The health toll of nicotine use disorder — and how to quit

According to the World Health Organization (WHO), 1.3 billion people across the globe use tobacco products. Many of these people are addicted to tobacco use because it contains nicotine, a harmful substance that makes it difficult to quit. Unfortunately, this addictive substance makes tobacco use dangerous and even deadly. Tobacco products kill over eight million people every year — both directly and due to secondhand smoke.

Most people who use tobacco products want to quit. If you’re addicted to nicotine, a chemical found in tobacco products, there’s hope. Nearly 9% of adult smokers were able to quit, and getting some social and professional support can help you fight cravings and quit once and for all.

Signs of nicotine use disorder

Tobacco use disorder is officially recognized as a type of substance use disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which means there’s a specific list of diagnostic criteria you must meet to be diagnosed with it.

According to the DSM, symptoms of tobacco use disorder include:

• Using more nicotine than you planned or finding it hard to cut back
• Wanting to quit but feeling like you can’t, even after trying
• Spending a lot of your time getting, using, or recovering from nicotine
• Having strong cravings that feel hard to ignore
• Continuing to use nicotine even when you know it’s affecting your body or mind
• Struggling to keep up with responsibilities at work, school, or home because of nicotine use
• Experiencing withdrawal symptoms when you try to quit using nicotine

Keep in mind that even if you don’t meet these exact diagnostic criteria, it doesn’t mean you don’t deserve support. If you’re struggling to quit nicotine in any capacity, working with a therapist can help you curb cravings and make life choices that feel healthier for you.

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What causes nicotine dependence?

Nicotine use (or, for that matter, any other type of substance use) isn’t a sign of weakness. People of any gender, age, or race can become addicted to nicotine.

Nicotine is addictive because of the way it affects your brain. When you use nicotine, it releases dopamine, a “feel-good” neurotransmitter. Over time, your brain begins to rely on nicotine to release dopamine, creating a cycle of dependence.

Research also shows a behavioral component to nicotine use. Not only is nicotine itself addictive, but the act of smoking a cigarette or vaping can become a comforting ritual you rely on during times of distress. In this way, nicotine use can become a behavioral addiction, like gambling or overeating, that’s triggered by stress or boredom. 

Certain people may also be at a higher risk of starting to use nicotine, which increases their vulnerability to addiction. These risk factors include:

• Peer pressure or exposure to nicotine at a young age
• Having parents or close family members who use nicotine
• Exposure to high-stress environments or life circumstances
• Easy access to nicotine products, including vaping devices
• Being exposed to tobacco marketing that appeals to younger people

Unfortunately, nicotine use disproportionately affects people of certain groups, including African Americans, rural Americans, sexual and gender minorities, American Indians/Alaskan Natives, veterans, people who live with mental health or substance use disorders, and people living in poverty.

What are the effects of nicotine on your health?

Nicotine use can have serious health consequences, and, for some people, it can even lead to death.

Some of the most significant health consequences of nicotine use include:

• Lung damage, including chronic obstructive pulmonary disease (COPD) and increased risk of lung cancer
• Cardiovascular issues like high blood pressure, heart disease, and stroke
• Increased risk of various cancers, including throat, mouth, and bladder cancer
• Compromised immune system, which makes you more vulnerable to infections
• Impaired reproductive health, including reduced fertility

Many of these consequences are associated with smoking cigarettes, one of the main ways people consume nicotine. While research has shown that vaping isn’t as fatal as smoking cigarettes, it comes with its own health risks and isn’t considered a safe alternative.

You may already know about the risks of nicotine use, but quitting any substance — nicotine included — is rarely as simple as just knowing the consequences. It might be helpful to think about what these health consequences mean for your life. For example, you may not feel affected by hearing that nicotine can damage your lungs. But what would damaged lungs mean concretely for your life? Would it mean you’d have less energy to spend with the people you love?

Six tips for curbing nicotine cravings

Many people are able to stop using nicotine on their own. Try these tips to fight cravings and quit:

Delay the urge

When a craving hits, remind yourself that it will pass. Cravings typically only last a few minutes, even though they can feel intense in the moment. 

