Nicotine Addiction



Nicotine acts on the brain's chemistry. It creates feelings of pleasure. These feelings go away within a few minutes. People will need to keep using nicotine to feel this way again. This cycle can lead to addiction.

Risk Factors

Use of nicotine products is the main risk factor.

The risk of addiction increases with:

  • Family history or exposure to smoking
  • Depression
  • Bullying



Symptoms only happen when nicotine is not being used. This is known as withdrawal. Symptoms are:

  • Increased hunger
  • Craving
  • Headache
  • Irritability
  • Nervousness
  • Thinking and attention problems
  • Trouble sleeping


The doctor will ask about symptoms and past health. The person will also be asked about their history of using tobacco products. A physical exam will be done.

A blood test can check cotinine level in the saliva or blood. This will show changes in nicotine use. The doctor may use it to check the person's progress.



The doctor can help the person develop a treatment plan. Treatment may involve one or more therapies. Options include:

Nicotine Replacement Therapy (NRT)

NRT eases withdrawal symptoms. NRT products include:

  • Nicotine gum
  • Lozenges
  • Nasal sprays
  • Patches
  • Inhalers

The chance of becoming dependent on these products is low. NRT does not create the same 'feel good' feelings as nicotine.

NRT may help the person to:

  • Avoid smoking
  • Reduce the amount of tobacco they use
  • Quit and stay smoke-free

Electronic Cigarettes

Electronic cigarettes (e-cigarettes) turn liquid nicotine into a vapor. There is conflicting evidence on whether or not they may help a person quit. In addition, the long-term effects of e-cigarette use are not known.

Behavioral Therapy

Behavioral therapies include:

  • Counseling
  • Group behavior therapy
  • Telephone quit lines, cell phone programs, and text messaging programs
  • Internet and computer-based programs
  • Self-help classes and manuals
  • Cognitive-behavioral therapy


Medicine that may help a person quit include:

  • Antidepressants
  • Nicotine partial agonists—mimics effect of nicotine to ease withdrawal

Other medicine may help ease withdrawal symptoms. A third type may be used if a person starts smoking again. It blocks the pleasure feeling when they use nicotine.


The best prevention is to never use tobacco products. Try to avoid places where people are smoking as well.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.