Definition
Nicotine is an ingredient present in all tobacco products and e-cigarette fluids. This chemical possesses a pronounced opiate flavor and is present in tobacco plants. Nicotine can be synthetically synthesized in a laboratory. Nicotine is derived from the Nicotiana species, a tobacco plant native to South America that later expanded to North America, Africa, and Australia. It belongs to the nightshade plant family.
Nicotine induces a sense of euphoria and relaxation while simultaneously elevating the heart rate and augmenting cardiac oxygen consumption. Upon entering the body, nicotine induces the secretion of endorphins. Endorphins aid in the alleviation of stress, the mitigation of pain, and the enhancement of mental and physical health.
Through the blood vessels, nicotine enters the body immediately and travels to the brain, where it causes a pleasurable sensation in the body. Both nicotine in the body and the emotions it induces have a brief duration. This can result in a smoking cycle in which the desire to continue smoking for the same pleasurable effect is generated.
Nicotine can enhance the secretion of the hormone dopamine. Dopamine is a chemical that the brain utilizes to generate sensations of pleasure. Excessive nicotine consumption can alter the brain's functioning in terms of self-regulation, stress response, and cognitive abilities. Prolonged usage may lead to both dependency and withdrawal symptoms in individuals who abstain from smoking.
Nicotine withdrawal syndrome, often known as nicotine withdrawal symptoms, refers to a range of physical, mental, and emotional symptoms experienced when nicotine is eliminated from the body. Upon cessation or reduction of nicotine consumption, the body experiences nicotine withdrawal, leading to the manifestation of unpleasant symptoms. Some people may have symptoms such as nicotine cravings, nausea, headaches, and irritability.
Causes
Nicotine will bind to specific brain receptors. This results in the brain producing a chemical known as dopamine. Dopamine conveys the experience of being in a "good" mood. The continuous use of nicotine-containing products will result in the continued release of dopamine.
Nicotine will no longer stimulate the brain receptors of people who quit smoking or using nicotine-containing products. This results in a decrease in dopamine release.
Insufficient dopamine levels in the sensation center, which controls mood and behavior, result in side effects. Nicotine affects the equilibrium of neurochemical communication within the brain. Cessation of nicotine use will consequently induce transformations in the chemical equilibrium, potentially leading to the manifestation of physical and additional adverse effects.
Risk factor
Tobacco smokers are susceptible to addiction. It is advisable to avoid tobacco products. A family history of nicotine addiction or having grown up in a household with smokers who are also at risk of smoking are both risk factors for nicotine addiction.
Symptoms
The symptoms of nicotine withdrawal differ among individuals. The frequency of nicotine product use and the quantity of nicotine contained in the nicotine product ingested are determinants of the severity of the symptoms.
Here are some of the more prevalent symptoms:
- Nicotine craving. This symptom is the most common
- Headache
- Nauseous
- Dizzy
- Emotions of anxiety, irritability, and anger
- Emotions characterized by dissatisfaction, despair, or depression
- Insomnia
- Lack of focus
- Fatigue, exhaustion, or drowsiness
- Increased appetite and weight gain
- Constipation and abdominal distension
- Diarrhea
- Cough, dry mouth, and runny nose
- Dyspnea
Diagnosis
Nicotine dependency is classified according to diagnostic instruments such as the Diagnostic Statistical Manual (DSM) published by the American Psychiatric Association and assessments of tobacco dependence.
The criteria for nicotine withdrawal symptoms are dependent upon the following:
- Chronology of nicotine consumption daily for multiple weeks
- Indicating four or more nicotine withdrawal symptoms after stopping or minimizing nicotine consumption within 24 hours
Management
The doctor will engage in a discussion with smokers who are prepared to quit smoking, focusing on treatment options that can assist. Nicotine replacement treatment is effective in decreasing the symptoms of nicotine withdrawal. Replacement therapy consists of minimal quantities of nicotine without the presence of carcinogenic substances or other constituents typically found in tobacco.
Minimal doses of nicotine may effectively decrease the symptoms associated with nicotine withdrawal. Individuals will experience enhanced well-being and increased comfort, supporting the cessation of tobacco product usage. Nicotine replacement therapy is accessible through several options, including patches, gum, lozenges, nasal sprays, and inhalers. The replacement products, such as patches, gum, and lozenges, can be purchased without restrictions. However, the nasal spray and inhaler, which are also replacement medications, can only be obtained with a prescription from a doctor.
Nicotine withdrawal symptoms are also treated with antidepressant medications, including bupropion and varenicline, in addition to nicotine replacement therapy. Varenicillin is an antidiabetic medication that functions by blocking the gratifying effects of nicotine.
Physical nicotine dependency is treated with nicotine replacement therapy and other medications. However, therapy to address emotional and mental issues may require the participation of others. Your doctor may recommend smoking cessation groups for moral support. A combination of replacement therapy, medication, and behavior modification programs can enhance the possibility of successfully quitting rather than relying just on a single treatment option.
Complications
Nicotine withdrawal syndrome is a non-life-threatening disorder. Nevertheless, this situation will induce physiological and psychological changes upon the cessation of smoking.
- Increased appetite and weight gain
Appetite and olfactory function will return to normal once a person quits smoking. This has beneficial side effects and increases the individual's appetite. Some individuals experience a tendency towards consuming foods that are rich in fat and sugar.
Consuming nutritious food options like low-fat yogurt, raw almonds, and carrots will help you control your urges and keep the weight off. Eat slowly, and enjoy the food. Avoid distractions while eating and exercising.
- Mental disorders
Specific individuals may encounter mental health issues. Depression may recur in individuals with a history of depression. This phenomenon can also manifest in individuals diagnosed with bipolar illness or other psychiatric conditions. Generally, nicotine withdrawal-related depression is temporary and can disappear with time.
Depression is treatable, but it can be fatal if left untreated. If you have a history of depression, consult your doctor about how to manage symptoms during smoking cessation therapy.
Prevention
Quitting smoking will result in nicotine withdrawal symptoms, which cannot be avoided. The doctor will suggest over-the-counter medications and other therapies to reduce the symptoms. Some of these products can help you overcome the impulse to consume nicotine.
There are several behavioral treatments for overcoming nicotine withdrawal symptoms, including:
- Consume water or fiber-rich foods to relieve constipation
- Drink fluids to relieve coughing
- Practice breathing exercises to reduce chest tightness
- Drink water and chew sugar-free gum or candies to relieve dry mouth and throat
- Organize work to improve concentration
- Rest and short breaks help overcome fatigue
- Gradually transition between positions to prevent vertigo
- Overcome hunger by consuming low-calorie foods or nutritious snacks and drinking plenty of water
- Avoid consuming beverages and foods containing caffeine, including chocolate, several hours before bedtime
- Immerse yourself in the peaceful summer and put away your devices for a better night's sleep
- Try deep breathing exercises, a warm bath, or even a short walk to relieve discomfort
When to see a doctor?
Consult a doctor to prepare for quitting smoking. If you cannot overcome nicotine withdrawal symptoms, see a doctor for the best nicotine replacement medication.
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- dr. Pandu Lesmana