Tobacco Use Disorder
(Nicotine Addiction; Smoking Addiction)
Tobacco use disorder occurs when the use of tobacco harms a person’s health or social functioning, or when a person becomes dependent on tobacco. Tobacco may be consumed in the form of cigarettes, smokeless tobacco products (eg, snuff, chewing tobacco), cigars, or pipes.
This condition can be treated. Talk to your doctor if you think you have tobacco use disorder.
Tobacco products contain nicotine, which is transported to the brain and causes pleasurable sensations. The effects of nicotine dissipate within a few minutes, however. This cause tobacco users to continue using tobacco to maintain the pleasurable effects and prevent withdrawal. Other chemicals in tobacco products may also contribute to tobacco use disorder.
The following factors increase your chance of developing tobacco use disorder. If you have any of these risk factors, tell your doctor:
If you experience any of these symptoms, do not assume it is due to tobacco use disorder. These symptoms may be caused by other health conditions. If you experience any one of them, see your physician.
- Increase in blood pressure, respiration, and heart rate
- Hyperglycemia (abnormally high blood sugar level)
- Thinking and attention problems
- Sleep disturbances
- Increased appetite
Tobacco-related health problems:
- Smoker’s cough
- Hot flashes in women * 6]]>
- Cancer, including cancers of the ]]>larynx (voice box)]]> , oral cavity, ]]>throat]]> , ]]>esophagus]]> , ]]>lung]]> , and ]]>colon]]> .
- ]]>Chronic bronchitis]]>
- ]]>Chronic obstructive pulmonary disease]]>
- ]]>Heart disease]]>
- ]]>Miscarriage]]> , ]]>premature delivery]]> , stillbirth, infant death, low birth weight, or ]]>sudden infant death syndrome (SIDS)]]>
- Tobacco-related social problems
A study involving over 100,000 women found that smoking is associated with a shorter life span. After five years of quitting smoking, though, women had a reduced chance of dying compared to those who continued smoking.
Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she will ask you specific questions about your tobacco use, such as how long you have been using tobacco and how often you use it.
Your doctor can test your lung function and compare the results to those of a non-smoking person. The results can be given to you as your “lung age.” Knowing your “lung age” right after having the test done may help you to stop smoking. * 3]]>
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Nicotine Replacement Therapy
Nicotine replacement therapy]]> (NRT), including nicotine gum, nasal sprays, patches, and inhalers, are used to relieve nicotine withdrawal symptoms. They do not produce the pleasurable effects of tobacco products, so there is little chance NRT will be abused. Combining behaviorial therapy with NRT may be even more helpful. ]]>*¹]]>
According to studies, NRT may help you to:
- Reduce the amount of tobacco you usually consume and quit altogether even if you are unable or unwilling to stop smoking ]]>*²]]>
- Quit and stay smoke-free if you use the product before your actual "quit day" ]]> * 4]]>
- Abstain from smoking ]]> * 5]]>
Talk to you doctor about how to best use this therapy.
Behavioral therapies to help people quit using tobacco include:
- Step-by-step manuals
- Telephone quit lines
- Self-help classes
- Group behavior therapy—This may be more helpful than self-help programs. ]]> * 7]]>
- ]]>Cognitive behavioral therapy]]> —This teaches people to recognize high-risk tobacco use situations, develop alternate coping strategies, manage stress, improve problem-solving skills, and increase social support.
Research has shown that certain medications, including the antidepressant ]]>bupropion]]> (Zyban) and ]]>varenicline tartrate]]> (Chantix) may help people quit smoking. Varenicline tartrate helps ease symptoms of nicotine withdrawal and may block the effects of nicotine if people resume smoking.
A Note About the Effects of Secondhand Smoke Exposure
Even if you’re not a smoker, exposure to smoke from tobacco products on a regular basis is dangerous, sometimes even life-threatening.
Here are the US Surgeon General’s conclusions about effects from inhaling secondhand smoke:
- Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke.
- Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, and more severe ]]>asthma]]> . Smoking by parents causes respiratory symptoms and slows lung growth in their children.
- Exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer.
- The scientific evidence indicates that there is no risk-free level of exposure to secondhand smoke.
- Separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate exposure of nonsmokers to secondhand smoke. But eliminating smoking in indoor spaces fully protects nonsmokers from exposure to secondhand smoke.
American Cancer Society
Canadian Cancer Society
The Lung Association
Diagnostic codes (ICD9-CM). Surgeon General website. Available at: http://www.surgeongeneral.gov/tobacco/codes.htm . Accessed September 25, 2006.
Kenfield SA, Stampfer MJ, Rosner BA, Colditz GA. Smoking and smoking cessation in relation to mortality in women. JAMA. 2008;299:2037-2047. In: Tobacco use disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed May 22, 2008.
Questions about smoking, tobacco, and health. American Cancer Society website. Available at: http://www.cancer.org/ . Accessed September 25, 2006.
Research report series: tobacco addiction. National Institute on Drug Abuse website. Available at: http://www.nida.nih.gov/ResearchReports/Nicotine/Nicotine.html . Accessed September 25, 2006.
* 1 2/27/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Etter JF, Stapleton JA. Nicotine replacement therapy for long-term smoking cessation: a meta-analysis. Tob Control. 2006;280-285.
* 2 9/24/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : LF Stead, T Lancaster. Interventions to reduce harm from continued tobacco use [review]. Cochrane Database of Systematic Reviews. 2007;3.
* 3 3/25/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Parkes G, Greenhalgh T, Griffin M, Dent R. Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial. BMJ. 2008;336:598-600.
* 4 10/14/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Shiffman S, Ferguson SG. Nicotine patch therapy prior to quitting smoking: a meta-analysis. Addiction. 2008;103:557-563.
* 5 12/16/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Eisenberg MJ, Filion KB, Yavin D, et al. Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials. CMAJ. 2008;179:135-144.
* 6 2/5/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Cochran CJ, Gallicchio L, Miller SR, Zacur H, Flaws JA. Cigarette smoking, androgen levels, and hot flushes in midlife women. Obstet Gynecol. 2008;112:1037-1044.
* 7 2/17/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2009;(1):CD001007.
Last reviewed January 2009 by ]]>Theodor B. Rais, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.