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Nicotine Addiction: Effects, Symptoms, and Risk Factors

Medically Reviewed by: Charley Allen

Table of Contents

The most prevalent addiction in the US is nicotine addiction. Nicotine is a substance primarily absorbed through the lungs by smoking cigarettes that can cause addiction.

In this article, learn more about nicotine addiction and its effects, symptoms, and risk factors.

Understanding Nicotine Dependence

Nicotine is a highly addictive substance inhaled into the lungs while smoking tobacco. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), nicotine addiction is also called tobacco use disorder.

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The Centers for Disease Control and Prevention’s (CDC) most recent figures from 2020 show that 12 percent (or 38 million) of Americans aged 18 years or older were smokers. In addition, another research by the Substance Abuse and Mental Health Services Administration (SAMHSA) states that tobacco is the number one preventable cause of death in the US— often causing heart disease, stroke, lung cancer, respiratory problems, and other serious diseases.

Why People Start Smoking and Why It’s Hard to Stop

Many people smoke for various reasons, including pleasure and stress relief. Others are more likely to start if their parents or friends also smoke. Most of them began their habit in their teen years. Furthermore, our culture is largely influenced by the industry’s advertisements and other product promotions, as shown in video games, on the internet, and television.

Anyone who starts smoking has a chance of developing a nicotine addiction. According to the American Cancer Society, it is most likely to establish a habit throughout adolescence. The younger you start, the more likely it is that you will get hooked to nicotine. This is because the nicotine receptors stimulate the brain’s reward center, which is still growing in adolescence.

Moreover, if individuals quit after doing it regularly for a few weeks or longer, they may encounter discomfort, making it hard to stop.

Symptoms of Nicotine Addiction

The following are the signs of nicotine addiction:

  • Strong cravings for nicotine products
  • Being unable to stop using nicotine despite wanting to
  • Withdrawal symptoms like restlessness show when nicotine consumption has stopped
  • An urge to continue despite potential health risks
  • Needing more nicotine to feel satisfied

Causes of Nicotine Addiction

Nicotine reaches the brain within a few seconds of smoking a cigarette. It enhances the release of neurotransmitters, the brain chemicals that help control your mood and behavior. One of these neurotransmitters, dopamine, is produced in the brain’s reward system, resulting in sensations of pleasure and an elevated mood.

The more cigarettes you smoke, the more nicotine you need to feel good. Nicotine swiftly ingrains itself into your routine and influences your feelings and habits.

Who is At Risk?

Anyone who smokes is at risk of becoming dependent. The following factors also impact nicotine use:

  • Environment. Children who grow up with parents and friends who smoke are more likely to follow suit.
  • Genetics. Tendencies may be partially hereditary. The way receptors on the surface of your brain cells react to the high levels of nicotine that cigarettes provide may depend on genetic variables.
  • Age. Most individuals start when they are children or adolescents. As mentioned, the younger you smoke, the more likely it is that you will get hooked to nicotine. Nicotine stimulates the brain’s reward system, which still develops in adolescence.
  • Substance Use or Drug Abuse. Individuals who abuse alcohol and illicit substances are more inclined to smoke.
  • Mental Health Problems. Research has linked smoking with depression. Individuals suffering from depression, schizophrenia, post-traumatic stress disorder, or other mental illnesses are more prone to smoke.

Who Is Most Likely to Become Addicted?

Anyone who smokes has a chance of developing a nicotine addiction. Every day, almost 3,200 young individuals try cigarettes for the first time.

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Research shows that most individuals who smoke do so before age 26, and the younger someone starts using tobacco, the more likely they will develop an addiction. Some young people show indications of nicotine addiction as soon as two weeks after they start using cigarettes. This can hasten their transition from occasional to frequent smoking.

Is Smoking Tobacco Really Addictive?

Tobacco products contain over 4,000 compounds, some of which may lead to addiction. When used sparingly, nicotine produces pleasant feelings and helps the user overlook unpleasant ones. This encourages tobacco users to smoke even more. It also affects mood by influencing the central nervous system and brain chemistry. Similar to other addictive substances, nicotine works by stimulating the brain’s reward pathways with the neurotransmitter dopamine. Moreover, it causes a little adrenaline surge that isn’t noticeable but is enough to quicken the heartbeat and increase blood pressure.

