What to know about smoking addiction

Is smoking addictive?

Tobacco products that people use, like cigarettes or e-cigarettes, contain a naturally occurring addictive chemical called nicotine. The American Cancer Society (ACS)Trusted Source highlights that this chemical may be as addictive as cocaine or heroin.

Addiction is the most severe formTrusted Source of SUD, which is a mental health disorder that affects a person’s brain and behavior, leading to an inability to control the use of substances. These substances may include tobacco products.

The American Psychological Association (APA) notes that addiction is a state of psychological or physical dependence on the use of drugs or other substances.

This psychological or physical dependence may be one of the reasons many people who smoke regularly have difficulty quitting, even if this is something they would really like to do.

The United States Department of Veteran Affairs (VA) notes that adults with SUD are 2 to 4 times more likely to smoke than someone without SUD. People who use tobacco products often use other substances, too, like cannabis or alcohol.

A person may be experiencing smoking or nicotine addiction if they still smoke even though they know it is negatively affecting their:

• physical health
• mental health
• loved ones’ health through secondhand or thirdhand smoke
• responsibilities at work or school due to taking multiple smoking breaks, for example

Who is at risk of smoking addiction?

Anyone who starts smokingTrusted Source or using nicotine in any way can experience nicotine addiction, according to the ACS.

A 2020 studyTrusted Source found that, compared with people who started smoking at the age of 21 years or older, people who started smoking regularly at the age of 18 to 20 years old were more likely to experience high levels of nicotine dependence and less likely to attempt or intend to quit later in adulthood.

This suggests that the younger someone is when they start smoking, the more likely they are to experience nicotine addiction.

How does nicotine affect the brain?

According to the ACS, when a person smokes, the nicotine and other chemicals from the tobacco product are absorbedTrusted Source into the bloodstream from the lungs. The chemicals then travel through the bloodstream and into various tissues and organs, like the brain.

Research indicates that when nicotine reaches the brain, it activates reward pathwaysTrusted Source by increasing levels of dopamine, which is a type of neurotransmitter.

Nicotine also activates other pathways in the brain that may cause aversive effects, such as dizziness or nausea. However, researchers think that the more often a person smokes, the less sensitive they become to the unpleasant effects of nicotine. Eventually, they may not experience these unpleasant effects at all.

This means that, over time, a person may associate smoking with positive feelings, such as relaxation. They may also feel the need to smoke more frequently over time. This is because the more often a person smokes, the more the brain adapts to the nicotine, meaning they may need to smoke more often to experience the same positive feelings. People may refer to this as nicotine tolerance.

Additionally, people may experience nicotine withdrawal symptoms after spending time without smoking, like feeling irritable or jumpy, which may include after sleeping during the night or while attempting to give up smoking. A person may feel relaxed when they smoke because they are stopping the withdrawal symptoms from occurring.

Withdrawal symptoms can get worse over time, which is why many people have difficulty quitting. Although these symptoms do get better eventually.

People should also note that other chemicals in tobacco products may also contribute to changes in the brain. However, further research into the topic is necessary.

When to speak with a doctor

Anyone who wants to quit smoking should speak with a healthcare professional for support, which may include:

• recommending nicotine replacement therapy (NRT) medications, which work by replacingTrusted Source some of the nicotine a person used to get from smoking
• sharing resourcesTrusted Source to help quit, such as local support groups or phone lines like 1-800-QUIT-NOW (1-800-784-8669)
• recommending lifestyle changesTrusted Source that may help, like removing lighters, ashtrays, and cigarette packs from the home

There are many health benefits to giving up smoking, but it can be challenging. A person may need to make multiple attempts to quit using tobacco products. A healthcare professional can still support someone regardless of how many attempts they have made to quit smoking in the past.

Summary

Smoking can be a form of SUD, especially if a person has difficulty controlling their use of cigarettes or other tobacco products. Addiction is the most severe form of SUD.

Nicotine is a naturally occurring addictive chemical in tobacco. When it enters a person’s brain, it causes dopamine to release in the reward circuits. This may cause a person to associate smoking with positive feelings. People may also experience nicotine withdrawal symptoms if stop smoking, which is why many individuals have difficulty quitting.

A doctor can offer support for people who want to quit smoking, including recommendations for NRT medications and local support groups.