Question

As a nurse practitioner, the duties of lead patient educator often fall to you. As you get more familiar with your patients’ communities, you will be able to identify specific patient risks and make educational materials that speak directly to your patient’s population.

Research a trend in substance abuse for teens and college-age adults (i.e., use of tobacco, vaping, marijuana, hookah, pill parties, bath salts, etc.) within your community.

Include the following elements in your brochure:

• Description of the substance abuse trend
• List of the risk factors, including legal factors
• Resources for treatment
• At least 2 visuals to enhance your brochure
• Tone and language appropriate for your teen and college-age audience

Answer 1

Use of tobacco

People can smoke, chew, or sniff tobacco. Smoked tobacco products include cigarettes, cigars, bidis, and kreteks. Some people also smoke loose tobacco in a pipe or hookah (water pipe). Chewed tobacco products include chewing tobacco, snuff, dip, and snus; snuff can also be sniffed.

Tobacco is one of the most widely abused substances in the world. It is highly addictive. The Centers for Disease Control and Prevention estimates that tobacco causes 6 million deathsTrusted Source per year. This makes tobacco the leadingTrusted Source cause of preventable death.

Nicotine is the main addictive chemical in tobacco. It causes a rush of adrenaline when absorbed in the bloodstream or inhaled via cigarette smoke. Nicotine also triggers an increase in dopamine. This is sometimes referred to as the brain’s “happy” chemical.

Dopamine stimulates the area of the brain associated with pleasure and reward. Like any other drug, use of tobacco over time can cause a physical and psychological addiction. This is also true for smokeless forms of tobacco, such as snuff and chewing tobacco.

symptoms of tobacco and nicotine addiction

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Tobacco and Nicotine Addiction

Medically reviewed by Timothy J. Legg, PhD, CRNP — Written by Mara Tyler — Updated on September 3, 2018

• Symptoms
• Treatments
• Outlook
• Resources

Tobacco and nicotine

Tobacco is one of the most widely abused substances in the world. It is highly addictive. The Centers for Disease Control and Prevention estimates that tobacco causes 6 million deathsTrusted Source per year. This makes tobacco the leadingTrusted Source cause of preventable death.

Nicotine is the main addictive chemical in tobacco. It causes a rush of adrenaline when absorbed in the bloodstream or inhaled via cigarette smoke. Nicotine also triggers an increase in dopamine. This is sometimes referred to as the brain’s “happy” chemical.

Dopamine stimulates the area of the brain associated with pleasure and reward. Like any other drug, use of tobacco over time can cause a physical and psychological addiction. This is also true for smokeless forms of tobacco, such as snuff and chewing tobacco.

In 2011, about 70 percentTrusted Source of all adult smokers said they wanted to stop smoking.

What are the symptoms of tobacco and nicotine addiction?

A tobacco addiction is harder to hide than other addictions. This is largely because tobacco is legal, easily obtained, and can be consumed in public.

Some people can smoke socially or occasionally, but others become addicted. An addiction may be present if the person:

• cannot stop smoking or chewing, despite attempts to quit
• has withdrawal symptoms when they try to quit (shaky hands, sweating, irritability, or rapid heart rate)
• must smoke or chew after every meal or after long periods of time without using, such as after a movie or work meeting
• needs tobacco products to feel “normal” or turns to them during times of stress
• gives up activities or won’t attend events where smoking or tobacco use is not allowed
• continues to smoke despite health problems

HEALTH RISKS OF SMOKING OR USING SMOKELESS TOBACCO

There are many health risks from smoking and using tobacco. The more serious ones are listed below.

Heart and blood vessel problems:

• Blood clots and weakness in the walls of blood vessels in the brain, which can lead to stroke
• Blood clots in the legs, which may travel to the lungs
• Coronary artery disease, including angina and heart attack
• Temporarily increased blood pressure after smoking
• Poor blood supply to the legs
• Problems with erections because of decreased blood flow

Other health risks or problems:

• Cancer (more likely in the lung, mouth, larynx, nose and sinuses, throat, esophagus, stomach, bladder, kidney, pancreas, cervix, colon, and rectum)
• Poor wound healing after surgery
• Lung problems, such as COPD, or asthma that is harder to control
• Problems during pregnancy, such as babies born at a low birth weight, early labor, losing your baby, and cleft lip
• Decreased ability to taste and smell
• Harm to sperm, which may lead to infertility
• Loss of sight due to an increased risk of macular degeneration
• Tooth and gum diseases
• Wrinkling of the skin

Smokers who switch to smokeless tobacco instead of quitting tobacco still have health risks:

• Increased risk of cancer of the mouth, tongue, esophagus, and pancreas
• Gum problems, tooth wear, and cavities
• Worsening high blood pressure and angina

HEALTH RISKS OF SECONDHAND SMOKE

Those who are often around the smoke of others (secondhand smoke) have a higher risk of:

• Heart attack and heart disease
• Lung cancer
• Sudden and severe reactions, including of the eye, nose, throat, and lower respiratory tract

Infants and children who are often exposed to secondhand smoke are at risk of:

• Asthma flares (children with asthma who live with a smoker are much more likely to visit the emergency room)
• Infections of the mouth, throat, sinuses, ears, and lungs
• Lung damage (poor lung function)
• Sudden infant death syndrome (SIDS)

treatments for tobacco and nicotine addiction

There are many treatments available for tobacco addiction. However, this addiction can be very difficult to manage. Many users find that even after nicotine cravings have passed, the ritual of smoking can lead to a relapse.

There are several different treatment options for those battling a tobacco addiction:

The patch

The patch is known as a nicotine replacement therapy (NRT). It’s a small, bandage-like sticker that you apply to your arm or back. The patch delivers low levels of nicotine to the body. This helps gradually wean the body off it.

Nicotine gum

Another form of NRT, nicotine gum can help people who need the oral fixation of smoking or chewing. This is common, as people who are quitting smoking may have the urge to put something into their mouths. The gum also delivers small doses of nicotine to help the you manage cravings.

Spray or inhaler

Nicotine sprays and inhalers can help by giving low doses of nicotine without tobacco use. These are sold over the counter and are widely available. The spray is inhaled, sending nicotine into the lungs.

Medications

Some doctors recommend the use of medication to help with tobacco addictions. Certain antidepressants or high blood pressure drugs might be able to help manage cravings. One medication that’s commonly used is varenicline (Chantix). Some doctors prescribe bupropion (Wellbutrin). This is an antidepressant that’s used off-label for smoking cessation because it can decrease your desire to smoke.

Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that has not been approved. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients.

Psychological and behavioral treatments

Some people who use tobacco have success with methods such as:

• hypnotherapy
• cognitive-behavioral therapy
• neuro-linguistic programming

These methods help the user change their thoughts about addiction. They work to alter feelings or behaviors your brain associates with tobacco use.

Treatment for a tobacco addition requires a combination of methods. Keep in mind that what works for one person won’t necessarily work for another. You should talk to you doctor about what treatments you should try.