NEXT =>

3. Withdrawal from Nicotine

The criteria used to diagnose substances of abuse, including nicotine, are found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV, 1994). Nicotine dependence causes changes in brain functioning gradually over time in response to prolonged periods of exposure to nicotine (Gold & Herkov, 1998). Changes in the brain are both acute and prolonged and in some tobacco users may be permanent. Abstinence from nicotine may allow certain addicts to recognize that they cannot function at their pre-morbid level.

Smokers learn that regular smoking prevents abstinence symptoms from developing (Parrott, 1999). Nicotine users feel normal on the drug and must maintain their nicotine intake in every type of situation. The regular smoker needs nicotine to maintain normal moods and suffers from unpleasant feelings of irritability and tension between cigarettes when the plasma nicotine levels are falling. The link between regular intake of nicotine and keeping moods within normal bounds becomes strongly conditioned over time.

Nicotine withdrawal can begin within a few hours of cessation, typically peak in one to four days and last several weeks (Gold & Herkov, 1998). Withdrawal symptoms include a desire for sweets and weight gain, impaired performance on tasks requiring vigilance, mood changes, and cravings for the tobacco product. The effects of withdrawal from chronic nicotine exposure on the dopamine system cause a rebound in dopamine activity suggesting a dysregulation of these important motivational and mood systems.

NEXT =>