Addiction to nicotine does not happen quickly, after using tobacco once or twice; it develops over time. Most smokers go through a series of steps from experimentation to regular use on their way to becoming addicted. Particularly in the industrialized countries, most people addicted to nicotine initiated smoking during adolescence.The first use of nicotine, physical effects increase the likelihood of repeated nicotine consumption. Nicotine binds to cholinergic receptors in the central nervous system. In response to repeated nicotine use, the receptors rapidly desensitize and increase in number, and both these phenomena conspire to increase the addictive power of nicotine.
Nicotine replacement therapy increases the chances of stopping smoking by 50 to 70%. Group programs are more effective for helping people to stop smoking than being given self-help materials without face-to-face instruction and group support. 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. Common, in most studies, is the statement that the best medicine for nicotine treatment in methadone and buprenorphine-maintained subjects is far from adequate and the need of tailored interventions for this population.