Nicotine and Tobacco Addiction: Causes, Symptoms, Treatment

Medically Reviewed by Zilpah Sheikh, MD on July 23, 2024
Written by Suzanne Wright, Marijke Vroomen Durning, RN
15 min read

Tobacco is a plant that is processed to make products that people can smoke, chew, sniff, or use as snuff – held inside the lip or cheek. 

Tobacco history

Using tobacco in some form or another goes back centuries. Archaeologists found signs it may have been used in the 1st century BC by the Mayan people in Central America. It seems that tobacco was used for religious rites and as medicines. People believed tobacco could help cure several illnesses, like:

  • Asthma
  • Earaches
  • Gastrointestinal (bowel) problems
  • Fevers
  • Sore eyes
  • Depression
  • Insect bites
  • Burns

Tobacco use spread as European sailors brought it around the world.

How common is tobacco use?

The World Health Organization (WHO) reports that about 1.3 billion people in the world use tobacco products, with most of them (80%) living in low- or middle-income countries. In the U.S., about 46 million people use some type of tobacco product.

What does it look like?

Tobacco takes on different forms, depending on how you’re going to use it:

  • Whole tobacco leaves in cigars
  • Finely cut tobacco leaves in cigarettes
  • Finely ground powder for snuff
  • Loose, shredded, or twisted tobacco leaves for chewing

Is tobacco dangerous?

We’ve known for many years that tobacco is dangerous. It’s the No. 1 cause of preventable death in the U.S. Just cigarette smoking alone causes almost 500,000 deaths in the country. 

Secondhand smoke – the smoke that people breathe in from the environment because someone else is smoking – is also a health danger, especially for children. For them, secondhand cigarette smoke causes up to 300,000 lower respiratory tract infections, like pneumonia, bronchitis, and bronchiolitis, in the U.S. every year. It causes about 430 deaths from sudden infant death syndrome (SIDS) in the U.S. every year. 

Nicotine is an addictive chemical found in the tobacco plant. It’s part of all tobacco products. It is also added to some liquid vaping products. 

You can find tobacco in several types of products.

Cigarette and cigar tobacco

Cigarette tobacco and cigar tobacco are similar, but cigarette tobacco is cut into much smaller pieces, while cigar tobacco is not cut and is rolled up in a large tobacco leaf.

Pipe tobacco

Pipe smokers use various types of pipes, but all pipes have a bowl or are attached to a bowl of some sort where you place the tobacco. Pipe tobacco is a loose-leaf tobacco that is tamped down into the bowl and then lit. You inhale the tobacco smoke through a tube attached to the bowl.

Chewing tobacco

Chewing tobacco is often called smokeless tobacco because you don’t light it up to use it, so there’s no smoke. It can be flavored. Chewing tobacco is loose, not packed, and can be twisted or compressed. This is sometimes called a plug. To use chewing tobacco, you place a bit of it between your cheek and gum. After a short while, saliva builds up and you spit it out. 

Snuff tobacco

Snuff tobacco is also placed in the cheek, but it can also be placed between the lip and gum. It's a much finer, ground type of tobacco. Some people snort or sniff this tobacco.

Menthol tobacco products

In the 1920s and 1930s, tobacco companies started adding menthol to their products to make the taste of smoking less harsh. It also helped reduce the irritation and coughing caused by nicotine, making smoking easier to tolerate. 

Other tobacco products

Snus is processed tobacco that has been heated up briefly to a high temperature – pasteurized. The goal of processing it is to kill bacteria that the makers say can produce cancer-causing chemicals. It’s used as a snuff tobacco.

Dissolvable tobacco is a powdered form of tobacco sold in shapes: tablets, sticks, or strips. They can look a lot like candy because dissolvable tobacco can be flavored. To use dissolvable tobacco, you place it on your tongue or chew it until it’s gone.

Nicotine is the feel-good chemical in tobacco products but it’s also a stimulant, regardless of the product you use. 

Once nicotine enters your body and is absorbed into your bloodstream, it goes to your adrenal glands. The adrenal glands respond by releasing adrenaline. The adrenaline raises your blood pressure, heart rate, and breathing rate. Nicotine also releases a “feel-good” chemical in your brain called dopamine. It gives you a sense of pleasure or even euphoria. But dopamine can also cause people to have trouble sleeping or have poor impulse control.

How long do the effects of nicotine last?

The nicotine effects on your body don’t last long. You can start to feel them in less than 10 seconds, but they only last a few minutes.

Is nicotine addictive?

