An Overview of

Nicotine Dependence

Early death is a tragic loss and one of the most difficult events that can happen to a person and their family. Most early deaths are preventable, including the number one leading cause of premature deaths in the United States: Tobacco. In the United States, cigarette smoking causes about one in five deaths every year (approximately half a million people every year). In the 15th century, tobacco was thought to be a healthy product to ease pain and cure some diseases. Medicine slowly understood the magnitude of health problems caused by tobacco, but it is still popularly consumed worldwide. Today, the medical community clearly feels that even experimental use of tobacco can be risky, so it strongly advices everyone to stay off all tobacco products


The leaves of the tobacco plant are used to make cigars, cigarettes, smoking tobacco, and chewing tobacco. Nicotine is a chemical in the tobacco that causes addiction (dependency). Nicotine addiction and tobacco dependence refer to the same medical condition called nicotine dependence.


If you or someone you love is Nicotine dependent, you know that the symptoms are very strong. Common symptoms of Nicotine dependence include:

  • Being unable to stop smoking even after multiple attempts to quit.
  • Experiencing withdrawal symptoms like severe cravings, anxiety, irritability, restlessness, difficulty concentrating, frustration, or anger and sleeping difficulty.
  • Continue to smoke or use tobacco products despite having health problems and social problems.
  • Avoiding people, places, jobs or other parts of life that require smoke free living.


Because Nicotine is a short living drug, its effect goes down within 2-4 hours. This is why you may feel the need to smoke consistently throughout the day. In other words, your brain is asking you to provide nicotine consistently.  Due to this reason, after a prolonged sleep, the brain, which is deprived of nicotine, finds the first cigarette pleasurable. It is important to remember that the longer a person stays sober, the less intense the cravings become and this is why the initial days of quitting can be extremely challenging.


There is a certain region of the brain (called the limbic system) which is involved in pleasure and motivation. One of the most important brain chemical involved in the pleasure experience is the Dopamine chemical. When the smoke is inhaled, the chemical in the cigarette goes to the lungs; then to the blood, which is taken directly to the brain. In the brain, Nicotine stimulates Dopamine and makes the experience pleasurable. Continued smoking makes changes to the brain circuit making an individual addicted to nicotine. Eventually, continuous use of tobacco products changes the brain’s network and makes “tobacco” a necessary part of daily living.


Lifetime prevalence of nicotine dependence is nearly 25 percent of the U.S. Population. The highest risk for nicotine dependence occurred in the first 16 years after daily smoking began. Younger individuals between the ages of 15 to 24 are the least likely to smoke daily, but are also at a higher risk of dependence.

Types of Tobacco Product

There is no “safe” tobacco. The medical community does not endorse any tobacco products as a safer or healthier option. You may think that chewing tobacco, E-cigarettes, or other modified products are a healthy alternative. This is not true. All tobacco related products are dangerous to your health. Even smokeless tobacco causes cancer. The full health impact and risk of modified products like E-Cigarettes are unknown but Food and Drug Administration (FDA) has reported that a laboratory analysis of electronic cigarette samples has found that they do contain carcinogens (cancer causing chemicals) and toxic chemicals that are harmful.

Importance of Treatment

Although some tobacco users depend on Nicotine to help them deal with stress and anxiety, tobacco is a dangerous product to help with any problem. Self-medication is not the right way to manage even simple day-to-day issues. Please talk to a doctor or health provider to understand what is going on with your health in order to receive appropriate treatment for the problem.

Treatment and Drugs

There are several treatment options available to help you and your loved ones escape from Nicotine dependence. A combination of therapy and medication has proven to be most effective. Several medications have been FDA approved as safe and effective in treating nicotine dependence. They include Nicotine Replacement Therapy (NRT), Bupropion (Zyban, Wellbutrin) and Varenicline (Chantix). The success of these medications is increased when combined with therapy.

Risks of Smoking

According to Centers for Disease Control and Prevention, smoking is estimated to increase the risk of several life-threatening illnesses.

  • Smoking increases coronary heart disease and stroke by two to four times.
  • Men who smoke are 23 times more likely to develop lung cancer. Women are 13 times more likely.
  • Smoking increases the risk of death from chronic obstructive lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times; 90% of all deaths from chronic obstructive lung disease are caused by smoking.

Secondhand Smoke

Secondhand smoke is not safe, and can cause several additional risk factors. Even brief exposure to secondhand smoke can cause ill health effects primarily to children or at-risk adults including:

  • More frequent asthma attacks in children
  • Respiratory infections in children (i.e., bronchitis, pneumonia)
  • A greater risk for sudden infant death syndrome (SIDS)

In adults who have never smoked, it can cause heart disease and lung cancer.


Even a brief exposure to tobacco products can cause ill health. So stopping early is beneficial. Even people who have failed multiple attempts can increase their chances of staying abstinent with appropriate treatment intervention.


  • The History of Tobacco – – Accessed February 27, 2013. 
  • CDC – Fact Sheet – Tobacco-Related Mortality – Smoking & Tobacco Use – – Accessed February 27, 2013. 
  • Nicotine dependence – – – Accessed February 27, 2013. 
  • Safety Alerts for Human Medical Products  Electronic Cigarettes – – Accessed February 27, 2013. 
  • CDC – Fact Sheet – Secondhand Smoke Facts – Smoking & Tobacco Use – – Accessed February 27, 2013. 
  • CDC – Fact Sheet – Health Effects of Cigarette Smoking – Smoking & Tobacco Use – – Accessed February 27, 2013.
  • Nicotine dependence in the United States: prevalence, trends, and smoking persistence – – Accessed June 25, 2013