Smoking Addiction

What Is Smoking Addiction?

Smoking addiction is a condition where a person experiences a compulsive need to smoke tobacco, often continuing despite negative consequences.

Addiction to smoking happens when the body becomes dependent on nicotine, the active ingredient in tobacco products like cigarettes.

Someone who smokes occasionally, however, may not be truly addicted. Typically, addiction to smoking (or any substance) is categorized by a compulsive need to continue the habit.

Smoking addiction is a little complicated; people who are addicted to smoking often develop rituals around their smoking habits. As a result, the act of cigarette smoking becomes a comforting habit itself, strengthening the addiction.

Smoking Addiction VS. Nicotine Addiction

Smoking addiction and nicotine addiction are often used interchangeably, but they are technically different things.

Smoking addiction not only involves the compulsory need to keep smoking. It also encompasses the behavioral aspect of smoking that we mentioned above. Smoking often becomes an addiction due to a combination of nicotine dependence and the comforting routine of smoking.

Nicotine addiction, on the other hand, is more like a component of smoking addiction. Nicotine is a powerful stimulant found in tobacco. Smoking cigarettes (or other tobacco use) can quickly create a physical nicotine dependence.

Nicotine dependence is another way to describe your body becoming reliant on that regular level of nicotine. People who become dependent on nicotine will often experience withdrawal symptoms when quitting, cutting back, or going too long between nicotine uses.

From there, nicotine dependence can quickly lead to addiction. Remember, addiction is defined by a compulsion, whereas dependence is the body’s reliance on a substance. Dependence can very easily lead to addiction.

Therefore, when comparing smoking addiction to nicotine addiction, you can think of it this way:

Nicotine addiction is a component of smoking addiction. An addiction to smoking will usually also involve the psychological and behavioral part of the habits and comforting rituals around smoking that make it even harder to quit.

How Does Smoking Addiction Happen in the Brain?

When a person smokes, nicotine is rapidly absorbed into the bloodstream and reaches the brain within seconds. In the brain, nicotine interacts with the brain’s reward system, causing a flood of dopamine.

The increase in dopamine can cause relaxation and euphoria, which in turn often makes a person want to keep using nicotine products.

As a person continues to smoke, their brain becomes accustomed to the increased levels of dopamine and other neurotransmitters, often leading to dependence on nicotine and then a nicotine addiction.

When nicotine use is combined with rituals, like having a cigarette after a meal or smoking around friends on a night out, the addiction often deepens.

How Common Is Smoking Addiction?

According to the U.S. Centers for Disease Control and Prevention (CDC), 11.5% of all American adults smoked cigarettes in 2021.

Somewhat alarmingly, the CDC also reports that every day, an estimated 2,000 adolescents (under the age of 18) smoke their first cigarette.

While this data doesn’t necessarily indicate addiction, we know that nicotine is a highly addictive chemical. Only about 6% of smokers succeed in quitting in a given year out of the 70% of U.S. adults who report a desire to stop smoking.

Thankfully, data shows that smoking addiction is declining. The CDC reports a 30% decline in U.S. smoking over the past 14 years.

On a global scale, the WHO Global Report on Trends in Prevalence of Tobacco Use 2000-2025 reports that smoking rates worldwide are trending downward: Male smokers decreased from 43% in 2000 to 34% in 2020, and female smokers dropped from 11% to 6% over the same time period.

Signs of Smoking Addiction

Identifying the signs of smoking addiction can help you or a loved one get help to quit early on. We know that over time, the health risks that tobacco users face increase significantly—up to and including cancer or even death.

If you recognize these signs of smoking addiction, the good news is that there are many, many resources, tools, and support options available to help you quit and lead a tobacco-free life.

Physical Symptoms

The physical and behavioral symptoms of smoking addiction tend to be pretty easy to recognize.