People who smoke often increase their nicotine intake as their bodies become accustomed to it. As a result, they have more in their blood, meaning more of it is required to get the same effect. This is referred to as tolerance

Once a particular amount has been reached over time, the individual must continue using tobacco to keep the levels within a comfortable range.

How It’s Diagnosed

The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria are often used to diagnose tobacco use disorder. An unhealthy pattern of tobacco consumption that causes at least two of the following to occur during 12 months is associated with tobacco use disorder:

  1. It is consumed in greater amounts and for longer than anticipated
  2. Unsuccessful attempts to cut back on or stop using tobacco
  3. Excessive time spent obtaining or consuming tobacco products
  4. Strong cravings
  5. Inability to fulfill commitments and responsibilities
  6. Continued consumption despite negative social or interpersonal repercussions
  7. Setting aside social, professional, or recreational pursuits in favor of cigarettes
  8. Use of tobacco in risky circumstances
  9. Continued use despite knowledge of health issues or psychological effects specifically related to using tobacco regularly
  10. Nicotine tolerance as demonstrated by:
  • The need for increasing its doses to get the desired effect
  • A lessened effect despite using the same dose

11. Withdrawal symptoms after stopping, as demonstrated by

  • The typical signs linked to quitting have started to appear.
  • More use or an alternative medication is used to lessen withdrawal signs

Your doctor may ask additional questions to determine your dependence. Understanding the extent of your nicotine dependence will enable your doctor to choose the best course of therapy for you. The more you smoke every day and the sooner you use cigarettes after waking up, the more dependent you are.

How It’s Treated

Most smokers make several tries before successfully quitting for good and longterm. If you adhere to a treatment program that treats both the behavioral and physical elements of its dependence, you have a higher chance of succeeding in quitting for good. Your chances of success will greatly increase by using medication and working with a medical professional who has received specialized training in helping individuals quit.

Successful treatments for quitting are available, including behavioral therapy and medicines that have received FDA approval.

  • Behavioral Treatments

Patients using cessation medicines have been reported to benefit from in-person and telephone counseling. Their specialists often provide behavioral counseling for four to eight sessions. There are several methods for providing therapy to help people quit, such as Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Mindfulness, and Telephone Support and Quitlines.

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  • Medications

Certain stop-smoking medications are referred to as “nicotine replacement therapy.” Some medications that replace it require a prescription, while others don’t.

Any of these drugs can assist in lowering cravings and withdrawal signs, increasing the likelihood that you’ll quit smoking permanently. Employing more than one medication might also improve your outcomes.

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Ask your medical provider for assistance in creating an effective treatment plan for you or suggestions on where to get assistance in quitting smoking.

How Nicotine Affects You

Nicotine enters your bloodstream and flows to your adrenal glands above your kidneys. Adrenaline, released by the glands, raises your heart rate, respiration, and blood pressure. Moreover, adrenaline causes a wave of positive emotions.

It also raises dopamine levels, a neurotransmitter in the brain’s reward system responsible for pleasure and reward sensations. When dopamine is released, it reinforces the person’s habit of smoking.

Nicotine consumption continually alters how the body responds to stress, learning, and self-control.

Anatomy of Nicotine Addiction

Nicotine from tobacco triggers receptors to produce a feel-good chemical called dopamine. Over time, nicotine receptors grow and alter the structure of your brain. When the receptors don’t get it once you quit tobacco, you inhibit the brain’s pleasure response, which results in nicotine withdrawal symptoms. 

Your body’s level of nicotine receptors returns to normal if you utilize smoking cessation medications to manage your cravings and withdrawal signs. This will help you stop smoking permanently.

How Powerful is Nicotine Addiction?

It not only causes physical dependence in people. There is also a considerable psychological and emotional reliance since it impacts emotions, mood, and behavior. When someone uses tobacco to help them cope with negative emotions and feelings, quitting smoking might be difficult for them. Smokers may also associate smoking with various other activities, such as socializing. Due to all of these reasons, smoking is a difficult habit to curb.

According to research, quitting smoking may be more difficult than quitting cocaine or opioids like heroin.

What About Nicotine in Other Tobacco Products?

