Tobacco and nicotine
Tobacco is one of the most widely abused substances in the world. It is highly addictive. The Centers for Disease Control and Prevention estimates that tobacco causes 6 million deaths per year. This makes tobacco the leading cause of preventable death.
Nicotine is the main addictive chemical in tobacco. It causes a rush of adrenaline when absorbed in the bloodstream or inhaled via cigarette smoke. Nicotine also triggers an increase in dopamine. This is sometimes referred to as the brain’s “happy” chemical.
Dopamine stimulates the area of the brain associated with pleasure and reward. Like any other drug, use of tobacco over time can cause a physical and psychological addiction. This is also true for smokeless forms of tobacco, such as snuff and chewing tobacco.
In 2011, about 70 percent of all adult smokers said they wanted to stop smoking.
A tobacco addiction is harder to hide than other addictions. This is largely because tobacco is legal, easily obtained, and can be consumed in public.
Some people can smoke socially or occasionally, but others become addicted. An addiction may be present if the person:
- cannot stop smoking or chewing, despite attempts to quit
- has withdrawal symptoms when they try to quit (shaky hands, sweating, irritability, or rapid heart rate)
- must smoke or chew after every meal or after long periods of time without using, such as after a movie or work meeting
- needs tobacco products to feel “normal” or turns to them during times of stress
- gives up activities or won’t attend events where smoking or tobacco use is not allowed
- continues to smoke despite health problems
There are many treatments available for tobacco addiction. However, this addiction can be very difficult to manage. Many users find that even after nicotine cravings have passed, the ritual of smoking can lead to a relapse.
There are several different treatment options for those battling a tobacco addiction:
The patch is known as a nicotine replacement therapy (NRT). It’s a small, bandage-like sticker that you apply to your arm or back. The patch delivers low levels of nicotine to the body. This helps gradually wean the body off it.
Another form of NRT, nicotine gum can help people who need the oral fixation of smoking or chewing. This is common, as people who are quitting smoking may have the urge to put something into their mouths. The gum also delivers small doses of nicotine to help the you manage cravings.
Spray or inhaler
Nicotine sprays and inhalers can help by giving low doses of nicotine without tobacco use. These are sold over the counter and are widely available. The spray is inhaled, sending nicotine into the lungs.
Some doctors recommend the use of medication to help with tobacco addictions. Certain antidepressants or high blood pressure drugs might be able to help manage cravings. One medication that’s commonly used is varenicline (Chantix). Some doctors prescribe bupropion (Wellbutrin). This is an antidepressant that’s used off-label for smoking cessation because it can decrease your desire to smoke.
Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that has not been approved. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care. Learn more about off-label drug use here.
Psychological and behavioral treatments
Some people who use tobacco have success with methods such as:
- cognitive-behavioral therapy
- neuro-linguistic programming
These methods help the user change their thoughts about addiction. They work to alter feelings or behaviors your brain associates with tobacco use.
Treatment for a tobacco addition requires a combination of methods. Keep in mind that what works for one person won’t necessarily work for another. You should talk to you doctor about what treatments you should try.
Tobacco addiction can be managed with proper treatment. Addiction to tobacco is similar to other drug addictions in that it’s never really cured. In other words, it is something that you will have to deal with for the rest of your life.
Tobacco users tend to have high relapse rates. It’s estimated that about 75 percent of people who quit smoking relapse within the first six months. A longer treatment period or change in approach may prevent a future relapse.
Research has also shown that altering lifestyle habits, such as avoiding situations where there will be other tobacco users or implementing a positive behavior (like exercising) when cravings start can help improve chances for recovery.
How to cope with a smoking relapse »
A tobacco addiction can have fatal consequences without treatment. Tobacco use can cause:
- cancers of the lungs, throat, and mouth
- heart disease
- chronic lung diseases such as emphysema and bronchitis
Any one of these conditions can be fatal. Quitting smoking or tobacco use can significantly reduce the risk of death due to these diseases. Even once the disease has been diagnosed, stopping tobacco use can improve treatment efforts.
Many resources are available to individuals with tobacco addiction. The following organizations can provide further information about tobacco addiction and possible treatment options: