Alternative Names
nicotine addiction; nicotine use disorder; tobacco addiction; tobacco dependence
Symptoms & Characteristics
Cigarettes and other forms of tobacco, including cigars, pipe tobacco, snuff, and chewing tobacco, contain nicotine. Nicotine is absorbed into the bloodstream when a tobacco product is smoked, chewed or inhaled. Some signs and symptoms of nicotine dependence include:
- An increased tolerance for nicotine
- Preoccupation with the substance
- Continued use despite health concerns and problems
- Avoidance of situations where smoking is not permitted (such as at restaurants and social events)
- Withdrawal symptoms upon stopping (such as irritability, anxiety, difficulty concentrating, insomnia, restlessness, and increased appetite)
Research demonstrates that nicotine acts on the brain's neurotransmitter acetylcholine receptor to produce a number of physical and mood-altering effects. Specifically, nicotine acts on circuitry within the brain that regulates feelings of pleasure and euphoria, stress reduction, improved cognition and other nervous system effects. These feelings, although temporary, reinforce the dependence and continued use of tobacco products. Nicotine is believed to be as addictive as alcohol or heroin and is one of the hardest addictions to break.
Nicotine dependence can lead to a variety of health problems related to the substances in tobacco products and smoke. Some of the adverse health consequences of tobacco use include lung disease, heart disease, stroke, clouding of the eye lens (cataracts), as well as lung cancer and other types of cancer.
Treatment
The best way to reduce the harmful effects of tobacco use is to quit using tobacco products. It can be difficult to quit, but medications, nicotine-replacement products, counseling, support groups and smoking cessation programs may help.
Women who smoke during pregnancy, may be at increased risk for pregnancy loss, stillbirth, premature labor, as well as other pregnancy complications. Studies also suggest that maternal smoking during pregnancy causes an increased risk to have a baby with low birth weight and/or oral-facial clefting. It is always important to speak with a doctor about effective ways to quit smoking.
How Common Is It?
In the United States, approximately 20% of adults smoke, the majority of whom are believed to be nicotine-dependent.
Cigarette smoking is the greatest preventable cause of cancer, accounting for at least 30% of all cancer deaths and over 85% of all lung cancer deaths.
Genetics & Inheritance
Nicotine dependence is most likely multifactorial, which means it involves a combination of genetic, lifestyle and environmental factors.
- Some risk factors that have been proposed to contribute to nicotine dependence include a personal or family history of alcohol/drug abuse and/or mental illness.
Researchers believe that there are probably a number of genes that affect nicotine dependence. Twin studies have revealed that smoking cessation success is largely heritable and overlaps with susceptibility to dependence on addictive substances.
- Single nucleotide polymorphisms (or SNPs) are small variations in a single "letter" of DNA that can be found throughout our entire genetic make-up. Some researchers have proposed that multiple SNPs may influence the risk to develop nicotine dependence in some people. Over 10 SNPs have been associated with nicotine dependence. However, much of this SNP research is limited. Further research is needed to replicate study findings and clearly establish associations.
- Other yet to be identified or adequately classified genes may also contribute to nicotine dependence.
Genetic Testing
Clinical genetic testing for nicotine dependence is currently unavailable. For more information on the genetics of nicotine dependence: use our find a genetic professional directory to locate a trained genetic professional in your area.
Informational genetic testing for nicotine dependence is available online (over the internet) as part of a whole genome scan. Whole genome scanning involves analyzing thousands of SNPs at once related to a number of different health conditions.
- At this point, many genetic professionals do not consider this testing clinically useful or medically relevant, but for informational purposes only. Go to the Tests tab to link to the best providers, compare providers and read provider reviews.
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