Nicotine Abuse and Dependence

What is nicotine abuse and dependence?

Nicotine is a chemical in cigarettes, pipe tobacco, cigars, and smokeless (chewing) tobacco. It is both a stimulant, which increases energy, and a sedative, which calms you down.

Abuse and dependence are patterns of using nicotine that lead to serious personal, family and health problems. Abuse is when you keep using nicotine even though it causes problems.

If you continue to abuse nicotine, you can become dependent. When you are dependent on nicotine, you:

  • Need to use more and more nicotine, or use it more often to get the same effects
  • Lose control, which means you keep smoking even though you know that it is harmful to you or others, or you can’t stop smoking when you try
  • Crave nicotine so much that you spend a lot of time and energy getting nicotine, using nicotine, and getting over the effects
  • Have withdrawal symptoms when you stop smoking

Dependence is also called addiction. Nicotine is very addicting and smoking cigarettes is dangerous to you and the people who are around you when you smoke. The chemicals in cigarettes cause many types of cancer, heart, and lung problems. Secondhand smoke causes many health problems for people who don’t smoke.

What is the cause?

The brain makes chemicals that affect thoughts, emotions, and actions. Nicotine changes the balance of these chemicals in your brain. When you use nicotine regularly, your brain starts to get used to it. As a result you don’t feel right unless you use nicotine. When you stop using nicotine suddenly, the balance of chemicals in your brain changes, which causes the symptoms of withdrawal.

You may enjoy the ritual of handling, lighting, and smoking cigarettes. If you try to quit, not having these rituals to follow may make withdrawal symptoms and cravings worse.

You have a higher risk of becoming dependent on nicotine if you:

  • Have a family history of tobacco, drug, or alcohol abuse
  • Have abused tobacco, alcohol, or drugs in the past
  • Are easily frustrated, have trouble dealing with stress, or feel like you aren’t good enough
  • Are regularly around people who use tobacco, alcohol, or drugs
  • Have a mental health problem

What are the symptoms?

The symptoms of nicotine abuse or dependence depend on how much and how often you use nicotine. The symptoms can be mild to severe, such as:

  • Fast heartbeat, fast breathing
  • Symptoms of new or worse health problems caused by long-term nicotine use, such as cancer, high blood pressure, heart, or lung problems

The symptoms of nicotine withdrawal can be mild to severe. You may have some of these symptoms when you stop using nicotine:

  • Restlessness and irritability
  • Trouble paying attention
  • Trouble sleeping
  • Increased appetite
  • Cravings for tobacco

The symptoms of withdrawal may be very strong, especially during the first 72 hours after you stop using tobacco.

How is it diagnosed?

Your healthcare provider will ask how much and how often you smoke. Be honest about your smoking. Your provider needs this information to give you the right treatment. He will also ask about your symptoms and medical history and examine you. You may have blood or urine tests.

How is it treated?

Nicotine abuse and dependence can be treated. You must stop all use of tobacco, including smoking cigarettes, cigars, or pipes, and chewing tobacco.

Your healthcare provider can prescribe nicotine replacements that can almost double your chances of quitting for good. They include nicotine inhalers, lozenges, nasal sprays, and patches. Nicotine replacement therapy lets you slowly decrease the amount of nicotine in your system over time. Using a nicotine replacement as you quit tobacco may reduce cravings and ease physical symptoms. The dose of nicotine is slowly decreased over several weeks or months.

Electronic cigarettes, also called e-cigs, are battery-operated devices that look like a cigarette or cigar. They make a smokeless vapor that the user inhales. The vapor contains many chemicals, and often contains nicotine. E-cigs are not a good way to quit smoking because:

  • They have not been proven to be safe. Some of the chemicals are harmful. E-cigs affect lungs and breathing in some of the same ways that tobacco cigarettes do.
  • There is no proof that e-cigs help with quitting smoking. E-cigs deliver nicotine in a way that can continue nicotine and smoking addiction.

Your healthcare provider might prescribe medicine to help reduce your cravings for nicotine or to decrease the positive feelings caused by nicotine.

Hypnosis and acupuncture may help you to quit smoking. However, you still need to learn to live without nicotine in your daily life. Joining an organized quit-smoking program while you are using medicines can help you quit.

How can I take care of myself?

There are things you can do you help yourself quit smoking:

  • Make a plan:
    • Set a date for when you plan to quit and tell your family and friends. Some people gradually use less tobacco in the days leading up to their quit date. Others use the same amount of tobacco right up to their quit date.
    • It may also help to chew sugarless gum or eat hard candy, beef jerky, or sunflower seeds when you feel like smoking or chewing tobacco.
    • Throw out all your tobacco products and anything that you use with your tobacco, such as lighters and ashtrays.
    • Think about all the reasons you do not want to use tobacco. For example, you may hate the smell and the cost. You can write these reasons down and review them whenever you feel tempted to use tobacco.
    • Make a list of the situations, places, or emotions that make you more likely to use tobacco. These things are called triggers. Being aware of these triggers can help you avoid them or be ready for them. For example, if you always use tobacco after an argument with your partner, make a plan to take a walk the next time you have an argument.
  • Get support. Talk with family and friends. Join a stop-smoking support group or class.
  • Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example, take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed.
  • Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. Don’t use alcohol or drugs. Exercise according to your healthcare provider’s instructions.
  • Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.
  • Contact your healthcare provider for a prescription medicine that can help you quit. Ask about using nicotine gum or patches.
  • Keep trying. Many people try more than once to quit smoking before they finally succeed. So, never say, “I can’t.” You CAN learn to live without cigarettes in your daily life.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-03-14
Last reviewed: 2014-03-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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