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Nicotine and tobacco

Definition

Tobacco and nicotine can be addictive like alcohol, cocaine, and morphine.

Alternative Names

Withdrawal from nicotine; Smoking - nicotine addiction and withdrawal; Smokeless tobacco - nicotine addiction; Cigar smoking; Pipe smoking; Smokeless snuff; Tobacco use; Chewing tobacco; Nicotine addiction and tobacco

Causes

Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed.

Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. There is also an increase in the number of persons who smoke electronic cigarettes (e-cigarettes), using nicotine cartridges. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong.

Both smoking and smokeless tobacco use carry many health risks.

Symptoms

Nicotine use can have many different effects on the body:

Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. People who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms. For those who are quitting, symptoms will peak about 2 to 3 days later. Common symptoms include:

You may notice some or all of these symptoms when switching from regular to low-nicotine cigarettes or cut down on the number of cigarettes smoked.

Treatment

It is hard to stop smoking or using smokeless tobacco, but anyone can do it. There are many ways to quit smoking.

There are also resources to help you. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are acting alone.

To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts to quit as failures. See them as learning experiences.

Most smokers find it hard to break all the habits they have created around smoking.

A smoking cessation program may improve your chance for success. These programs are offered by hospitals, health departments, community centers, work sites, and national organizations.

Nicotine replacement therapy may also be helpful. It involves the use of products that provide low doses of nicotine, but none of the toxins found in smoke. Nicotine replacement comes in the form of:

You can buy many types without a prescription. The goal is to relieve cravings for nicotine and ease your withdrawal symptoms.

Health experts warn that e-cigarettes are not a replacement therapy for cigarette smoking. It is not known exactly how much nicotine is in e-cigarette cartridges, because information on labels is often wrong.

Your health care provider can also prescribe other types of medicines to help you quit and prevent you from starting again.

Outlook (Prognosis)

People who are trying to quit smoking often become discouraged when they do not succeed at first. Research shows that the more times you try, the more likely you are to succeed. If you start smoking again after you have tried to quit, do not give up. Look at what worked or did not work, think of new ways to quit smoking, and try again.

Possible Complications

There are many more reasons to quit using tobacco. Knowing the serious health risks from tobacco may help motivate you to quit. Tobacco and related chemicals, such as tar and nicotine, can increase your risk of serious health problems such as:

When to Contact a Medical Professional

See your health care provider if you wish to stop smoking, or have already done so and are having withdrawal symptoms. Your provider can help recommend treatments.

References

American Cancer Society. What About Electronic Cigarettes? Aren't they Safe? Available at: www.cancer.org/cancer/cancercauses/tobaccocancer/questionsaboutsmokingtobaccoandhealth/questions-about-smoking-tobacco-and-health-e-cigarettes. Updated February 13, 2014. Accessed November 2, 2014.

George TP. Nicotine and tobacco. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 31.

Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2012;11:CD000146. PMID 23152200. www.ncbi.nlm.nih.gov/pubmed/23152200

U.S. Preventive Services Task Force. Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women. U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2009;150:551-555. PMID 19380855. www.ncbi.nlm.nih.gov/pubmed/19380855



Review Date: 11/2/2014
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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