Nicotine dependence
Nicotine is found in tobacco products. Nicotine is a psychoactive drug affecting mood and performance and is the source of addiction to tobacco.
Nicotine travels to the brain in about 7-10 seconds and inhaling is the quickest way. Once the nicotine reaches the brain many relaxing chemicals are released. The effect of nicotine lasts on average 20-40 minutes. The addicted smoker needs to ‘top up’ their nicotine regularly. One of the reasons people continue to smoke is because they enjoy the effect of these relaxing chemicals being released in the brain. Tobacco use produces tolerance to nicotine, withdrawal symptoms and dependence. Nicotine addiction is reinforced through this reward and withdrawal.
A smoker can manipulate (titrate) the dose of nicotine from a cigarette to regulate a particular level of nicotine in the body. Intake of nicotine from a given product depends on factors such as number of puffs and how deeply they inhale. Smokers tend to titrate higher levels of nicotine from ‘light’ cigarettes by breathing in deeper and holding the smoke in the lungs longer. Smokers who cut down the number of cigarettes smoked per day will often increase their average intake of nicotine from each cigarette.1
Features of nicotine dependence include:
- smoking soon after waking;
- smoking when ill;
- difficulty refraining from smoking;
- reporting the first cigarette of the day to be the one most difficult to give up; and
- smoking more in the morning than in the afternoon.
The NSW Ministry of Health has produced ‘Guide for the management of nicotine dependent inpatients’
