Nicotine dependence
Tobacco dependence involves both physical nicotine dependence and psychological and social dependence.
The strength of the dependence can be assessed based on factors such as the quantity of smoking and the smoking habits.
Use a test to assess your nicotine dependence
Physical nicotine dependence
Nicotine causes strong dependence. Nicotine is transmitted by smoke or vapour either into the lungs via the respiratory tract or through the oral mucous membranes, and it quickly enters the blood circulation. The first nicotine molecules reach the brain within a few seconds.
The nicotine concentration drops with a few hours of smoking. At this point, a person who is addicted to nicotine needs a new dose in order to avoid withdrawal symptoms. If someone smokes regularly, their ability to tolerate nicotine increases, which can in turn increase their smoking.
Nicotine-induced feeling of pleasure, combined with the withdrawal symptoms, create a self-reinforcing cycle that maintains the dependence.
The withdrawal symptoms from quitting smoking are strongest within a few days of quitting. The worst withdrawal symptoms normally pass within a few weeks.
| Symptom | Frequency (%) | Average duration of worst phase |
|---|---|---|
| Increased irritability | 80 | 2 weeks |
| Anxiety | 87 | 1 week |
| Concentration difficulties | 73 | 1–2 weeks |
| Restlessness | 73 | 1 week |
| Low mood | 39 | 3 days |
| Impatience | 76 | 1–2 weeks |
| Sleep difficulties | 80 | A few nights |
| Craving for cigarettes | 62 | 2–3 weeks |
| Weight gain | Not known | 1–3 months |
| Headaches | 33 | 3 days |
| Dizziness | 11 | 7 days |
Psychological and social dependence
Smoking is often part of everyday routines. It is a way of dealing with emotional states, and it connects with situations and places. For example, some smoke to avoid or tolerate unpleasant feelings. On the other hand, it can also be a way of strengthening positive experiences.
Pressure, stress, tiredness and hunger can also easily trigger the need to smoke.
Smoking involves a lot of repetitive movements, such as hand movements and inhaling. If someone smokes several times a day, this sequence of movements remains in the muscle memory. Repeating it becomes a routine that brings pleasure.
The longer a person smokes, the stronger these different routines become. They strengthen the psychological dependence on tobacco.
Smoking is often strongly linked to social situations and the sense of belonging between smokers that is created by these situations. Social dependence on tobacco reinforces the other aspects of tobacco dependence.
Sources
- Current Care Guidelines (2018): Prevention and treatment of tobacco and nicotine addiction (in Finnish). Working group established by the Finnish Medical Society Duodecim and the Finnish Association for General Practice. Helsinki: Finnish Medical Society Duodecim.
- Heloma A, Korhonen T, Patja K, Salminen O, Winell K. Tobacco and nicotine dependence (in Finnish). Helsinki: Duodecim, 2022.
