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Understanding Nicotine Use Disorder

More than 480,000 deaths each year are caused by cigarette smoking, making it the leading cause of preventable death in the US.

Cigarette smoking and vaping damages nearly every organ in the human body, and can cause lung cancer, respiratory disorders, heart disease, stroke, and other illnesses.

Tobacco is a plant grown for its leaves, which are dried and fermented before being used in tobacco products. Tobacco contains nicotine, an addictive ingredient, which is why so many people who use tobacco find it difficult to quit. Studies suggest that other chemicals found in tobacco products may also contribute to its addictive potential.

How is it used?

Tobacco can be smoked, vaporized, chewed, or sniffed. 

Short-Term Effects

Cigarettes, and more recently e-cigarettes or "vapes", have been engineered to efficiently deliver nicotine into the body. When tobacco is smoked, nicotine rapidly reaches peak levels in the bloodstream and enters the brain. When tobacco is not inhaled--in products such as cigars, pipes, and smokeless tobacco --nicotine is absorbed through mucous membranes and reaches peak levels more slowly.

Nicotine stimulates the adrenal glands, which results in the discharge of epinephrine (adrenaline). This rush of adrenaline stimulates the body and causes an increase in blood pressure, breathing, and heart rate.

Long-Term Health Consequences

Cigarette smoking contributes to an estimated 480,000 deaths in the US each year—more than alcohol, illegal substance use, homicide, suicide, car accidents, and HIV/AIDS combined. (NIDA)

Cigarette smoking harms nearly every organ in the body with wide ranging health impacts - from cataracts to pneumonia, - and it accounts for about one-third of all cancer deaths and almost 90 percent of all cases of lung cancer. Smoking is also associated with cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, bladder, and acute myeloid leukemia. The overall rates of death from cancer are twice as high among smokers as nonsmokers.

Pregnant women who smoke cigarettes incur an increased risk of miscarriage, stillborn or premature infants, or infants with low birth weight. Secondhand smoke exposure can cause health problems in both adults and children, such as reduced lung function, pneumonia, and bronchitis. Research suggests that children and teens may be especially sensitive to nicotine, making it easier for them to develop a tobacco use disorder.

Tobacco Use Disorder Treatments

Although some smokers can quit without help, most people need assistance. Smoking cessation can have immediate health benefits--within 24 hours of quitting, blood pressure and chances of heart attack decrease. Long-term benefits of smoking cessation include decreased risk of stroke, lung and other cancers, and coronary heart disease. A 35-year-old man who quits smoking will, on average, increase his life expectancy by five years. (NIDA)

The most effective treatment strategies for tobacco use disorder include a combination of medications and behavioral interventions.

  • Medications include:

    • Nicotine replacement therapies (NRT) that deliver nicotine in the form of gum, patches, sprays, inhalers, or lozenges without the harmful chemicals found in tobacco products.

    • Bupropion (Zyban®), helps with withdrawal symptoms and cravings,

    • Varenicline (Chantix®) eases withdrawal symptoms and blocks the effects of nicotine if a patient begins smoking again.

  • Behavioral interventions range from cognitive behavioral therapy to mindfulness training and can be accessed in a variety of ways, including formal clinical settings, on the phone, and through resources accessible online and at your local library.

Scientists are also investigating the potential of a vaccine that targets nicotine and prevents it from entering the brain for use in relapse prevention. (NIDA)

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