1. Nicotine and nicotine withdrawal 6 quick facts for clinicians and administrators Geisel School of Medicine at Dartmouth 2015

2. WHAT is Nicotine? Nicotine is a chemical made by the tobacco plant
Nicotine is the main addictive component of tobacco
Nicotine is otherwise safe in cigarette amounts
Nicotine in huge doses can be poisonous, but it is not possible to get that amount from smoking or from nicotine replacement therapy

3. Other components of tobacco can be very harmful
Many other tobacco components
Plant components
599 approved additives
Many are harmful toxins
Tobacco smoke has over 4000 components
Many chemicals in smoke are harmful

4. IT’S THE Toxins in smoke THAT cause CVD, cancer, lung disease, diabetes

5. Neurobiology of Nicotine
Nicotine from tobacco is a chemical that is similar to naturally made chemicals in the body
Nicotine effects are mediated by receptors in many parts of the body, including the gastro-intestinal system and the neurons in the brain
Nicotine slightly improves
Memory and attention
Relaxation, ability to enjoy things
(reward)
People who use tobacco regularly
become dependent on nicotine, as
with caffeine, causing withdrawal if one stops abruptly

6. What is Nicotine withdrawal?
Withdrawal symptoms
Peak in 1-4 days, lasts weeks to months
Can be very uncomfortable and they include:
Urges & craving for tobacco
Dysphoric or depressed mood
Irritability, frustration, anger
Anxiety
Insomnia
Difficulty concentrating
Restlessness
Decreased heart rate
Increased appetite/weight gain
Reduced concentration and increased impulsivity
Nicotine Replacement Therapy reduces withdrawal symptoms

7. Nicotine Replacement Therapy reduces nicotine withdrawal
Using nicotine replacement therapy makes cutting down and quitting more tolerable for people
May improve ability to remember and use coping skills when urges occur
Nicotine replacement therapy does not suppress cue-induced craving
People need help learning skills to avoid smoking when they have an urge even when using nicotine replacement therapy

8. Summary: 6 facts about nicotine
Nicotine is the addictive component in tobacco
Nicotine in cigarette doses is not toxic; smoke is toxic
People who use nicotine regularly become addicted
Reducing or stopping nicotine leads to withdrawal symptoms
Nicotine replacement therapy reduces but does not completely get rid of withdrawal symptoms
Learning skills to cope during withdrawal increases people’s ability to quit tobacco