Signs & Symptoms of Nicotine Addiction

Nicotine is one of the most heavily used addictive drugs in the United States. In 2002, 30 percent of the U.S. population 12 and older–71.5 million people–used tobacco at least once in the month prior to being interviewed. This figure includes 3.8 million young people aged 12 to 17; 14 million people aged 18 to 25; and 53.7 million aged 26 and older.* Most of them smoked cigarettes.

Cigarette smoking has been the most popular method of taking nicotine since the beginning of the 20th century. In 1989, the U.S. Surgeon General issued a report that concluded that cigarettes and other forms of tobacco, such as cigars, pipe tobacco, and chewing tobacco, are addictive and that nicotine is the drug in tobacco that causes addiction. The report also determined that smoking was a major cause of stroke and the third leading cause of death in the United States. Statistics from the Centers for Disease Control and Prevention indicate that tobacco use remains the leading preventable cause of death in the United States, causing more than 440,000 deaths each year and resulting in an annual cost of more than $75 billion in direct medical costs.

(See https://www.cdc.gov/tobacco/data_statistics/fact_sheets/index.htm)

Nicotine is highly addictive. Nicotine provides an almost immediate “kick” because it causes a discharge of epinephrine from the adrenal cortex. This stimulates the central nervous system, and other endocrine glands, which causes a sudden release of glucose. Stimulation is then followed by depression and fatigue, leading the abuser to seek more nicotine.

Nicotine is absorbed readily from tobacco smoke in the lungs, and it does not matter whether the tobacco smoke is from cigarettes, cigars, or pipes. Nicotine also is absorbed readily when tobacco is chewed. With regular use of tobacco, levels of nicotine accumulate in the body during the day and persist overnight. Thus, daily smokers or chewers are exposed to the effects of nicotine for 24 hours each day.

Addiction to nicotine results in withdrawal symptoms when a person tries to stop smoking. For example, a study found that when chronic smokers were deprived of cigarettes for 24 hours, they had increased anger, hostility, and aggression, and loss of social cooperation. Persons suffering from withdrawal also take longer to regain emotional equilibrium following stress. During periods of abstinence and/or craving, smokers have shown impairment across a wide range of psychomotor and cognitive functions, such as language comprehension.

Women who smoke generally have earlier menopause. If women smoke cigarettes and also take oral contraceptives, they are more prone to cardiovascular and cerebrovascular diseases than are other smokers; this is especially true for women older than 30. Pregnant women who smoke cigarettes run an increased risk of having stillborn or premature infants or infants with low birth weight. Children of women who smoked while pregnant have an increased risk for developing conduct disorders. National studies of mothers and daughters have also found that maternal smoking during pregnancy increased the probability that female children would smoke and would persist in smoking.

Adolescent smokeless tobacco users are more likely than nonusers to become cigarette smokers. Behavioral research is beginning to explain how social influences, such as observing adults or other peers smoking, affect whether adolescents begin to smoke cigarettes. Research has shown that teens are generally resistant to anti-smoking messages.

In addition to nicotine, cigarette smoke is primarily composed of a dozen gases (mainly carbon monoxide) and tar. The tar in a cigarette, which varies from about 15 mg for a regular cigarette to 7 mg in a low-tar cigarette, exposes the user to an increased risk of lung cancer, emphysema, and bronchial disorders.

The carbon monoxide in the smoke increases the chance of cardiovascular diseases. The Environmental Protection Agency has concluded that secondhand smoke causes lung cancer in adults and greatly increases the risk of respiratory illnesses in children and sudden infant death.

Despite the demonstrated health risk associated with smoking, young Americans continue to smoke. However, past-month smoking rates among high school students are declining from peaks reached in 1996 for 8th-graders (21.0 percent) and 10th-graders (30.4 percent) and in 1997 for seniors (36.5 percent). In 2003, rates reached the lowest levels ever reported by MTF; 10.2 percent of 8th-graders, 16.7 percent of 10th-graders, and 24.4 percent of high school seniors reported smoking during the month preceding their responses to the survey.

The decrease in smoking rates among young Americans corresponds to several years in which increased proportions of teens said they believe there is a “great” health risk associated with cigarette smoking and expressed disapproval of “pack-a-day” smokers. Students’ personal disapproval of smoking had risen for some years, but showed no further increase in 2003 among 8th-graders and only small increases among 10th- and 12th-graders. In 2003, 84.6 percent of 8th-graders, 81.4 percent of 10th-graders, and 74.8 percent of 12th-graders stated that they “disapprove” or “strongly disapprove” of people smoking one or more packs of cigarettes per day.

For additional information on nicotine abuse and addiction, please visit: www.smoking.drugabuse.gov

For more information on how to quit smoking, please visit: www.cdc.gov/tobacco