It’s true that many new smokers don’t enjoy their first cigarettes. The cigarettes can cause you to cough and gag, or feel dizzy and nauseated. But smokers typically develop a tolerance very quickly as they continue to smoke. Once they’ve gotten used to the cigarettes, the dopamine gives them that “buzz” or even a high for a few minutes. 

The fact that the nicotine effect lasts such a short time is what makes it addictive. Tobacco without nicotine would not be addictive, but with nicotine, new smokers – especially if they are young – get addicted quickly.

If you smoke menthol cigarettes, your likelihood of becoming addicted to nicotine increases, and the addiction is usually stronger.

Is nicotine bad for you?

Nicotine is bad for your body. It is addictive and it causes damage. It raises your heart rate and blood pressure. It also narrows your arteries. This means your blood has a harder time flowing through your blood vessels, and your heart has to work harder to push it through. After time, this can cause a heart attack. Nicotine can also cause gastrointestinal (GI) issues to worsen, and if you have surgery or some other types of wounds, nicotine could make it take longer for you to heal.

If you use nicotine with birth control pills, you are also at a higher risk of having blood clots. 

How long does nicotine stay in your system?

Even though the feel-good effect of nicotine lasts only a few minutes, the chemical itself stays in your body for several hours.

Nicotine long-term effects

As you smoke, the nicotine can cause many long-term effects to your body. They include:

If babies are exposed to cigarette smoke while in the womb, they could be born with birth defects.

If you use tobacco products, there is a high chance you will become nicotine-dependent and find it hard to stop. The dependence is both physical and psychological.

You might be addicted to nicotine if you:

  • Try to stop smoking but can’t, even if you have health problems with your lungs or heart
  • Feel you must have to smoke within a half-hour of waking
  • Feel that the first cigarette of the day is the most important one
  • Smoke cigarettes regularly throughout the day
  • Avoid activities where you can’t smoke
  • Have withdrawal symptoms when you try to stop smoking, such as:
    • Anxiety
    • Crankiness
    • Restlessness
    • A hard time concentrating
    • Feeling depressed
    • Frustration
    • Anger
    • Increased appetite
    • Insomnia
    • Constipation or diarrhea

Nicotine tolerance

Nicotine tolerance isn’t the same thing as dependence, but it can lead to dependence. The feel-good sensation from the nicotine you get when you have a cigarette gets shorter over time, so this is why you feel like you need to smoke more cigarettes throughout the day. This is because your body is developing nicotine tolerance.

Whether it’s you or someone you love, the first step to treating a nicotine addiction is admitting there’s a problem. How do you know if you’re dependent? These are some signs:

  • You’ve tried to quit using nicotine but can’t.
  • You avoid being at places or with friends where you can’t smoke.
  • You use tobacco to manage stress or anxiety.
  • You have health problems, but you still use tobacco.
  • You get cranky, moody, restless, shaky, or angry when you don’t use nicotine.
  • You crave nicotine.

Once you recognize the negative effects of nicotine, you can take steps to kick your unhealthy habit. That starts with seeing your doctor. They’ll ask you questions about how you use nicotine to figure out if you’re addicted and how serious your problem is.

No matter how long you’ve been using nicotine, when you stop, your health improves. Research shows a mix of counseling and medications works best to help you kick the habit.

Nicotine replacement therapy (NRT)

Because nicotine is addictive, when you try to stop using tobacco, your body may go into withdrawal. One way to quit smoking is to use a replacement for the tobacco but still get some of the nicotine – without all the other chemicals that come along with smoking or using other types of tobacco. Research shows that NRT doubles your chances of quitting smoking. These products target the same receptors in your brain that nicotine does. That’s how they safely ease cravings and withdrawal symptoms. NRT is especially helpful in the beginning of your stop-smoking efforts, or if you have a severe addiction. 

