Nicotine is highly addictive — some say it’s as addictive as cocaine, heroin and alcohol. Using nicotine just one time puts you at risk of becoming dependent on the drug because of its immediate effect on your brain. There are several treatments that can help you quit.
Nicotine is a type of stimulant found in tobacco products. Nicotine dependence occurs when your body gets used to having some level of nicotine in your system. In physical and psychological ways, your body “depends” on constantly having the chemical.
Stimulants like nicotine speed the messaging between your brain and body. They cause your brain to release more dopamine, which makes you feel pleasure. Stimulants also increase feelings of wakefulness and exhilaration.
Using nicotine can make you dependent on it. Nicotine products change how your brain works, leading to dependence.
Nicotine affects people of all ages but is most dangerous among teens. The brain is still developing during the teenage years, making it easier to become addicted to nicotine.
Science has shown that the younger you are when you start using nicotine, the more likely you are to become addicted. A Surgeon General’s Report (SGR) found that about 3 of 4 high schoolers who smoke will still smoke in adulthood.
Nicotine dependence is common, affecting about 23.6 million Americans or 8.5% of people ages 12 and older.
Yes. Using anything that contains nicotine can make you dependent. This includes tobacco products (like cigarettes, cigars or dip) and e-cigarettes used for vaping.
Nicotine is an addictive substance. When your body needs nicotine for physical or psychological reasons, it’s called tobacco use disorder. Nicotine floods your brain’s reward circuits with a feel-good chemical called dopamine. This creates a pleasant feeling, and when it wears off, you often want more.
Using nicotine can also become a habit. For example, if you’re used to smoking a cigarette every morning when you wake up, doing so becomes part of your routine.
Nicotine dependence is when your body gets used to nicotine and the sensations it creates. Substance use disorder (SUD) is when your body needs nicotine to avoid withdrawal symptoms. Because nicotine disturbs your brain’s reward circuits, it’s highly addictive.
Caffeine is a common stimulant found in coffee, teas and sodas. You can develop a dependence on caffeine because your body gets used to it.
Caffeine and nicotine both cause the brain to release dopamine, but the release from caffeine is much smaller. Nicotine changes how the brain works, making it one of the most addictive substances in the world.
Using tobacco products is the main cause of nicotine dependence. When you use tobacco products, nicotine travels to your lungs and is quickly absorbed into your blood. Once in your bloodstream, it travels to other areas of your body. Your brain releases dopamine, which creates temporary feelings of happiness and satisfaction.
When the feel-good effects of nicotine wear off (usually within a few minutes), you might feel edgy or irritated. At this point, many people keep using nicotine to continue enjoying the pleasurable effects. The more you use nicotine, the higher your body’s tolerance. This means your body will gradually need more nicotine to feel good.
Nicotine is incredibly addictive — possibly as addictive as alcohol, cocaine or heroin. Your body can start to depend on nicotine right away — even after one or two uses.
The most common symptoms of tobacco use disorder include:
When you feel a physical craving for nicotine, you’ll likely feel edgy, anxious and restless. You could also experience tightness in your throat or stomach. Cravings can come in waves of intensity, sometimes feeling subtle and then becoming stronger.
You get nicotine withdrawal symptoms when you stop giving your body nicotine. While withdrawal symptoms from nicotine dependence vary from person to person, the most common ones include:
Physical withdrawal symptoms:
Psychological/emotional withdrawal symptoms:
Symptoms of nicotine withdrawal usually start a few hours after your last dose. They’ll be most intense on the second or third day after quitting.
Talk to your healthcare provider if you’re worried about nicotine withdrawal. They’ll work with you to find a treatment or combination of treatments to help you manage withdrawal. Treatment often involves a combination of medication and therapy.
Your healthcare provider can diagnose nicotine dependence by asking a few questions or having you fill out a questionnaire. This is called the Fagerström Test for Nicotine Dependence.
Your provider determines your level of dependence according to:
You can cure nicotine dependence. Eliminating your need for nicotine takes time, but you can end your dependence for good.
You don’t need treatment to cure nicotine dependence, but those who get treatment are often more successful. There are cessation treatments that effectively cure nicotine dependence and help reduce withdrawal symptoms. Treatments include medications approved by the U.S. Food and Drug Administration and behavioral therapies.
Research shows that those who use a combination of behavioral therapies and medications have more success quitting nicotine than those who only use one treatment or none at all.
Medications available for nicotine dependence include:
Your provider may recommend behavioral therapy along with medication:
You may experience some side effects from the medications used to treat nicotine dependence.
Side effects of NRT patches include:
Side effects of NRT gum include:
Side effects of NRT nasal spray include:
Side effects of NRT inhalers include:
Side effects of NRT lozenges include:
Bupropion side effects may include:
If you choose to use medication to help cure nicotine dependence, make sure to:
Other strategies for managing nicotine withdrawal symptoms include:
Symptoms of nicotine withdrawal can last from a few days to several weeks. Every day your symptoms will improve a little more. When your withdrawal symptoms go away, your body is no longer dependent on nicotine.
The best way to prevent nicotine dependence is to avoid it. Don’t use any products containing nicotine, including e-cigarettes. Using nicotine just one time can start the process of nicotine dependence. If you can, avoid putting yourself in situations where you might be tempted to use nicotine.
If you have tobacco use disorder, you need a constant supply of the substance in your body. When nicotine fades out of your bloodstream, you’ll experience unpleasant withdrawal symptoms. Having a nicotine dependence also creates a higher tolerance for the substance over time, meaning you’ll need larger amounts of nicotine to feel the effects.
You can have tobacco use disorder for as long as you keep using nicotine. For some people, it can last a lifetime. Quitting nicotine is the only way to successfully cure tobacco use disorder, and you must make a conscious effort to quit.
Breaking nicotine dependence is hard but doable. It might not happen on your first try, but 3 in 5 adults who ever smoked have quit. It takes consistency and perseverance, but it’s possible.
When you stop using nicotine products, you benefit almost immediately. For example, your heart rate and blood pressure return to normal during the first 20 minutes after quitting. Over time, you’ll:
A note from Cleveland Clinic
Nicotine is one of the most addictive substances in the world. Using nicotine a handful of times can quickly turn into dependence, and this harmful drug can have long-lasting effects on your body. To beat tobacco use disorder, healthcare providers recommend a combination of medications and behavioral treatments to reduce withdrawal symptoms. If you have tobacco use disorder, talk to your provider about quitting. With their support, your journey to a nicotine-free life is around the corner.
Last reviewed by a Cleveland Clinic medical professional on 11/30/2022.
Learn more about our editorial process.