These physical symptoms can include:

• Experiencing cravings to smoke
• Needing to smoke more over time to achieve the same effect (i.e., tolerance)
• Experiencing withdrawal symptoms when not smoking (e.g., irritability, anxiety, weight gain, etc.)
• Chronic cough
• Recurring respiratory infections (e.g., sinusitis, bronchitis, etc.)
• Shortness of breath
• Lowered stamina or endurance during exercise or physical activities
• Reduced sense of smell or taste
• Yellow-stained fingertips or teeth
• Headaches
• Brittle nails
• Hair loss
• Poor circulation (i.e., cold hands and feet)

Behavioral Symptoms

As someone becomes addicted to any substance, they often experience a compulsion to keep using that substance despite adverse effects.

For someone addicted to smoking, these behavioral signs of addiction might look like:

• Continuing to smoke, even despite health problems like COPD or asthma
• Spending money on cigarettes instead of essential items
• Changing their routines to accommodate their smoking habit (i.e., quit going the gym, needing frequent smoke breaks at work)
• Lying or being secretive with loved ones about smoking
• Relying on smoking cigarettes as a primary way for managing stress or other negative emotions
• Trying and failing to quit smoking, despite a desire to quit

Risk Factors for Developing a Smoking Addiction

There is no singular cause behind an addiction to smoking itself, as this habit is generally a combination of social, psychological, and even hereditary factors.

Understanding these risk factors can help us implement preventative measures, such as educational campaigns for young adults or targeted support programs for at-risk populations.

For example, increasing access to after-school programs for teenagers can provide healthy, safe alternatives to smoking and reduce the likelihood of nicotine experimentation.

By recognizing your potential risk factors, you can better understand your potential predispositions to the habit, which can help you maintain a smoke-free life if you decide to quit for good.

Environmental Influences

In many cases, a person’s environment can make a huge impact on their routines, habits, and even risk factors for developing an addiction.

Some possible environmental factors that may influence smoking addiction include:

• Peer pressure—even passive peer pressure from being around friends who smoke
• Smoking habits of family members, especially when it’s normalized by relatives in the home
• Early access to tobacco
• Living in communities or cultures where smoking is widely accepted
• Workplace influence, such as jobs where smoke breaks are permitted or viewed as a chance to socialize with coworkers
• Media and advertising that portrays smoking as fun, glamorous, rebellious, etc.
• Stressful environments (e.g., high-pressure jobs or chaotic home life) that could lead to smoking as a coping mechanism

Psychological Influences

In addition to a person’s environment potentially influencing their desire to smoke, some psychological factors can equally influence someone’s potential for getting caught up in a smoking addiction.

Examples of potential psychological influences might include:

• Coping with stress or anxiety
• Dealing with co-occurring mental health issues, like depression
• Developing a smoking habit alongside another substance use disorder, such as alcoholism
• Associating smoking with positive activities (e.g., smoking during breaks or after meals)
• Smoking as a means of fitting in or feeling better about oneself

Genetic Factors

Believe it or not, genetics can also play a role in whether or not a person is more at risk for developing an addiction to smoking.

The following hereditary elements can play a role in someone’s potential risk of becoming a smoker:

• Metabolism and how quickly your body processes nicotine
• How sensitive your nicotine receptors are
• How well your body regulates dopamine
• Family history of substance use disorder (i.e., addiction) of any type

Health Consequences of Smoking

Understanding the health risks of smoking is crucial for making informed choices about your health and well-being.

Ultimately, what you decide is up to you, but you can at least make that choice based on having all the information available.

Immediate Effects of Smoking

The effects of nicotine can hit your system quickly. When tobacco cigarettes, nicotine enters your bloodstream almost immediately and can cause some almost instant side effects.

These short-term side effects can include:

• Increased heart rate
• High blood pressure
• Nausea
• Relaxation
• Euphoria
• Throat irritation
• Coughing or shortness of breath
• Constipation and/or gas

Long-Term Health Risks of Smoking

Over time, smoking can cause many health problems and poorly impact your overall quality of life.