There are several over-the-counter (OTC) and prescription products that provide nicotine replacement that may help you quit smoking:

  • Nicotine patch. Nicotine patches are available OTC or with a prescription. They come in different dosages and durations (up to 24 hours for one patch). You apply a patch to your skin, and the nicotine is absorbed throughout the day, giving your body the nicotine it feels it needs. It takes about 3 to 5 months as you start decreasing the patch dosage until you don’t need it anymore. It can take longer, though.
  • Nicotine gum. Nicotine gum is OTC, and it comes in two strengths (2 milligrams and 4 milligrams). If you are a heavier smoker, you typically might want to start with the higher nicotine-dose gum. As you chew the gum, the nicotine is absorbed through the membranes in your mouth. For the gum to work properly, it’s important to follow the package instructions because nicotine gum isn’t chewed like regular gum. Once you’ve chewed it for a while (slowly), you tuck it inside your cheek. Then you chew it again for a while, and repeat. The average time it takes for the nicotine gum to help people stop smoking is about 3 months, but it can take longer.
  • Nicotine lozenges. Nicotine lozenges are another OTC product. They also come in 2-milligram and 4-milligram strengths. According to the dosing, if you must smoke your first cigarette of the day within a half-hour of waking, you should try the 4-milligram lozenges first. If you can wait more than a half-hour, you can probably get by with the 2-milligram lozenges. It’s not recommended to use the lozenges for more than 3 months.
  • Nicotine sprays. You can only get nicotine sprays by prescription. You spray the product into your nose, and the nicotine enters your bloodstream quite quickly. It should be prescribed for 3 months and then repeated if you need, but nicotine sprays shouldn’t be used for more than 6 months. 
  • Nicotine inhalers. Nicotine inhalers are also prescription-only products. Inhalers may be popular with some people who are trying to quit smoking because it may almost seem like they are inhaling cigarette smoke. You inhale the nicotine from an inhaler cartridge, either using the cartridge all at once or drawing it out, puffing over a few minutes. It shouldn’t be used for more than 6 months. Nicotine inhalers aren’t e-cigarettes.

Medications

If you’ve tried to quit smoking on your own, or other methods, like NRT haven’t helped, you might want to try taking a drug that has been approved by the FDA as a quit-smoking medication. Examples are:

  • Bupropion. First used to treat depression, bupropion changes the way your brain processes feel-good chemicals. You’ll need a prescription for it. 
  • Varenicline (Chantix). This prescription medication helps your brain release the same chemicals that smoking does.

Counseling

Counseling can help you understand why you smoke and what triggers you to smoke. It can also help you identify ways you can cope if and when you have cravings.

  • Cognitive behavioral therapy (CBT). This type of talk therapy can help you recognize the thoughts, situations, and people that trigger your tobacco use. You’ll work with a therapist to build strategies that will improve your odds of stopping.
  • Motivational interviewing. A counselor will help you figure out what’s stopping you from quitting and what will inspire you to make healthy changes. They’ll also point out gaps between your goals and current behavior.
  • Mindfulness. This will help you become aware of and learn to detach from feelings, thoughts, and cravings that could cause you to use tobacco again. You’ll also learn ways to manage stress and negative thoughts that don’t involve tobacco.
  • Support hotlines. Every state offers free telephone helplines with trained counselors who can help you navigate smoking-related stress. You can call once or repeatedly, and your conversation is confidential. The number is 800-QUIT-NOW (800-784-8669). The U.S. Department of Health and Human Services also offers a Smoking Quitline at 877-44U-QUIT (877-448-7848).
  • Web, text, or social media-based interventions. You can use your cellphone, tablet, or social media accounts to help yourself quit smoking. These technologies break down geographical barriers, and they’re also low- or no-cost. These tools can work in combination with other smoking cessation methods.

Support groups

Support groups are like counseling but with people who are all going through the same thing as you. Some people are further along in their journey, some are at the same place as you, and others are just starting their journey. Support groups can be in person or online.

The Smoking Quitline at 877-44U-QUIT (877-448-7848) can help you find local resources and support.

Alternative treatments

Some people do well with alternative treatments to help them quit smoking.

  • Acupuncture. It’s part of some stop-smoking programs. Some studies show it may help more in the short term. And others say it doesn’t work as well as NRTs.
  • Hypnotherapy. Research results are mixed when it comes to this treatment. Some suggest it might help. Others say it doesn’t.

What works for one person may not work for another. Talk to your doctor. They can help you create a personalized treatment plan with the best shot for long-term success.

It’s easy for someone to tell you to stop smoking. The reality is much more complicated, so it’s important to find ways to reduce your risk of harm from tobacco and nicotine as you try to quit smoking. 

  • Choose a time of day that you won’t smoke, like if you’re in the car driving to work, then add more times when you won’t smoke.
  • Smoke fewer cigarettes during the day (or use other tobacco products), gradually increasing the time between each one.
  • Decide to smoke or use a tobacco product only on even hours or odd hours.
  • Limit where you’ll allow yourself to smoke.
  • Try waiting as long as you can in the morning before you have your first cigarette.

