Nicotine is a very dangerous dependence producing drug. It provides the reinforcement for cigarette smoking. The dependence produced by nicotine is extremely durable as evidenced by the difficulty to quit smoking. According to American Psychiatric Association, only 5% of the smokers are successful in unaided attempts to quit.
Nicotine is absorbed readily through the skin, mucous membranes, and lungs. The pulmonary route produces discernible CNS effects in as little as 7 seconds. Thus each puff produces some discrete reinforcement. With 10 puffs per cigarette, the one-pack-per-day smoker reinforces the habit 200 times daily.
Nicotine demonstrates both depressant and stimulant actions. The smoker will feel alert and muscle relaxation. Nicotine activates the nucleus accumbens reward system in the brain. Release of endogenous opioids and glucocorticoids is also influenced by nicotine.
When the blood concentration of nicotine reduces, dependent smokers develop withdrawal symptoms. They tempt to smoke. Low nicotine level sometimes have a disrupting effect over sleep, therefore some smokers even awaken in between sleep to have a cigarette. Commonly seen symptoms of nicotine dependence include anxiety, irritability, difficulty in concentrating, craving for tobacco, drowsiness, restlessness and stomach upset.
Depressed mood (dysthymic disorder, affective disorder) is associated with nicotine dependence. Depression increases significantly during smoking withdrawal, and this is an important reason for relapse.
Nicotine replacement therapy helps to overcome nicotine withdrawal symptom.
People addicted to gradually develops other health problems. Their heart, lungs and blood vessels are affected. Most common complication of nicotine addiction is lung cancer. Other complications include emphysema, chronic bronchitis, esophageal cancer, oral cancer, throat cancer and infertility.
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