Last reviewed:
Nov 21st 2022
OTR/L
Nicotine use disorder is the urge to continue taking nicotine through the lungs, usually through smoking tobacco products. Any amount of nicotine can lead to dependence. Signs of addiction are withdrawal symptoms and the urge to smoke despite negative consequences on health or social interactions. Treatment options include medications and counseling.
Nicotine use disorder or nicotine addiction generally occurs through the repeated use of smoked tobacco products, thus taking in nicotine and several other ingredients through the lungs. Nicotine addiction can occur with any amount of nicotine.
Nicotine is the feel-good chemical in tobacco products that reaches the brain within seconds to boost dopamine levels. This rush is a reward that occurs quickly but subsides fast, so the user will reach out for the product to experience the sensation again and again. Over time, the brain is rewired to require the chemical and stress occurs when this is not present. Nervousness, feelings of depression, and agitation occur when the product cannot be obtained.
Nicotine use disorder, sometimes called NUD, is a psychiatric diagnosis that refers to a compulsive pattern of nicotine use despite harmful consequences. Nicotine is most commonly consumed through cigarettes, but it can also be consumed in other ways, such as chewing tobacco, snuff, or electronic cigarettes.
Among those who smoke daily, around 50% have tobacco or nicotine use disorder. However, it is uncommon in those who do not smoke every day.[1]
People with NUD often feel unable to quit nicotine and may continue using it despite negative consequences, such as financial problems or social and relationship difficulties. NUD is a severe problem that can lead to many health complications, including cancer, heart disease, and stroke.
People with NUD need help from a healthcare provider to quit nicotine and reduce their risk of developing these serious health problems.[2]
While many people are aware of the dangers of smoking, they may not be aware of the potential side effects of nicotine use disorder. For these reasons, it is crucial for people who smoke to be aware of the possible side effects of nicotine use disorder and seek help if they feel they are struggling with an addiction.
Additionally, nicotine use disorder can increase the risk of developing cancer and other serious health conditions due to the numerous cancer-causing and harmful chemicals in tobacco products, whether these are smoked or not.
Side effects and long-term complications can include:
One must also remember the side effects or complications of those inhaling smoke without smoking. This is known as second-hand smoking.
The signs of nicotine use disorder are:
Even infrequent and little use of nicotine or tobacco products can lead to dependence because it is a highly addictive drug. It is also possible for smoking cessation aids, such as nicotine gum or nicotine patches, to lead to dependence. To make matters worse, the body quickly becomes accustomed to nicotine, and the more you use, the more you will need to feel good.
Nicotine becomes intertwined with daily routines, and the ritual of smoking becomes a habit as well as an addiction. Certain situations will trigger a craving to smoke. For example, some people will smoke first thing in the morning as soon as they wake up. Others will smoke whenever they take a break at work. Socialising often plays a role in smoking as people will go outside together at the office or the bar to smoke.
The risk factors of nicotine use disorder include:
The most effective way to prevent nicotine use disorder is not to smoke at all. Unfortunately, even the smallest amount of nicotine in your system can lead to cravings and addiction. Another crucial thing to do is to avoid environments where people are smoking. Children who grow up in households with smokers are more likely to take up the habit themselves.
If you are an ex-smoker and want to avoid developing nicotine use disorder, then you must avoid your triggers. For example, some people are more likely to smoke when drinking alcohol or when they are in the company of smokers.
If you are a new smoker, it is best to nip the habit in the bud, as the body develops a dependence to nicotine and tobacco products very quickly, especially (but not only) if you are prone to substance abuse.
According to the DSM-5, a pattern of nicotine/tobacco use is problematic when it leads to significant impairment or distress, as shown by at least two of the following patterns over twelve months:
A healthcare professional will assess by asking the patient questions about the above points.
Quitting smoking is the best way to reduce the risks associated with nicotine use disorder, but it can be challenging to do so without support. Most smokers have tried to quit at least once, and although some manage on the first try, it is rare to stop on the first attempt without getting help.
It's vital to remember that addictions are very powerful. This means that if you don't succeed at first, you should not feel ashamed or too defeated to try again.
There are many resources available to help people quit smoking:
These counselling tools are successful when combined with other smoking cessation methods.
Nicotine withdrawal is a set of symptoms that can occur when someone who uses tobacco products regularly suddenly stops using them. These symptoms can range from mild to severe and typically peak within the first week of quitting. Common symptoms include cravings, irritability, anxiety, difficulty concentrating, and increased appetite.
While nicotine withdrawal is not life-threatening, it can be challenging to manage and may negatively impact the quality of life. However, some treatments can help ease the process of quitting and make withdrawal symptoms more manageable. For example, medications can help to reduce cravings and other withdrawal symptoms while the individual adjusts to life without tobacco products.
One important self-care strategy is to avoid triggers that may cause cravings, e.g., the smoking areas in your place of work. Common triggers include stress, boredom, and social situations. For example, it may help you to take up a healthy habit away from triggers, such as exercising or cooking healthy meals.
It's also essential to have a support system in place, such as friends or family members who can provide encouragement and understanding. Additionally, many helpful resources are available, such as quit-smoking programs and support groups.
If you're trying to help someone quit nicotine, it's crucial to understand the disorder. Quitting smoking is a highly challenging activity, even if the person is determined and motivated to do so.
The prevalence of nicotine/tobacco use disorder is estimated to be 13% in the United States.[10]
Like with other addictive substances, unfortunately, nicotine use disorder is never really cured. Those with nicotine use disorder are prone to relapse on quitting cigarettes, and this relapse rate tends to be high. This is especially true in the first six months and in those who opt for a shorter withdrawal treatment. Smoking relapse should not be seen as a complete failure to quit, but a temporary setback can also be overcome; research has shown that the more someone tries to quit, the more they are likely to suceed in kicking the habit.[11]
Resources: