Nicotine Addiction Treatment

When people think of highly addictive drugs that are extremely difficult to quit using, their mind often goes to substances like heroin or methamphetamine. However, there is a substance that is not only equally challenging to quit, but unlike Heroin or Meth, it’s completely legal for adults to consume: nicotine.

Nicotine is a highly addictive substance that is found in products such as cigarettes, cigars, chewing tobacco, and vaping devices. The legality of nicotine has changed over the last few years. In 2019, the United States government passed a piece of legislation known as Tobacco 21 (T21), which raised the age at which someone could buy products containing nicotine from 18 to 21. Even with this new law, nicotine use continues to be a major public health issue.

In 2020, an estimated 12.5% (30.8 million) of US adults reported smoking cigarettes. Additionally, nearly 15% of adults reported ever having used an electronic nicotine vaping device, with the majority being between the ages of 18-24. While these numbers have fallen steadily over the last decade, the highly addictive nature of nicotine has remained the same.

Why Quitting Nicotine Is Hard

Because of the legality and social acceptance of nicotine products, many people, especially younger individuals, are quick to write off the possibility of addiction. Many people who use nicotine products try and rationalize their addiction by saying things like, “I can quit whenever I want to,” or “I’m not hurting anyone” to downplay their need for nicotine.

This type of rationalization can lead to multiple attempts at quitting, only to relapse and start using nicotine again. In fact, out of the nearly 30 million adults who smoke cigarettes, over 70% report trying to quit, with the average person attempting more than 30 times before successfully stopping nicotine use.

“From a scientific standpoint, nicotine is just as hard, or harder, to quit than heroin … but people don’t recognize that,” said Dr. Neil Benowitz, a nicotine researcher at the University of California, San Francisco.

Nicotine, just like any other commonly abused drug, releases dopaminewhich makes it pleasurable to use, and activates the reward centers of the brain. Over time, this pleasurable feeling diminishes and requires more substance to achieve the same effect. This is known as a tolerance.

When someone stops using products that contain nicotine, their brain has a significant reduction in the release of dopamine. This can cause a state of dysphoria, and endue feelings of anxiety, depression, and other common symptoms of withdrawal. Additionally, since nicotine is a powerful stimulant, it can help people concentrate, and when they don’t have nicotine, they have trouble focusing.

Why Quit Nicotine?

The thought of coping without nicotine can be enough to keep many people from quitting. However, quitting nicotine can have profound benefits for your overall health and well-being.

Smoking is currently the leading cause of preventable death worldwide. Globally, more than 1 billion people smoke cigarettes, and each day in the US alone, more than 3,200 youths 18 and younger smoke their first cigarette, with another 2,100 moving from occasional to daily tobacco use.

Each year in the US, more than 480,000 people die because of tobacco use, accounting for nearly 1 out of every 5 deaths. According to the Centers for Disease Control and Prevention (CDC), the life expectancy for someone who smokes is over 10 years shorter than those who do not use tobacco products. Furthermore, tobacco use is responsible for upwards of 90% of all cases of lung cancer, which is the leading cause of cancer-related death.

Fortunately, there is hope for those looking to quit using nicotine products. It has been shown that quitting nicotine use before the age of 40 reduces the risk of dying from related diseases by about 90%. While it can be a daunting task, Nicotine addiction can be overcome with the right approach.

Medications And Therapy Options For Nicotine Treatment

There are many different treatment and therapy options for those looking to kick their nicotine addiction. The goal of treating nicotine addiction is to reduce the impact of withdrawal symptoms. This is typically done using a combination of approaches, such as nicotine replacement therapy (NRT) and behavioral therapies like cognitive behavioral therapy (CBT).

Nicotine Replacement Therapy (NRT)

NRT is a type of therapy for quitting nicotine that works by giving someone nicotine without smoking or using devices like nicotine vapes. This therapy method slowly releases nicotine into the bloodstream, however, at much lower doses than normal tobacco products. Common NRT examples include:

  • Nicotine gum: This chewing gum is among the most common types of NRT, with 2 million people who smoke reportedly used a type of nicotine chewing gum in the last year. To use this NRT, a person chews the gun until a peppery taste is present after which they place the gum between their cheek and gum for about 20 minutes or until the craving has subsided.
  • Nicotine patch: Alongside gum, nicotine patches are one of the most common types of NRT. A patch is placed on the skin, typically for around 24 hours, and allows nicotine to slowly be released into the bloodstream throughout the day, lessening the cravings for nicotine.
  • Nicotine inhaler: While less common than gum or patches, nicotine inhalers can be a successful NRT for many people. Similar to an inhaler for asthma, a cartridge containing nicotine is placed into a device that the user can use to inhale nicotine. This type of NRT is typically available only via prescription.
  • Nicotine nasal spray: These products typically combine nicotine with a saline spray that can be sprayed directly into each nostril where it can be absorbed by the nasal membranes. People report preferring this method because it allows the nicotine to reach the brain faster than gum or patches.

While NRT can be an effective way to overcome nicotine addiction, they are often paired with other types of treatment to help manage cravings and withdrawal symptoms.

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Aside from NRTs, several medications can be prescribed to help with nicotine addiction. Typically, medications are reserved for more advanced nicotine addiction, however, this does not mean that someone with a mild nicotine addiction would not be able to obtain a prescription. Some commonly prescribed medications for nicotine addiction treatment include:

  • Bupropion: Bupropion is the only medication that does not include nicotine (non-nicotine) that is approved by the Food and Drug Administration for use in nicotine addiction treatment. This antidepressant acts like nicotine and releases dopamine and norepinephrine. It is commonly prescribed alongside NRT options like nicotine patches for about 14 days.
  • Clonidine: Typically used as a blood pressure medication, clonidine can be used to help curb nicotine cravings, although it is typically saved as a last resort due to side effects like fatigue and drowsiness.
  • Nortriptyline: Another antidepressant, Nortriptyline is another medication that is typically prescribed alongside NRT to help with nicotine cravings. The maximal dose is between 75 to 100mg a day, and a typical regimen lasts between 8 and 12 weeks.


While NRT and medication can both help overcome a nicotine addiction, they are oftentimes prescribed alongside behavioral approaches like therapy to increase the likelihood of success. Studies have shown that combining them with behavioral or medical approaches can nearly double a person’s chances of successfully quitting nicotine use. Common therapies for nicotine addiction include:

  • Cognitive Behavioral Therapy (CBT): CBT helps people identify the people, places, or things that may trigger their nicotine cravings and teach them how to avoid them and better cope with stress. Studies have found that when paired with an NRT patch, those who undergo CBT for smoking have higher quit rates than those who undergo general health education sessions.
  • Motivational Interviewing: Motivational interviewing (MI) is a type of therapy where counselors help patients enhance their motivation toward a specific goal such as quitting nicotine. During sessions, counselors point out discrepancies between a patient’s goals and actions, which can help root out the underlying cause of their addiction. Studies have shown MI results in higher quit rates than advice from others to quit smoking.
  • Online Therapy: In recent years, the popularity and availability of online therapy have grown exponentially. Online therapy can consist of many different types of therapy and can be done from the comfort of one’s home, at virtually any time of day. These platforms can greatly improve a person’s ability to quit using nicotine products, as they can overcome many of the barriers of traditional treatment like location, time, and money.

For more extensive treatment options, or if a nicotine addiction is present alongside other addictions or mental health issues, inpatient and outpatient treatment centers are available for those in need of extra help.

Overcoming Nicotine Addiction

If you or someone you know is struggling with a nicotine addiction, know that help is available. While it can be difficult to overcome, no one should have to battle nicotine addiction alone. For more information on treatment options for an addiction to nicotine, speak with a therapist today to get started on your path toward recovery.