Nicotine addiction
Nicotine addiction refers to a dependency on nicotine, a substance found in tobacco products like cigarettes, cigars, and e-cigarettes. This form of addiction can create powerful cravings, making it comparable to dependencies on drugs such as heroin and cocaine. While the tobacco plant, Nicotiana tabacum, is legal in most countries, its use is heavily regulated due to health risks associated with tobacco consumption. Nicotine interacts with the brain’s neurotransmitters, increasing dopamine levels and producing a temporary sense of euphoria, which reinforces the desire to continue using the substance.
The health implications of nicotine addiction are significant, as tobacco smoking contributes to a wide range of health issues, including various cancers, respiratory diseases, and cardiovascular problems. Withdrawal symptoms can include irritability, anxiety, and difficulty concentrating, making cessation challenging. Additionally, psychological factors, such as stress and social habits, can exacerbate the addiction, influencing individuals to maintain their tobacco use despite health consequences. Efforts to combat smoking and nicotine addiction have led to a booming industry for cessation products and increased legislative measures to restrict where smoking can occur, reflecting a growing public health initiative against tobacco use.
Nicotine addiction
DEFINITION: Unlike many damaging addictions (with the exception of alcohol abuse), the smoking or chewing of tobacco is legal in most countries. Cigars, cigarettes (including e-cigarettes), and pipe and chewing tobacco contain many chemicals, but the addictive substance is nicotine, which creates a craving in many people that may be as difficult to break as addiction to heroin, cocaine, or other drugs.
- STATUS: Legal in most of the world, but restricted by location of use and age of user worldwide
- SOURCE: Tobacco plant Nicotiana tabacum
- TRANSMISSION ROUTE: Inhalation, oral ingestion
History of Use
Nicotine was named for the tobacco plant Nicotiana tabacum, which itself was named for Jean Nicot de Villemain, a French ambassador, who imported the plant to Portugal in 1560 as a medicine. The colony of Jamestown, Virginia, began to cultivate tobacco on a large scale around 1616. Starting in 1617, exports rose from 20,000 pounds to 1.5 million by 1629.
What had been characterized as a detestable weed soon began to be used by the English, who were told that the tobacco would improve their health. The colonists abandoned other ventures to cultivate tobacco, drawing about 4,600 new colonists from Europe, who flooded onto lands that the Powhatan had used to grow food and hunt game over the subsequent decade.
The smoking or chewing of tobacco became popular for centuries. Until the 1950s, many university lecture halls were built with ashtrays. Indoor smoking was widely accepted. The newsroom of the New York Times, for example, was used by so many chain smokers in the 1930s that by the end of each work day janitors swept away cigarette butts with push brooms.
The US surgeon general in 1963 issued a detailed report that associated the use of tobacco with many health problems, including heart disease, stroke, and cancer. Since then, even the inhalation of tobacco smoke from other people’s lungs (secondhand or passive smoking) has been associated with health risks.
Nicotine itself usually does not cause health risks. Most of the physical damage is caused by other substances, including tar and various chemicals. In 2022, about 11.6 percent of adults in the United States smoked cigarettes, according to the Centers for Disease Control and Prevention (CDC). That figure marked a decline from 20.9 percent in 2005. However, the use of e-cigarettes rose during that period, especially among youth. In 2022, 6 percent of American adults used e-cigarettes. Overall, the CDC found that 19.8 percent of adults used some kind of tobacco product in 2022.
Effects and Potential Risks
The human body receives nicotine (and other addictive substances) through acetylcholine receptors in the brain, increasing the levels of neurotransmitters that regulate mood and behavior. The use of nicotine provides a shot of dopamine, a neurotransmitter that briefly produces a sense of euphoria and relaxation, rewarding continued use and thus reinforcing addiction. The use of nicotine also increases the flow of the stimulating hormone adrenaline (epinephrine). Nicotine also increases heart rates by about twenty beats per minute, elevating blood pressure and constricting arteries.
Burning tobacco contains a minimum of sixty cancer-causing chemicals. According to the American Cancer Society, the smoking of tobacco plays a role in about 80 percent of lung-cancer cases, as well as many cases of emphysema and chronic bronchitis; it also aggravates asthma. Inhalation of burning tobacco also provokes cancers of the esophagus, larynx, mouth, and throat (pharynx). It also negatively affects the stomach, pancreas, kidneys, bladder, cervix, and other parts of the body, and it can increase the risk of infertility and impotence. The CDC reported that secondhand smoke alone killed some 50,000 Americans each year.
The use of tobacco at a young age increases the likelihood of serious addiction. Dependence becomes slightly more intense each time the drug is used. Thus, while going without the drug is easier for younger people, the addiction becomes more trenchant with age. Going without nicotine causes withdrawal symptoms (such as irritability and anxiety) that vary in intensity and duration among different users.
Other symptoms of nicotine withdrawal include difficulty concentrating, restlessness, a depressed mood, frustration, anger, hunger, occasional insomnia, and constipation or diarrhea. The use of tobacco even after the onset of serious health problems is a sign of serious addiction. Some people continue using tobacco even after lung-cancer surgery, and some people defend their “freedom” to be addicted.
Although nicotine addiction is physiological, it also involves psychological cues. The desire experienced by smokers to raise their nicotine levels is often associated with daily rituals, including a cup of morning coffee, free time between work tasks, or an evening over drinks at a familiar bar. Meeting with friends (especially those who smoke) also can intensify the urge. Smoking also can be associated with specific sites, or a ride in a familiar automobile. Psychological stress can raise anxiety levels and increase the desire to smoke. Smelling burning tobacco also may increase a smoker’s desire to use the substance.
People who experience schizophrenia, depression, or other mental illnesses are more likely to smoke tobacco than those without such illnesses. Abusers of alcohol and illegal drugs also use tobacco at higher rates. Products meant to aid smokers in quitting have become a worldwide industry on which several billion dollars are spent each year. Many states have passed laws that ban smoking in public venues in an effort to decrease exposure to secondhand smoke. By 2024, twenty-eight states and Washington, DC, had enacted smoke-free legislation. Additionally, hundreds of cities and counties across the country have enacted such legislation as well.
Bibliography
Benowitz, Neal L., ed. Nicotine Safety and Toxicity. Oxford UP, 1998.
Bock, Gregory, and Jamie Goode, eds. Understanding Nicotine and Tobacco Addiction. Wiley, 2006.
"Health Risks of Smoking Tobacco." American Cancer Society, 28 Oct. 2020, www.cancer.org/healthy/stay-away-from-tobacco/health-risks-of-tobacco/health-risks-of-smoking-tobacco.html. Accessed 14 Nov. 2024.
Kozlowski, Lynn T., Jack E. Henningfield, and Janet Brigham. Cigarettes, Nicotine, and Health: A Biobehavioral Approach. Sage, 2001.
"Tobacco Product Use Among Adults—United States, 2022." US Centers for Disease Control and Prevention, 17 Sept. 2024, www.cdc.gov/tobacco/media/pdfs/2024/09/cdc-osh-ncis-data-report-508.pdf. Accessed 14 Nov. 2024.
"U.S. State and Local Issues: Smoke-Free Laws." Campaign for Tobacco-Free Kids, 1 Oct. 2024, www.tobaccofreekids.org/what-we-do/us/smoke-free-laws. Accessed 14 Nov. 2024.
Wagner, Eric F., ed. Nicotine Addiction among Adolescents. Haworth, 2000.