What is nicotine addiction?

Updated: Jul 16, 2018
  • Author: R Gregory Lande, DO, FACN; Chief Editor: Glen L Xiong, MD  more...
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Nicotine addiction is the second-leading cause of death worldwide. The important causes of smoking-related mortality are atherosclerotic vascular disease, cancer, and chronic obstructive pulmonary disease (COPD). Smoking also can contribute to other diseases, such as histiocytosis X, respiratory bronchiolitis, obstructive sleep apnea, idiopathic pneumothorax, low birth weight, and perinatal mortality.

Currently, there are about 1.3 billion smokers the world, most (84%) of them in developing countries. [5] Worldwide, tobacco use causes nearly 6 million deaths per year, and current trends show that tobacco use will cause more than 8 million deaths annually by 2030. Through direct healthcare costs and loss of productivity from death and illness, tobacco will cost governments an estimated US $200 billion per year. A third of these costs will be borne by the developing countries. Many factors have led to increased global smoking rates, including the following:

  • Trade liberalization

  • Direct foreign investment

  • Global marketing

  • Transnational tobacco advertising, promotion, and sponsorship

  • International tobacco smuggling

Research investigating why people smoke has shown that smoking behavior is multifaceted. Factors influencing initiation of smoking differ from those influencing maintenance of smoking behavior. Nicotine dependence, genetic factors, and psychosocial factors all influence maintenance of smoking behavior.

Nicotine in cigarette smoke affects mood and performance and is the source of addiction to tobacco. It meets the criteria of a highly addictive drug, in that it is a potent psychoactive substance that induces euphoria, reinforces its own use, and leads to nicotine withdrawal syndrome when it is absent. As an addictive drug, nicotine has 2 very potent effects, being both a stimulant and a depressant. Thus, cigarettes may both get a smoker going in the morning and “chill out” the smoker during the day.

All healthcare professionals should be aware of the risks of tobacco smoking, understand nicotine addiction, and assist patients with smoking cessation.

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