Tobacco use as a public health issue

Given that tobacco use is a major public health issue, many organizations are trying to stop the use of tobacco. For example:

  • The American Lung Association has the Freedom From Smoking program, which helps people who smoke better understand tobacco dependency, their own need for tobacco, and how to strategize for the best chances of quitting.
  • The American Heart Association has their Live Fierce; End Tobacco & Vaping campaign, which provides information not only to people who want to quit smoking, but to elementary schools to help children from picking up that first cigarette or tobacco product, as well as to middle and high schools.
  • The U.S. government is trying to ban menthol cigarettes because the menthol makes it feel that smoking is not so bad. It’s also banned e-cigarette products that are flavored so the taste of nicotine can be hidden.

Nicotine is an addictive drug found in tobacco products. It’s harmful to your health because it causes you to be addicted to tobacco, which leads to many illnesses and conditions, including heart attacks. The addiction to nicotine is strong, so it can be hard for people to stop smoking. If you want to stop smoking, there are several tools that can help you, such as counseling, nicotine replacement products, even some medications. 

How much nicotine is in a cigarette?

The average smoker inhales about 1 to 2 milligrams of nicotine per cigarette. How much you actually get depends on how much of the cigarette you smoke and how deeply you inhale.

Does nicotine cause cancer?

Nicotine itself hasn’t been thought to cause cancer. Researchers thought it was the combination of other chemicals in the tobacco products. But new research is starting to find some possible links between nicotine and cancer.

Is nicotine gum bad for you?

Because nicotine speeds up your heart rate and raises your blood pressure, nicotine gum isn’t really good for you. But using nicotine replacement is better than smoking, so using it while you’re trying to stop smoking is helpful.

How harmful is nicotine?

Nicotine is very harmful because it is so addictive. Most nicotine is consumed through tobacco products, which are known to cause cancer and other serious illnesses.

What is nicotine supposed to do to your body?

Nicotine releases a “feel-good” chemical that gives a high or a buzz, but it only lasts a few minutes.

Is nicotine a strong drug?

Yes, nicotine is a strong drug. You feel its effects within seconds of inhaling or consuming it.

What does nicotine do to your brain?

When your body absorbs nicotine, your brain releases a chemical called dopamine, often called a “feel-good” chemical. It’s this chemical that starts the cycle of nicotine addiction. You consume nicotine, you feel good, the feeling wears off after a few minutes, and you consume more nicotine.

Is nicotine or caffeine worse?

Nicotine is worse than caffeine. Although caffeine can be addictive in high amounts, its effect on your body is not as harmful as nicotine. While nicotine can cause heart disease, caffeine is generally safe for adults as long as you don’t drink too much of it.

What does tobacco do to the body?

Smoked tobacco damages your body in several ways. Here are just a few: It damages the airways and is the leading cause of lung cancer. Smoking tobacco also causes other kinds of cancer, such as of the esophagus, bladder, mouth, and stomach, to name a few. It also causes coronary heart disease and strokes. It can reduce a man’s fertility, and it can cause preterm deliveries, stillbirths, and sudden infant death syndrome. Smoking can also affect your mouth, causing tooth decay and loss. Your eyesight might be affected with cataracts or other types of eye conditions that can lead to blindness. 

What is tobacco used for?

Tobacco is used for smoking, chewing, and consuming through a tablet.

Why is tobacco so harmful?

Tobacco is so harmful because it can cause several types of cancer, as well as heart disease and many other illnesses.

Are tobacco and cigarettes the same?

A cigarette is a rolled-up cylinder/tube of tobacco wrapped in paper. Tobacco is the leaf of the tobacco plant that can be used in a cigarette, but also in cigars, pipes, chews, and more.

Does tobacco leave your body?

It’s not the tobacco that goes in or out of your body, it’s the ingredients in the tobacco, like nicotine. Even though the feel-good effect of nicotine lasts only a few minutes, the chemical itself stays in your body for several hours.

What are the side effects of tobacco?

The side effects of tobacco are related to the chemicals inside the tobacco. Aside from getting heart disease or cancer, you could lose your eyesight, develop type 2 diabetes, have fertility issues, and ruin your teeth, to name a few things.

What happens if you smoke tobacco every day?

If you smoke tobacco every day, you have a higher chance of getting heart disease, lung disease, and cancer, among other illnesses.

Can lungs heal after 20 years of smoking?

Unfortunately, lung damage from smoking is permanent, and the longer you smoke, the more damage there is. That said, if you stop smoking, you will stop more damage from occurring.