Try to delay the urge by distracting yourself with a quick activity, like taking a walk, calling a friend, or scrolling through your favorite playlist. Just delaying yourself for five minutes can make a difference. The longer you wait, the easier it can become to ride out cravings without giving in.

Use nicotine replacement to avoid withdrawal

Nicotine withdrawal can make quitting feel even harder. Products like nicotine gum, patches, or lozenges can help ease withdrawal symptoms while you work on breaking the habit. These replacements provide a safer way to reduce nicotine levels gradually, which can give your body and mind a chance to adjust without the same intensity of cravings.

Avoid triggers

Certain places, people, or situations might make you want to reach for nicotine. Maybe it’s going to certain bars, stepping outside for a coffee break, or socializing with friends who smoke or vape. 

Identifying your triggers is key. Once you know what sets off your cravings, you can take steps to avoid those situations or prepare yourself with healthier coping strategies when you can’t avoid them.

Find replacement behaviors

You might automatically reach for a cigarette when you feel stressed or bored. Replacing the physical habit of smoking or vaping can be helpful as you quit. 

For example, chewing sugar-free gum, sipping water, or keeping your hands busy with a stress ball can act as substitutes for the ritual of using nicotine. Over time, these healthier behaviors can replace the automatic urge to reach for a cigarette or vape pen.

Be mindful of stress

Stress is a common trigger for cravings, so finding ways to manage it is helpful while you’re trying to quit. Practice mindfulness techniques like deep breathing, meditation, or journaling to help you stay calm and centered. Regular physical activity can also reduce stress and help you feel more in control. By addressing stress directly, you may be better equipped to resist cravings when they arise.

Find an accountability partner

Quitting nicotine is hard, but you don’t have to do it alone. Reach out to someone you trust, like a friend, family member, or coworker, who can support your journey to quit. Having an accountability partner gives you someone to talk to when cravings hit and helps keep you motivated to stick with your goals. 

It may be helpful to talk to someone who’s quit nicotine themselves. If possible, consider connecting with a support group or online community for extra encouragement.

Supportive treatment for quitting nicotine

Nicotine use can be a difficult habit to break. Most people who use nicotine typically quit and then restart nicotine use a few times before they’re able to stop for good. Although this may sound discouraging, it’s actually a hopeful sign. Even if you’re not successful right away, you can be successful if you just stick with it. Try not to get discouraged if you relapse after quitting the first time.

Therapy and substance abuse counseling can be helpful tools when walking away from any addiction, including nicotine use disorder. Some of the most effective therapy methods for nicotine use disorder include:

• Cognitive behavioral therapy (CBT): Helps identify triggers and develop healthier coping mechanisms
• Motivational interviewing: Focuses on building your internal motivation to quit nicotine
• Group therapy: Connects you with others who are on a similar journey, providing a sense of community and accountability

Many people also find that support groups, including 12-step groups, are helpful for staying motivated. While these groups aren’t a replacement for professional therapy, they can connect you to others who know what you’re going through.

Quitting nicotine can also bring withdrawal symptoms, which may include:

• Irritability or mood swings
• Increased appetite or weight gain
• Fatigue or difficulty concentrating
• Intense cravings for nicotine

These symptoms aren’t dangerous, just uncomfortable. If you’re feeling concerned about withdrawal symptoms, talk to a healthcare provider. Some people use nicotine replacement tools, like patches and gum, to help them avoid withdrawal symptoms and break the addiction to more harmful types of nicotine use, like cigarettes.

Find care with Rula

If you’re one of the millions of people across the globe who are addicted to nicotine and want to quit, support is available to you. Nicotine replacement tools, tools to fight cravings, professional therapy, and support groups can help you fight the urge to use tobacco products and walk away from this addiction for good.

Rula has 10,000+ licensed therapists with expertise in over 80 clinical specialties, including nicotine use disorder. You can meet with a Rula therapist via live video as soon as tomorrow and start beating tobacco addiction.

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