Tobacco and addiction
Tobacco products are highly addictive. Nicotine, the drug in tobacco that causes addiction, is as addictive as heroin or cocaine.Footnote 1Footnote 2
- Key facts about tobacco use and addiction
- What is addiction?
- How does tobacco use lead to addiction?
- How does addiction affect quitting?
- Health benefits of quitting tobacco use at any age
- For help to quit
Key facts about tobacco use and addiction
- Nicotine, a naturally occurring chemical in tobacco, can produce negative effects in the brain, such as mood changes.Footnote 2Footnote 3
- Nicotine can kill brain cells and stop new ones from growing in the hippocampus, a brain region involved in memory.Footnote 4
- The developing brains of youth and young adults are particularly vulnerable to long-term nicotine exposure.Footnote 3
- Adolescents can become nicotine dependent faster than adults. They also find nicotine more rewarding and underestimate the risks of tobacco-related addiction.Footnote 5
- The addictive nature of nicotine is the main reason people continue using tobacco.Footnote 1Footnote 6Footnote 7Footnote 8Footnote 9Footnote 10
View health labels for cigarettes and little cigars.
What is addiction?
Addiction is characterized by:
- tolerance - the need to use the drug in larger quantities to achieve the same effect;
- withdrawal - the symptoms experienced if a drug is abruptly discontinued after regular use; and
- compulsive drug use despite known harmful consequences.Footnote 11
How does tobacco use lead to addiction?
When tobacco is smoked, nicotine rapidly enters the bloodstream through the lungsFootnote 8 and reaches the brain within seconds.Footnote 12Footnote 13
Nicotine interacts with the brain to create pleasurable sensations for the person using tobacco, which reinforces the behaviour to use more tobacco.Footnote 1 Long-term exposure to nicotine can lead to changes in the brain and addiction.Footnote 13
Someone who smokes will take 10 cigarette puffs over a five minute period, on average. If someone smokes around one and a half packs per day (about 30 cigarettes) they are getting 300 "hits" of nicotine to the brain daily.Footnote 13
Among youth and young adults, nicotine exposure can reduce impulse control, lead to attention and cognitive issues, and increase the risk of mood disorders such as major depressive disorder, panic disorder, or antisocial personality disorder.Footnote 3 Footnote 14Footnote 15Footnote 16Footnote 17
How does addiction affect quitting?
If someone stops or reduces smoking, they will likely experience symptoms of withdrawal. Nicotine withdrawal may include anger, anxiety, irritability, depression, difficulty concentrating or sleeping, impatience, increased appetite, deficits in cognition, and restlessness.Footnote 13Footnote 18 Symptoms of withdrawal may appear within hours of quitting, causing cravings which can lead people to smoke again. Withdrawal symptoms peak within one to two days and typically last from 2 to 4 weeks. However, symptoms can persist for months in some people.Footnote 13
Tobacco addiction can be treated. Nearly 8 million Canadians aged 15 years and older have reported quitting smoking.Footnote 21 There are many options to help someone quit smoking:
- Behavioural counselling (including Quit line counselling) and quit medications increase quit success compared with self-help materials or no treatment.Footnote 2
- Behavioural counselling and quit medications are both effective in increasing quit success, and even more so when used together.Footnote 2
- Combining short- and long-acting forms of nicotine replacement therapy (NRT) increases smoking cessation compared with using single forms of NRT.Footnote 2
- Changing lifestyle by avoiding situations where tobacco use occurs, or engaging in a positive activity (like exercise) when cravings start can help improve quit success.Footnote 22
Some people are able to quit on their first attempt. Those who don't succeed right away should keep trying. Most people require multiple attempts before they are successful.Footnote 22
Each attempt, though difficult, provides an important learning opportunity that moves people closer to successful quitting.
Health benefits of quitting tobacco use at any age
Tobacco use affects one's health by causing multiple serious diseases.Footnote 19 Quitting tobacco use reduces the risk of premature death, improves health, and enhances quality of life.Footnote 2 Quitting at any age is beneficial to one's health.Footnote 2 Even people who have smoked or used tobacco heavily for many years benefit from it.Footnote 2Footnote 20 Quitting is the most important thing someone who smokes can do to improve their health.
