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Articles - Quitting Smoking
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Am I Addicted to Tobacco?

Why do knowledgeable, intelligent people continue to use tobacco when they know it is harmful to their health? The short answer is—they are addicted.

Most tobacco-addicted persons never succeed in quitting, and half die prematurely of tobacco-related disease. In the United States, less than 10 percent of the nearly 20 million people who quit smoking for a day remain abstinent one year later. With only 2 percent to 3 percent of smokers succeeding in smoking cessation, tobacco is considered among the most addictive of drugs.

There are about 47 million adults in the United States who smoke cigarettes and 6 million people use smokeless tobacco. Approximately 440,000 people die of tobacco-related illness each year, making tobacco addiction the most deadly of all.

Nicotine

How nicotine produces its pleasurable effects and why it’s so addictive have been the focus of intense research over the past 20 years. Nicotine and other ingredients in tobacco and cigarette smoke act upon structures deep in the brain, where emotions and survival drives are located. When stimulated, these structures produce a feeling of pleasure, calm and relaxation among tobacco users.

Specifically, nicotine stimulates the release of a neurotransmitter called dopamine along an area of the brain called the reward pathway. This reward pathway is the biological target for alcohol and all drugs of abuse. Smoking or chewing causes an increase in dopamine, which sends a strong pleasure signal that the individual desires to repeat. This nicotine-induced “pleasure”—experienced by tobacco users as calming and relaxing—forms the biological foundation for cravings, abuse, addiction and, ultimately, withdrawal symptoms if nicotine use is discontinued.

Smoking cigarettes delivers nicotine to the brain much faster than chewing tobacco, which has to be absorbed into the bloodstream via the mucous membranes in the mouth and through the digestive system. The rule of thumb in understanding addiction is this: The faster the drug gets to the brain, the greater the potential for addiction.

Craving

Once dopamine clears the pleasure center, the brain is in a state of imbalance. As a result, addicted smokers and chewers will experience craving and agitation within hours of their last dose of nicotine. What is happening is the brain’s dopamine is temporarily depleted so the brain sends out a distress signal that it needs more dopamine. The addicted user interprets this signal as, “I need more tobacco.”

Craving is often triggered by situations, environmental cues and ritualistic behavior. Just looking at a cigarette or purchasing chew causes anticipatory reward in addicted users.

Withdrawal

When the addicted tobacco user stops abruptly, marked changes in his brain chemistry occur within hours. Neurotransmitters that help regulate mood are disrupted, causing symptoms of irritability, agitation, restlessness, insomnia and concentration problems that can persist for a week or more—all of which are reversed, almost immediately, by using tobacco. As a result relapse is the rule and not the exception.

Am I addicted to tobacco?

Answer “yes” or “no” to the following statements.

  1. I use tobacco within 30 minutes of waking.

  2. I use tobacco to calm me down when I am stressed, nervous or angry.

  3. I have made one or more serious, but unsuccessful attempts to stop.

  4. I have cravings for tobacco.

  5. When I cannot use tobacco for an extended time I experience one or more of the following symptoms:

    1. irritability

    2. restlessness

    3. anger

    4. difficulty concentrating

    5. headaches

    6. insomnia

    7. depression

  6. My tobacco use causes worry or distress for my loved ones.

  7. I have given up social or recreational activities because it interferes with my tobacco use.

  8. I am worried about my health.

  9. I know I should quit, but don’t think I can.

If you answered “yes” to at least two of the items, you are very likely addicted to tobacco. Take heart though, because there has never been a better time to quit.

Source: Gold, M.S., Edwards, D.W. (2000). Treating cigarette smokers in 2000. Your Patient & Fitness, 14(4): 6-11.

By Drew Edwards, EdD, MS
© 2005 Achieve Solutions