicotine and minimize some of the long-term effects of tobacco use.

Key Facts About Nicotine

What Is Nicotine?

Nicotine is the primary addictive component and one of the toxic chemicals found in tobacco products, including cigarettes and e-cigarettes. All tobacco products contain nicotine. 

Nicotine is a naturally occurring substance found in the tobacco plant. In low doses, nicotine has stimulant effects. In higher doses, it can block the action of nerve and skeletal muscle cells. 

Nicotine is highly addictive due to its reinforcing properties.

What Are the Common Side Effects of Nicotine?

In the short term, nicotine can have the following side effects:

• Increased heart rate and blood pressure
• Sweating
• Nausea and stomach upset
• Diarrhea
• Loss of appetite
• Increased alertness and heightened mood
• Heightened adrenaline
• Shallow breathing

Nicotine is addictive, which can cause you to continue using tobacco products and smoking even if you want to quit. 

The National Institute on Drug Abuse (NIDA) warns that smoking cigarettes can damage nearly all of the organs in your body. Smoking is the leading cause of cancer, and cancer death rates are twice as high for smokers than nonsmokers. 

Side effects of smoking long term can include an increased risk for the following:

• Lung cancer
• Cancers of the mouth, larynx, pharynx, esophagus, stomach, bladder, pancreas, kidney, colorectal, and cervix
• Lung diseases, such as emphysema, chronic bronchitis, and exacerbated asthma symptoms
• Chronic obstructive pulmonary disease (COPD)
• Heart disease
• Stroke
• Heart attack
• Vascular disease
• Aneurysm
• Type 2 diabetes
• Decreased immune function
• Inflammation
• Rheumatoid arthritis
• Coronary heart disease

Nicotine on its own can also have a host of negative long-term side effects as well. Studies have shown nicotine use can cause a decreased immune response, negative impacts on reproductive health, and higher risks for gastrointestinal, cardiovascular, and respiratory disorders. It can also cause damage to the cells and mechanisms that can lead to cancer and resistance to chemo.

What Are the Different Ways Users Consume Nicotine?

Nicotine is contained in all tobacco products, and it is commonly consumed through inhalation. This can include cigarette and cigar smoking as well as vaping. 

Cigarette smoking is the most common use of tobacco.  There are smokeless tobacco products, which include snuff and chewing tobacco. 

Combustible tobacco products, such as cigarettes, contain thousands of chemicals (many of them toxic). This makes them extremely dangerous to the user and those around them. Secondhand smoke can cause health issues to those around smokers.

The use of e-cigarettes is on the rise. While they do contain fewer chemicals than traditional cigarettes, e-cigarettes can be just as hazardous and addictive.

E-cigarettes have many additives, including specialty flavors. They have the potential to be even more addictive than traditional cigarettes, as users can buy extra-strength cartridges that deliver a higher concentration of nicotine at a time. The voltage of an e-cigarette can also be increased to deliver a bigger hit.

There are also nicotine-containing smoking cessation products, such as patches, lozenges, gum, spray, inhalers, and pills. Some of these products are available over the counter, while others require a doctor’s prescription. These products typically contain a lower dose of nicotine and/or use a time-release function since the goal is to help the user quit smoking.

How Addictive Is Nicotine?

Nicotine is one of the most addictive substances in the world. More than two-thirds of people who start smoking will become dependent in their lifetimes. 

Since nicotine is a reinforcing substance, the more you use it, the more you train your brain to “need” it. The reward center in your brain can actually be rewired to tell you that you need a cigarette. 

Activities that you do while smoking or using nicotine can become less enjoyable when you do not have nicotine. This can mean that you are less motivated to engage in them without nicotine. 

Nicotine use leads to physical dependence, which can cause intense cravings and uncomfortable withdrawal symptoms when the chemical is not active in your body. It can be extremely difficult to quit smoking or using nicotine on your own without a quit-smoking aid or professional intervention.

What Are the Causes of Nicotine Addiction?

Anyone who uses nicotine can become addicted to it. People with friends or family members who smoke are more likely to do so themselves. 

The younger you are when you start using nicotine, the more likely you are to get addicted to it. This is because nicotine can rewire parts of the brain, creating drug dependence and making it harder to stop using it. When this happens at a younger age, the changes can be more extensive.

Among adult smokers, 9 out of 10 started smoking before the age of 18. That being said, regular use of tobacco at any age can lead to nicotine addiction.

How Does Nicotine Impact the Mind & Body?

Nicotine has a wide range of negative effects on the brain and body.

Nicotine impacts levels of dopamine in the brain, and dopamine is involved in reward processing and feelings of pleasure. When you use nicotine, the brain is signaled to release more dopamine, which makes you happy and causes you to want to repeat this behavior. 

