What Causes Nicotine Addiction? 

Nicotine is an addictive drug. It causes changes in the brain that make people want to use it more and more. In addition, addictive drugs cause unpleasant withdrawal symptoms. The good feelings that result when an addictive drug is present — and the bad feelings when it's absent — make breaking any addiction very difficult. Nicotine addiction has historically been one of the hardest addictions to break.

The 1988 Surgeon General's Report, "Nicotine Addiction," concluded that

• Cigarettes and other forms of tobacco are addicting.
• Nicotine is the drug that causes addiction.
• Pharmacologic and behavioral characteristics that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine.

What else does nicotine do to the body?

When a person smokes a cigarette, the body responds immediately to the chemical nicotine in the smoke. Nicotine causes a short-term increase in blood pressure, heart rate and the flow of blood from the heart. It also causes the arteries to narrow. The smoke includes carbon monoxide, which reduces the amount of oxygen the blood can carry. This, combined with the nicotine effects, creates an imbalance between the demand for oxygen by the cells and the amount of oxygen the blood can supply.

How does nicotine in cigarettes increase the risk of heart attack?

Cigarette smoking may increase the risk of developing hardening of the arteries and heart attacks in several ways. First, carbon monoxide may damage the inner walls of the arteries, encouraging fatty buildups in them. Over time, this causes the vessels to narrow and harden. Nicotine may also contribute to this process. Smoking also causes several changes in the blood that make clots — and heart attack — more likely.

What are the symptoms of nicotine withdrawal?

• irritability
• impatience
• hostility
• anxiety
• depressed mood
• difficulty concentrating
• restlessness
• decreased heart rate
• increased appetite or weight gain

How long does nicotine stay in the body?

From 85–90 percent of nicotine in the blood is metabolized by the liver and excreted from the kidney rapidly. The estimated half-life for nicotine in the blood is two hours. However, smoking represents a multiple dosing situation with considerable accumulation during smoking. Therefore, it can be expected that blood nicotine would persist at significant levels for six to eight hours after smoking stopped.

Related AHA publications:

• The Effects of Smoking brochure (also in Spanish)
• For Your Children: Our guide to help you safeguard your children from heart disease and stroke brochure (also in Spanish)
• Quit Smoking for Good brochure
• Smoking and Your Risk of Stroke brochure
• " How To Avoid Weight Gain When Quitting Smoking",  " How Can I Handle the Stress of Not Smoking?" and " How Can I Quit Smoking?" printable sheets from Answers By Heart kit.

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