The most common long-term side effects of smoking are:

• Gum disease, tooth loss
• Decreased lung function
• Different types of cancer (e.g., lung cancer, throat cancer, etc.)
• Cardiovascular health issues (e.g., heart disease, COPD)
• Chronic sinus infections
• Increased chance of having a stroke
• Dry skin and pronounced wrinkles (especially around mouth/face)

Effects of Secondhand Smoke

Unfortunately, tobacco smoke can also harm the people around you. The CDC reports the following data regarding the risks of secondhand smoke:

• In adults, secondhand smoke can cause heart disease, stroke, and lung cancer.
• In children, secondhand smoke can lead to ear infections, respiratory infections, and asthma attacks. It may also lead to sudden infant death syndrome (SIDS).
• Pregnant women exposed to secondhand smoke are at a higher risk of giving birth to babies with lower birth weights, which can cause several health risks in the newborn.
• Approximately 2.5 million non-smokers died from health problems caused by secondhand smoke exposure since 1964.

Treatment Options for Smoking Addiction

Treatment options for smoking addiction include a variety of techniques to help people quit smoking and stay tobacco-free.

For many, one or more of these various treatment options can help manage cravings and alleviate symptoms of nicotine withdrawal.

Examples of nicotine withdrawal symptoms include:

• Irritability
• Headache
• Restlessness
• Insomnia
• Weight gain

Behavioral Therapies

Behavioral therapy, like counseling and support groups, can be a crucial part of a tobacco-free treatment approach.

Both individual and group therapy can help people identify their triggers, develop coping strategies outside of smoking, and build a strong support network.

Two of the most common therapy approaches used in treating smoking addiction are cognitive-behavioral therapy (CBT) and motivational interviewing (MI).

Medications

Your doctor might suggest prescription medications (aka “stop-smoking pills”) to help you quit.

One option is varenicline, which was specifically designed to help with smoking and tobacco cessation. Varenicline works by blocking the nicotine receptors in your brain, making it so that you won’t feel any of the positive side effects of smoking or other tobacco use.

The other option is bupropion (Welbutrin®), an antidepressant that helps minimize nicotine cravings.

Either of these options can be used alone or along with nicotine replacement therapy.

Nicotine Replacement Therapy (NRT)

Many people use one or more forms of nicotine replacement therapy (NRT) to help them quit smoking, and for good reason.

According to the American Cancer Society, people who use NRT are 50% to 70% more likely to succeed in fully quitting their smoking habit.

NRT helps you safely manage your nicotine intake, allowing former smokers to avoid the full intensity of nicotine withdrawal symptoms.

Additionally, NRT provides nicotine on a controlled basis without any of the harmful chemicals found in cigarettes and other tobacco products.

The U.S. Food and Drug Administration (FDA) has approved the following types of NRT:

• Nicotine lozenges
• Nicotine gum
• nicotine patches
• Nicotine inhalers
• Nicotine nasal spray

Nicotine lozenges, gum, and patches are available over the counter, while nicotine inhalers and nasal sprays require a prescription.

Support Groups and Programs

The right support and encouragement can make a huge difference for anyone who wants to quit smoking.

Support groups and programs offer encouragement, accountability, structure, and resources to help you stay motivated and maintain a tobacco-free life.

Here are some examples of popular support options:

• Nicotine Anonymous (NicA): A 12-step program offering peer support and meetings for those trying to quit smoking.
• Freedom From Smoking®: An online and group-based program from the American Lung Association that provides tools and support for quitting smoking.
• Smokefree.gov: A website with links, resources, and quitline Services providing free counseling and support. Their phone number is 1-800-QUIT-NOW (1-800-784-8669).
• SmokefreeTXT: A 24/7 text messaging service that gives encouragement, advice, and tips to help you quit smoking for good.

Start Your Smoke-Free Journey Today

Whether you’ve been smoking for days or decades, you can succeed at quitting once and for all if you have the right tools.

You can talk to your doctor for advice and recommendations based on your individual experience with smoking. You can also connect with experts like SmokeFree.gov or The American Lung Association if you aren’t sure where to start.

The important thing to remember is that when you are ready, so many helpful resources are already waiting to help you!