Nicotine Dependence

Nicotine dependence is characterized by both tolerance and withdrawal symptoms in relation to nicotine use. Nicotine dependence can occur with cigarette smoking, smokeless tobacco use, or cigar or pipe smoking. Nicotine is the chemical in tobacco that keeps you smoking. When a person smokes, it causes a short-term increase in blood pressure, heart rate and the flow of blood from the heart. The smoke includes carbon monoxide, which reduces the amount of oxygen the blood can carry. Carbon monoxide can also damage the inner walls of the arteries, allowing fat to build up. This causes the arteries to narrow and harden and a person may be at risk for a heart attack.

Nicotine replacement therapy increases the chances of stopping smoking by 50 to 70%. Adding behavioural support (in person or via telephone for at least four sessions of contact) to nicotine replacement therapy increases the chances of stopping smoking by a further 10 to 25%.  Medications such as nicotine replacement and bupropion are ineffective with adolescents. Bupropion and nortriptyline aid long-term smoking cessation in adults, but other antidepressant medications do not. Of all primary care attendees, 71% reported having ever used a tobacco product (life-time regular smokers 51%; life-time occasional smokers 21.5%.). According to recent researchfrom Germany, “Genetic factors contribute to the overall risk of developing nicotine addiction, which is the major cause of preventable deaths in western countries.