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. For the purposes of this chapter, the phrases “quitting smoking” will be used to represent complete abstinence from tobacco products, and “success” will be used to represent lifetime abstinence.Cigarette smoke is a complex mixture of chemical compounds that are bound to aerosol particles or are free in the gas phase. Chemical compounds in tobacco can be distilled into smoke or can react to form other constituents that are then distilled to smoke.
Nicotine treatment often includes replacement therapies combined with behavior change programs. These programs will provide psychological support and skills training. Generally, rates of relapse for smoking cessation are highest in the first few weeks and months and lessen considerably after about three months. Nicotine replacement products are the most common form of treatment, as they provide nicotine without smoking. Three abuse criteria (hazardous use, social/interpersonal problems and neglect roles) were prevalent among smokers, formed a unidimensional latent trait with nicotine dependence criteria, were intermixed with dependence criteria across the severity spectrum and significantly increased the diagnostic information over the dependence-only model.