Nicotine addiction or nicotine dependence is both a physical and psychological disease that can theoretically affect anyone, should they start smoking. Unfortunately, there are also more and more people who get into nicotine addiction through passive smoking and eventually start smoking themselves. Getting away from nicotine addiction is not an easy undertaking and should therefore be medically accompanied by a doctor. Despite all this: anyone can manage not to smoke anymore!
What is nicotine addiction (nicotine dependence)?
Nicotine addiction is the physical or psychological dependence on nicotine, a substance found in the tobacco plant. Often, just a few cigarettes are enough to fall into nicotine addiction. Sufferers of nicotine addiction experience withdrawal symptoms when they do not receive their daily dose of nicotine and often try in vain to quit smoking again. Unlike many other drugs, nicotine does not cause personality changes. Nicotine addiction combines physical and psychological dependence in most cases.
Causes
Physical nicotine addiction occurs because nicotine enters the blood through the lungs or oral mucous membranes and from there to the brain. Unlike many other toxins, nicotine can cross the blood–brain barrier. Only a few seconds after ingestion of the nerve toxin, it reaches the nerve cells in the brain, where it influences their activity. For example, nicotine causes the brain to release various messenger substances such as dopamine, serotonin and endorphins, all of which interact with the reward system in the brain. Therefore, it is not surprising that nicotine addiction occurs at a very early age. The nicotine comsum leads to a pleasant feeling and ensures, for example, in a stressful situation that the person becomes calmer again. It can lead to increased alertness and learning ability for a short time. Psychological nicotine dependence occurs when the user experiences positive effects in certain situations as a result of ingesting nicotine. Again, the reward center plays an important role in nicotine dependence. Nicotine provides inner peace and satisfaction. If the comsumer gets into a similar situation again, he will reach for nicotine again to evoke the same effect as the first time. In this way, he falls into a psychological nicotine dependence after only a short time.
Symptoms, complaints and signs
Nicotine addiction can be identified by different symptoms. These are consistent with the symptoms of other addictive disorders. Symptoms for nicotine addiction primarily include cravings for tobacco products and a willingness to continue using tobacco despite the health consequences. Finally, the addiction is defined by the fact that withdrawal symptoms occur when nicotine is not continued to be used. In addition, most people tend to develop tolerance and accordingly must increase the amount of nicotine supplied to experience the same effect. The withdrawal symptoms that are evident in nicotine addiction are most severe during the first two or three days of withdrawal. The main symptoms are depressed mood, irritability and sleep problems. Some people also experience digestive changes and increased appetite as a result of withdrawal. The pulse may slow and the ability to concentrate decreases. In most people who quit smoking, there is a lower or moderate increase in body weight. The psychological and vegetative symptoms usually subside after a few days or weeks. In many affected people, a strong desire to supply the body with nicotine still occurs weeks and months later. This craving can be particularly strong when the situation is stressful or the sufferer has consumed alcohol.
Disease progression
A nicotine addiction develops due to the special effect of nicotine on the human brain. It sets in after just a few cigarettes for most nicotine addiction sufferers. In many cases, users reach for higher and higher amounts of the neurotoxin over time or smoke at shorter intervals to achieve the same pleasant effect as at the beginning of nicotine addiction.Even after a short time without nicotine, nicotine addicts experience initial withdrawal symptoms such as inner restlessness, irritability or occasionally headaches, which cause the addict to reach for a cigarette again. It is therefore very difficult to free oneself from a nicotine addiction again.
Complications
A large proportion of smokers develop a nicotine addiction. This is present when more than three of the following six criteria are met:
Compulsive consumption, lack of/low control of smoking behavior, widening tolerance limits, putting other interests aside in favor of cigarette consumption, continued consumption despite already existing physical/psychological sequelae, physical withdrawal symptoms such as aggressiveness, irritability, concentration disorders. Already in the early morning – usually before breakfast – the first cigarette is due; the daily consumption increases. An independent attempt to reduce or completely stop smoking often leads to sleep disorders, irritability, aggressiveness, restlessness, concentration disorders, anxiety, depression, increasing appetite and weight gain. Smoking leads to damage/disruption of the respiratory and cardiovascular systems (smoker’s leg), brain, bones/joints, eyes, skin, oral flora, immune system, metabolism, wound healing, reproductive function, and may cause malformations and miscarriages (increased risk). The permanent damage severely limits quality of life even after successful weaning. Some, however, may progressively improve. Weaning itself often takes several attempts before it possibly leads to success. Finally, psychological dependence also plays an immensely important role. Numerous smoking cessation programs and offers do not save perseverance either. Depending on the intensity of the dependence, the consequences will be felt for many years to come. Nicotine itself is broken down by the liver within a few days.
When should you go to the doctor?
