Nicotine dependence occurs when you become reliant on nicotine and find it challenging to quit using tobacco. Nicotine is the chemical in tobacco that creates a temporary pleasurable effect in the brain, leading to addiction. As you smoke more, you develop a higher tolerance to nicotine, requiring more to achieve the same effect. Attempting to stop smoking can result in unpleasant mental and physical changes, known as nicotine withdrawal symptoms.

Quitting smoking can greatly improve your health, but breaking nicotine dependence isn’t easy. However, there are effective treatments available to help you quit. If you suspect nicotine dependence, seek help from a healthcare professional.


Signs of nicotine dependence may include:

  • Inability to quit smoking despite serious attempts
  • Experiencing withdrawal symptoms when attempting to quit, such as cravings, anxiety, irritability, restlessness, difficulty concentrating, depressed mood, frustration, anger, increased hunger, insomnia, constipation, or diarrhea
  • Continuing to smoke despite health problems
  • Limiting social activities to avoid smoke-free places

When to See a Doctor

If you’ve tried to stop smoking but haven’t been successful, you’re not alone. Most smokers make several attempts before achieving long-term abstinence. Seeking a treatment plan that addresses both the physical and behavioral aspects of nicotine dependence can significantly increase your chances of success. Medications and counseling from a tobacco treatment specialist can be helpful in quitting smoking.


Nicotine is the addictive chemical in tobacco that keeps you smoking. It rapidly reaches the brain after taking a puff, increasing the release of neurotransmitters that regulate mood and behavior. Dopamine, a neurotransmitter, is released in the brain’s reward center, causing pleasure and an improved mood. Over time, nicotine becomes part of your daily routine, intertwined with habits and feelings.

Common situations that trigger the urge to smoke include taking breaks at work, drinking coffee, drinking alcohol, driving, and spending time with friends. Overcoming nicotine dependence involves identifying these triggers and developing a plan to deal with them.

Risk Factors

Anyone who smokes or uses tobacco is at risk of becoming nicotine dependent. Factors that influence tobacco use include age, genetics, parental and peer influences, mental illness, and substance use.


Tobacco smoke contains numerous harmful substances, causing various health problems:

  • Lung cancer and lung disease
  • Other cancers
  • Heart and circulatory system problems
  • Diabetes
  • Eye problems
  • Infertility and impotence
  • Complications during pregnancy
  • Cold, flu, and other illnesses
  • Tooth and gum disease

Smoking also poses health risks to those around you, including family members and children.


The best way to prevent nicotine dependence is to avoid using tobacco in the first place. Parents who do not smoke or successfully quit smoking reduce the likelihood of their children taking up smoking.

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To diagnose nicotine dependence, your doctor may ask you questions or have you fill out a questionnaire to assess the level of your dependence on nicotine. The number of cigarettes you smoke per day and how quickly you smoke after waking up can indicate the severity of your dependence. Knowing the degree of your dependence will help your doctor determine the right treatment plan for you.


While most smokers make multiple attempts to quit, it’s rare to stop smoking on the first attempt without help. Using a combination of medications and counseling has been proven effective in helping people quit smoking. Medications known as nicotine replacement therapy (NRT) contain varying amounts of nicotine and can help reduce cravings and withdrawal symptoms. There are also non-nicotine medications available by prescription.

Counseling, whether individual or group-based, can help you develop the skills needed to quit smoking for good. The more time you spend with a counselor, the better your chances of success. Many hospitals, healthcare plans, providers, and employers offer treatment programs for smoking cessation, and some medical centers even provide residential treatment programs for more intensive support.

Methods to Avoid

Electronic cigarettes (e-cigarettes) are not considered safe, nor are they more effective in helping people quit smoking than NRT. In many cases, individuals who use e-cigarettes to quit end up using both products instead of quitting altogether. It’s essential to avoid substituting smoking with other forms of tobacco use, as tobacco in any form is not safe.

Avoid the following products:

  • Dissolvable tobacco products
  • Smokeless tobacco
  • Nicotine lollipops and balms
  • Cigars and pipes
  • Hookahs

Coping and Support

Seeking social support from family, friends, and co-workers is essential in achieving a stable and smoke-free life. Let them know how they can help you, and consider joining support groups, utilizing telephone counseling, mobile apps, or web-based programs to get personalized support and encouragement.

Preparing for Your Appointment

If you’re ready to seek help for quitting smoking, start by seeing your primary care doctor. To get ready for your appointment, consider your smoking triggers and any symptoms related to smoking. Make a list of your medications and invite a family member or friend along for support.

What to Expect from Your Doctor

Your doctor may ask questions such as:

  • How many cigarettes do you smoke each day? How soon after waking do you smoke?
  • Have you tried to stop smoking before? What worked and what didn’t?
  • What is motivating you to stop smoking now?
  • Do you have any physical health problems that you suspect are related to smoking?
  • Has smoking caused any problems at work or in your relationships?

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