  • Nicotine in Cigars

Individuals who smoke cigars absorb nicotine through their lungs just as fast as those who smoke cigarettes. Although cigarettes typically contain 8 mg of nicotine, they only release 1-2 mg. Several well-known kinds of bigger cigars contain 100–200 mg of. Smoking cigarettes would also deliver a similar quantity of 1 to 2 mg.

  • Nicotine in Smokeless Tobacco

The content of smokeless tobacco is measured in milligrams of nicotine per gram of tobacco. There have been a lot of variations of smokeless tobacco, ranging from 3 to 40 mg/g for chew tobacco to 11 to 25 mg/g for dry snuff. Yet, it has been demonstrated that the blood levels of nicotine in smokers of cigarettes and tobacco are essentially the same.

  • Nicotine in Non-combusted Products

It is present in non-combusted products, which can cause addiction. Non-combusted products contain tobacco and a heating source. Compared to a regular combustible cigarette, the tobacco is heated to a much lower temperature. The heat produces an aerosol, which the user inhales. 

Other non-combusted products include edible, dissolvable tobacco products. These might be sticks, gummies, lozenges, or strips. They may also resemble candy and are readily concealed. Additionally, there are nicotine gels, which are tobacco products that are applied to the skin.

  • Nicotine in E-cigarettes

Although not all e-cigarette types contain the same amount of nicotine, product labels occasionally fail to disclose the actual concentration. Aside from that, several e-cigarette manufacturers that advertise their products as nicotine-free have been confirmed to contain it.

The Effects of Nicotine Addiction

Tobacco has almost 4,000 compounds with physical, psychological, and mental effects. Smoking has serious negative effects on one’s health. It produces an increased risk of the following: lung cancer, emphysema, leukemia, stroke, heart disease, diabetes, weakened immune system, osteoporosis, peptic ulcer disease, gum disease and dental issues, ear infections, and eye issues.

Secondhand smoking also raises the risk of heart disease and lung cancer. According to CDC, children who grow up around smokers are more prone to develop sudden infant death syndrome, asthma, respiratory infections, and middle ear disease, among others.

Effects of Nicotine Withdrawal

Any of the following are possible withdrawal effects from nicotine:

  • Anxiety
  • Irritability
  • Cravings for nicotine
  • Restlessness or boredom
  • Dizziness (which can last a day or two after quitting)
  • Feelings of frustration, anger, and impatience
  • Depression
  • Trouble concentrating
  • Trouble sleeping
  • Tiredness
  • Chest tightness
  • Slower heart rate
  • Headaches
  • Increased appetite
  • Weight gain
  • Cough, nasal drip, dry mouth, and sore throat
  • Constipation and gas

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These health effects may appear a few hours after the last cigarette and may prompt a person to continue smoking to alleviate symptoms.


More than 60 compounds known to cause cancer are found in tobacco smoke and thousands of other harmful chemicals. 

Contrary to those who don’t smoke, people addicted to smoking have a substantially higher chance of developing and dying from several diseases. According to CDC, about 1 in 5 deaths in the US is caused by cigarette smoking.

The most common cause of lung cancer is smoking. In addition, smoking causes other lung diseases, heart diseases, diabetes, and other illnesses.

Alternative and Natural Remedies

Some methods that might assist you in overcoming your addiction include:

  • Essential oils
  • Hypnosis
  • Herbs
  • Acupuncture

However, each option’s effectiveness and safety are mostly unclear.


Avoiding smoking is the greatest approach to avoiding developing a nicotine addiction. Avoiding smoking is the best method to prevent children from starting. According to research, children who have non-smoking parents or parents who have successfully stopped smoking are far less likely to engage in smoking.

When to See a Doctor

It is important to contact a doctor if you have attempted to stop smoking but haven’t succeeded. Your optimal action will depend on your preferences, age, and any underlying medical concerns. Consult your physician for treatment options.

Support Groups

Building a secure and steady life free from smoking involves social support. Ask your loved ones, close friends, and colleagues for help and encouragement. Let them know that you are addicted to nicotine and want to quit using so they can help you.

Consider joining support organizations as well. Support groups provide coaching and mutual support from other individuals trying to stop and are frequently free or low-cost. There are several locations where you may find a Nicotine Anonymous group.

