Tobacco use disorder
Tobacco use disorder, often referred to as nicotine addiction, is a condition characterized by the harmful effects of tobacco on an individual's health and social well-being, alongside a dependency on nicotine, the addictive component in tobacco products. These products can be consumed in various forms, including cigarettes, smokeless tobacco, cigars, pipes, and e-cigarettes. The use of tobacco leads to pleasurable sensations through nicotine's action on the brain, but these effects are short-lived, prompting continued use to avoid withdrawal symptoms.
Several risk factors contribute to the development of tobacco use disorder, including mental health conditions such as schizophrenia and depression, as well as societal influences like peer pressure and advertising. Symptoms of the disorder can range from nicotine "highs" to withdrawal effects, which include irritability, cravings, and increased appetite. Serious health consequences associated with tobacco use are numerous, including various types of cancer, chronic lung diseases, and cardiovascular issues.
Diagnosis typically involves a medical evaluation focusing on the history and frequency of tobacco use, while treatment options may include nicotine replacement therapies and behavioral therapies to support cessation efforts. Preventative measures emphasize the importance of not using tobacco and educating youth about its dangers, as organizations like the CDC and FDA work to reduce tobacco accessibility and marketing targeted at young people.
Tobacco use disorder
ALSO KNOWN AS: Nicotine addiction
DEFINITION: Tobacco use disorder occurs when the use of tobacco harms a person’s health or social functioning, or when a person becomes dependent on the nicotine in tobacco. Tobacco may be consumed in the form of cigarettes, smokeless tobacco products (including snuff and chewing tobacco), cigars, pipes, or vape pens. This condition can be treated.
Causes
Tobacco products contain nicotine, which is transported to the brain and causes pleasurable sensations. The effects of nicotine dissipate within a few minutes, however. This causes tobacco users to continue using tobacco to maintain the pleasurable effects and prevent withdrawal. Other chemicals in tobacco products may also contribute to tobacco use disorder.
Risk Factors
There are many risk factors that increase the chance of developing tobacco use disorder, or nicotine addiction. Some risk factors are schizophrenia, post-traumatic stress disorder, bipolar disorder, major depression, and other mental illnesses.
Peer pressure has also been a risk factor in tobacco products. Starting with the birth of national advertising, commercials and promotions, like the Marlboro Man, made smoking appear trendy and stylish. Early Hollywood films, too, glamorized smoking and tobacco use, making it appear sexy. For young people, particularly teenagers, these marketing strategies coupled with the impact of their peers smoking led many in the 1970s through 1990s to pick up, and eventually become addicted to, tobacco products. However, with the exposure of the tobacco industry and the potentially fatal ramifications of being a lifelong smoker or user, the popularized image of smoking and tobacco began to fade, and less and less young people were purchasing such products.
In the early twenty-first century, though, electronic cigarettes (e-cigarettes), or vape pens, were used to inhale aerosol, which typically contained nicotine, flavorings, and other chemicals. In 2016, the US Food and Drug Administration (FDA) established that e-cigarettes were to be subject to government regulation as tobacco products. In 2021, the US government raised the minimum age to purchase tobacco products from 18 to 21 years old in an effort to curb usage by young adults.
Symptoms
Symptoms related to tobacco use disorder include nicotine “highs,” which are caused by an increase in blood pressure, blood sugar level, breathing rate, and heart rate. Symptoms of nicotine withdrawal include irritability, cravings, sleeplessness, increased appetite, nervousness, and headaches. Tobacco-related health problems may include smoker’s cough and hot flashes in women. Throat cancer is also strongly associated with tobacco use disorder. There are other consequences of tobacco use disorder as well, such as cancers of the larynx (voice box), oral cavity, throat, esophagus, lung, and colon; chronic bronchitis; emphysema; chronic obstructive pulmonary disease; heart disease; stroke; dementia; and miscarriage or premature delivery.
Screening and Diagnosis
A diagnosis of tobacco use disorder will involve a doctor inquiring about symptoms and medical history, as well as a physical examination and lung function tests. Doctors will typically ask questions pertaining to the duration and the frequency of tobacco use.
Treatment and Therapy
Treatment may consist of nicotine replacement therapy (NRT) and behavioral therapy. Nicotine replacement therapy (NRT) is used to relieve nicotine withdrawal symptoms. Examples of NRT products are nicotine gum, lozenges, nasal sprays, patches, and inhalers. Sometimes these products are used in combination, which may help some people stay smoke-free. Since NRT does not produce the pleasurable effects of tobacco, there is little chance that these products will be abused. According to various studies, NRT may help reduce the amount of tobacco consumed and help to control withdrawal symptoms after a person has quit smoking. NRT will also help smokers abstain from smoking.
Combining behavioral therapy with NRT may be even more helpful. Behavioral therapies are comprised of counseling, group behavior therapy, self-help classes and manuals, and text messaging programs. There is also cognitive-behavioral therapy, which teaches people to recognize high-risk tobacco situations, develop coping strategies, manage stress, improve problem-solving skills, and increase social support.
Certain medicines, such as some antidepressants, may help individuals quit smoking. Some medicines may help ease withdrawal symptoms and block nicotine effects if the person were to start smoking again. One side effect, however, is that these medicines may increase the risk of serious behavior changes.
Prevention
The best prevention is to never use tobacco products, as they are very addictive. One should also stay away from places where people are smoking to avoid harmful exposure to secondhand smoke.
In an effort to curb teen tobacco use, many government, community, and school organizations have created programs aimed at educating young people and their families on the dangers of tobacco use. The US Center for Disease Control (CDC) and the US Food and Drug Administration have both produced guidelines and information to help communities combat the rise in tobacco use among teens. The FDA's Youth Tobacco Prevention Plan outlined three major areas of focus: preventing access to tobacco products, curbing marketing of tobacco products, especially those aimed at young people, and educating teens about the dangers of using any tobacco product, including e-cigarettes, while educating retailers about their key role in protecting youth. According to the CDC, as of 2024, 2.1 million students, or over 7 percent, used e-cigarettes nationwide. This includes 550,000, or just below 5 percent, of middle school students and 10 percent, or 1.56 million, of high school students. These numbers may be underestimated, too, as many teens do not admit to smoking or using tobacco products.
Bibliography
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“FDA's Youth Tobacco Prevention Plan.” FDA, 29 Jan. 2024, www.fda.gov/tobacco-products/youth-and-tobacco/fdas-youth-tobacco-prevention-plan. Accessed 30 Aug. 2024.
How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Rockville: US DHHS, 2010. Print.
“Vaping Devices (Electronic Cigarettes) Drug Facts.” National Institute on Drug Abuse, 8 Jan. 2020, nida.nih.gov/publications/drugfacts/vaping-devices-electronic-cigarettes. Accessed 30 Aug. 2024.
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