Since nicotine is often used while doing other activities, such as driving, the brain’s reward system can begin to see these activities as connected and pleasurable. This causes you to crave nicotine while driving to feel the same levels of pleasure. While nicotine does not create the same euphoric experience as other drugs like cocaine or heroin can, it does have highly reinforcing effects. 

When you smoke tobacco products, the nicotine quickly reaches the brain. It is absorbed through the lungs into the blood where it is distributed throughout the body.

In the short term, nicotine can have stimulating effects, leading to better focus, attention, memory, and concentration. It can speed up functions of the central nervous system. 

Higher doses of nicotine interfere with nerve signals and can block pain sensations and relieve muscle tension. Over time, nicotine can cause problems with most bodily organs, increasing the risk for several types of cancer, damaging cells, and causing respiratory and gastrointestinal issues. It also decreases the function of your immune system, opening you up to infections, illnesses, and diseases. 

What Are the Signs & Symptoms of Nicotine Abuse & Addiction?

Addiction is the compulsive and regular use of a substance despite its negative effects and harmful consequences. Nicotine addiction is often characterized by a strong desire to quit smoking or using nicotine, numerous attempts to do so, and an inability to stop successfully. 

Regular nicotine use leads to drug tolerance, so you will need more nicotine to feel its effects. If you are a smoker, this can mean you will need to smoke more often, or more at a time, to feel the effects of the cigarette.

Regular use of nicotine creates dependence, which can mean that you will have withdrawal symptoms and cravings when the substance processes out of your brain and body. You can lose interest in activities or things you used to enjoy before, and your thoughts can become consumed with your next “fix,” using nicotine, and recovering from it. You will continue to use nicotine despite knowing that doing so is going to have negative consequences for your life. 

Additional signs of nicotine abuse and addiction can include the following:

• Social withdrawal and isolation
• Weight loss
• Mood swings 
• Personality shift
• Drop in grades at school or production at work
• Repeated absences from work or school
• Changes in social circle
• Inconsistency with fulfilling obligations at work, school, or home

Mixing Nicotine With Other Substances 

Nicotine is one of the most commonly combined substances with other drugs or alcohol. Using nicotine in conjunction with other drugs or alcohol increases the potential side effects of each substance. 

Nicotine can reinforce additional drug-using behaviors. For instance, nicotine use can increase concurrent alcohol consumption. 

Nicotine is often referred to as a gateway drug as well, opening the door to abuse of other substances. This could be related to the chemical and structural changes nicotine use can make in the brain.

For example, using nicotine in conjunction with other stimulant drugs like cocaine or meth can increase its stimulant effects, while using nicotine with opioids can increase drug consumption as well as the pleasure effects of smoking. When combined with marijuana, nicotine can increase the effects of THC, raising your heart rate and leading to an elevated and prolonged high. 

These interactions can make the substances’ effects more intense. Mixing substances can also increase drug dependence and exacerbate withdrawal symptoms from each substance.

What Are the Withdrawal Symptoms From Nicotine?

When you stop using nicotine after becoming dependent on it, you can experience withdrawal symptoms. The Centers for Disease Control and Prevention (CDC) reports that nicotine withdrawal can be uncomfortable, but it is not life-threatening. 

Some of the symptoms of withdrawal from nicotine can include the following:

• Strong cravings for nicotine
• Irritability
• Problems concentrating
• Trouble sleeping
• Feeling restless and on edge
• Hunger and weight gain
• Low moods, anxiety, and depression

Treatment Options for Addiction to Nicotine

It is possible to quit smoking for good. There are several methods and programs available to treat nicotine addiction and help you to quit smoking, including medications and therapeutic interventions. 

NIDA publishes that people who use both behavioral therapies and FDA-approved smoking cessation medications quit smoking at higher rates than those who do not. Resources to help you quit smoking or using nicotine can range from smartphone apps and online treatment options to pharmaceutical products and structured treatment programs. 

Quit-smoking products containing low doses of nicotine can be helpful to taper off the substance, and they are often effective when used in conjunction with behavioral therapies.

 Nicotine replacement medications include bupropion and varenicline, which also work well when combined with cognitive behavioral therapy (CBT), motivational interviewing, or motivational enhancement therapies.

Social media and text support as well as in-person support groups and help lines can be great resources for quitting smoking and nicotine products. Treatment for nicotine addiction is generally provided on an as-needed and outpatient basis unless it co-occurs with another mental illness or co-occurring substance use disorder. 

Treatment programs aim to build coping skills and mechanisms to manage nicotine cravings while helping to regulate moods and emotions and modulate stress. 

Nicotine addiction is treatable. While quitting can be tough, with the right help, you can leave smoking or any form of nicotine use in your past. The sooner you stop using the substance, the sooner your body and brain can start to heal.