Having a nicotine addiction does not necessarily mean going to the doctor right away. Many people who want to quit smoking manage to do so without the assistance of a doctor. However, a medical professional can educate people about the risks of smoking and thereby serve as a motivator. In addition, a comprehensive physical examination can determine what physical damage cigarette consumption has already caused. The lungs and blood vessels in particular need to be checked so that action can be taken against any diseases. If nicotine addiction has already caused significant physical problems, a doctor must be consulted immediately. Depending on the nature of the complaints, other specialists such as the pulmonologist or the gastroenterologist may be consulted. Accompanying the treatment of the physical ailments, therapeutic counseling is useful. If the patient wants to give up smoking, self-help groups and addiction counselors should also be involved in the therapy. Those who have already gone through several withdrawals and relapses should consult their doctor and pharmacist. On the one hand, specialists can help with practical tips and recommend smoking cessation programs. On the other hand, the doctor can prescribe nicotine patches or similar preparations that make it easier to stop smoking. During withdrawal, the doctor should be contacted regularly, especially in the event of severe withdrawal symptoms such as palpitations or migraines.
Treatment and therapy
There are several treatment approaches for nicotine addiction. The most promising method of treating a nicotine addiction is behavioral therapy combined with aids such as nicotine gum or nicotine patches that relieve withdrawal symptoms. Support groups can also help many sufferers on their journey out of nicotine addiction by providing some control. It is important that the group is led by a knowledgeable and trained person. Hypnotherapy also offers a way out of nicotine addiction, but it does not work for every sufferer. Many other forms of therapy help isolated individuals. However, the number of successful treatments is not enough to prove an effect. Instead, the treatment successes may be due to the placebo effect as well. These forms of therapy for nicotine addiction include switching to herbal bets, aversion therapy, or acupuncture. Even after initially successful treatment, many sufferers relapse.
Aftercare
Many nicotine addicts take both nicotine cessation and subsequent aftercare into their own hands. The key challenge in aftercare is often resisting the temptation to relapse. When nicotine addicts return to cigarettes and other nicotine-containing substances, stress, social pressure and motivational problems often play a role. Because relapse is common, especially among younger smokers, nicotine addicts should be aware of this risk. Special psychological programs designed to help cigarette addicts quit smoking therefore often conclude with a maintenance or stabilization phase. In this phase, nicotine addicts develop strategies for dealing better with stress, for example. They may also think about what support they can get from friends, family members, colleagues and others when a relapse is imminent – or how to make their environment generally nonsmoking-friendly to reduce temptation. In aftercare, former smokers often monitor themselves closely to detect an impending relapse as early as possible. If they then notice corresponding signs, they try to counteract them with the help of the strategies they have developed, for example with relaxation techniques. A relapse can still occur. In such a case, nicotine addicts should self-critically question why they could not remain steadfast and what they can do better next time in such a situation.
Outlook and prognosis
In the case of nicotine dependence, the further course of the disease depends considerably on the patient’s cooperation. His or her will and assertiveness, as well as willingness to change his or her lifestyle, are instrumental in overcoming the disease. Many sufferers do not need medical consultation to stop using nicotine. However, it may be considered helpful and quite beneficial to seek the cooperation of a medical professional or a psychotherapist. These provide support on both a physical and psychological level to the individual and provide feedback on the current state of health. Most nicotine addicts are aware of the physical damage as well as the health consequences. In spite of this, they often need an incentive to successfully overcome their nicotine addiction. A particularly favorable prognosis is given to those who refrain from active as well as passive consumption of nicotine for several years. The body’s own regeneration process means that after just five years the lungs are back to a normal state of health and life expectancy is thus in line with the average. An unfavorable course of the disease leads to the fact that the affected person does not cope with the nicotine addiction and thus increases the risk of secondary diseases. Cancers may occur, resulting in a potential threat to human life.
This is what you can do yourself
Self-help often goes hand in hand with treatment when it comes to nicotine withdrawal. The actual withdrawal does not carry the same risk as other substance addictions, although it is perceived as unpleasant. As a result, many smokers do not seek treatment, relying instead entirely on self-help. Not every smoker succeeds in completely controlling the craving for nicotine right away. In this case, the affected person should at least try to reduce the amount. Stressful situations are a typical stumbling block. Here it is important to remain steadfast and not give in to the craving. Some smokers initially switch to e-cigarettes with liquids containing nicotine. This does not combat the actual nicotine addiction. However, other health issues can benefit, especially lung health. Motivation plays an important role in quitting smoking. To work on motivation, the addict can write down his personal reasons on a piece of paper. He then hangs this piece of paper in a visible place – for example, above his desk or on the edge of a mirror. The motivation list can be added to later. Negatively formulated goals are often less favorable, which is why positive reasons also belong on the list. In addition, the personal motives should be formulated as concretely as possible.