Frequently Asked Questions

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Nicotine is an addictive chemical inhaled via the lungs while smoking tobacco products. Nicotine may be found in various items, including cigarettes, cigars, chewing tobacco, and other forms of snuff.

Although electronic cigarettes do not include nicotine, other chemicals may still exist.

Nicotine stimulates the brain to produce the neurotransmitter dopamine, which gives people a pleasant feeling. With time, the brain continues to crave that pleasant feeling from nicotine, and more people who smoke achieve the same feeling.

Since nicotine products are socially and legally acceptable, many people, especially younger people, quickly dismiss the potential of addiction. About half of those addicted to nicotine attempt to discontinue smoking yearly, but only a few succeed without assistance.

When people stop smoking or using nicotine-containing products, their brain produces much less dopamine. This may result in feelings of anxiety and depression, as well as typical signs of withdrawal. Also, nicotine is a potent stimulant, so it can help with concentration. Conversely, when people aren’t using nicotine, they have problems concentrating.

Giving up nicotine can have a significant positive impact on your general health and well-being. Quitting smoking improves the quality of life and health conditions. It also allows people to live longer and increase their life expectancy by up to 10 years. Furthermore, smoking cessation lowers the chance of a wide range of harmful health impacts, including chronic obstructive pulmonary disease (COPD), cancer, and cardiovascular disease.

The following are the common nicotine withdrawal effects:

  • Having cravings
  • Feeling irritated or upset
  • Feeling restless
  • Having sleeping difficulty
  • Having a hard time concentrating
  • Feeling hungrier or gaining weight
  • Feeling anxious, sad, or depressed

Yes. Several treatment choices are available for people who smoke and are trying to overcome their nicotine dependence. The goal of addiction treatment is to lessen the severity of withdrawal effects. Usually, various methods are used to do this, including behavioral therapies, medicine, and nicotine replacement therapy (patch, gum, inhaler, and nasal spray).

Rest assured that assistance is available if you or someone you know is struggling with nicotine dependence. No one should have to fight nicotine addiction alone, even though it might be challenging to overcome, especially with a co-occurring mental illness. Speak with a doctor immediately to begin your recovery journey and stop smoking long-term. Your doctor will also provide several options for treating nicotine addiction. If you want more information on tobacco addiction and other available resources, please feel free to contact us at Design for Recovery.

Other Articles Related to Addiction:

[1] Fentanyl Addiction

[2] Opioid Addiction

[3] Heroin Addiction

[4] Suboxone Addiction

[5] Alcohol Addiction

[6] Tramadol Addiction

[7] Synthetic Weed Addiction

[8] Sex Addiction

[9] Methadone Addiction

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  1. Centers for Disease Control and Prevention. (2022, March 17). Current Cigarette Smoking Among Adults in the United States.
  2. Substance Abuse and Mental Health Services Administration. (n.d.). Alcohol, Tobacco, and Other Drugs. Retrieved February 22, 2022, from
  3. American Cancer Society. (2022, June 23). Why People Start Smoking and Why It’s Hard to Stop.
  4. Tiwari, R. K., Sharma, V., Pandey, R. K., & Shukla, S. S. (2020). Nicotine Addiction: Neurobiology and Mechanism. Journal of pharmacopuncture, 23(1), 1–7.
  5. Truth Initiative. (2015, September 8). Youth and young adults are the most at-risk of tobacco addiction.
  6. Centers for Disease Control and Prevention (US), National Center for Chronic Disease Prevention and Health Promotion (US), & Office on Smoking and Health (US). (2010). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General.
  7. NIDA. (2021, April 12). What are treatments for tobacco dependence?
  8. CDC. (2022, September 14). General Information About Secondhand Smoke.


Edited by: David Beasley

David Beasley - Design for Recovery

David Beasley is a certified RADT (Registered Alcohol/Drug Technician). David, moved to California from North Carolina after many failed attempts to get sober.

Medically Reviewed by: Charley Allen

Charley earned his Masters of Clinical Psychology from Antioch University, Los Angeles, and is a California Licensed Marriage and Family Therapist (LMFT).He teaches mindfulness to both adults and children in group setting such as schools, corporate workplaces, and medical treatment facilities.

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