Read more about the benefits of quitting smoking.
For help to quit
Free quit counselling, coaching and other services in your province or territory
- Footnote 1
U.S. Department of Health and Human Services. The Health Consequences of Smoking: Nicotine Addiction. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1988.
- Footnote 2
U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2020.
- Footnote 3
U.S. Department Of Health And Human Services Public Health Service. Office of the Surgeon General. 2016. E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon General.
- Footnote 4
Abrous DN, Adriani W, Montaron MF, Aurousseau C, Rougon G, Le Moal M et al. Nicotine self-administration impairs hippocampal plasticity. Journal of Neuroscience. 2002;22(9):3656-3662. https://doi.org/10.1523/JNEUROSCI.22-09-03656.2002
- Footnote 5
Goriounova N, Mansvelder H. Short- and long-term consequences of nicotine exposure during adolescence for prefrontal cortex neuronal network function. Cold Spring Harbour Perspectives in Medicine. 2012;2(12):a012120. doi: 10.1101/cshperspect.a012120.
- Footnote 6
Benowitz N, Henningfield J. Nicotine Reduction Strategy: State of the science and challenges to tobacco control policy and FDA tobacco product regulation. Preventive Medicine. 2018;117;5–7. https://doi.org/10.1016/j.ypmed.2018.06.012
- Footnote 7
Royal College of Physicians. Nicotine without smoke: Tobacco harm reduction. London: RCP, 2016.
- Footnote 8
U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.
- Footnote 9
The Royal Society of Canada. Tobacco, Nicotine, and Addiction. Royal Society, Ottawa, Ontario, August 31, 1989.
- Footnote 10
Royal College of Physicians. Nicotine Addiction in Britain. A report of the tobacco advisory group of the Royal College of Physicians; London, 2000.
- Footnote 11
U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016.
- Footnote 12
Benowitz N. Pharmacology of nicotine: Addiction, smoking-induced disease, and therapeutics. Annu Rev Pharmacol Toxicol. 2009;49:57–71. doi: 10.1146/annurev.pharmtox.48.113006.094742.
- Footnote 13
National Institute on Drug Abuse. Tobacco Addiction. U.S. Department of Health and
Human Services. NIDA Research Report Series. NIH Publication Number 09-4342
Printed July 1998, Revised June 2009.
- Footnote 14
Brown RA, Lewinsohn PM, Seeley JR, Wagner EF. 1996. Cigarette smoking, major depression, and other psychiatric disorders among adolescents. J Am Acad Child Psychiatry. 1996;35(12):1602–1610. doi: 10.1097/00004583-199612000-00011.
- Footnote 15
Brook JS, Cohen P, Brook DW. Longitudinal study of co-occurring psychiatric disorders and substance use. J Am Acad Child Adolesc Psychiatry. 1998;37(3):322–330. https://doi.org/10.1097/00004583-199803000-00018.
- Footnote 16
Brook DW, Brook JS, Zhang C, Cohen P, Whiteman M. Drug use and the risk of major depressive disorder, alcohol dependence, and substance use disorders. Arch Gen Psychiatry. 2002;59(11): 1039–1044. doi:10.1001/archpsyc.59.11.1039.
- Footnote 17
Johnson JG, Cohen P, Pine DS, Klein DF, Kasen S, Brook JS. Association between cigarette smoking and anxiety disorders during adolescence and early adulthood. JAMA. 2000;284(18):2348–2351. Doi:10.1001/jama.284.18.2348.
- Footnote 18
Hughes, JR. Effects of abstinence from tobacco: Valid symptoms and time course. Nicotine and Tobacco Research. 2007;9(3):315-327. doi: 10.1080/14622200701188919.
- Footnote 19
2014 U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
- Footnote 20
U.S. Department of Health and Human Services. The Health Consequences of Smoking. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.
- Footnote 21
Canadian Tobacco and Nicotine Survey (CTNS): Summary of results for 2020. Available at: https://www.canada.ca/en/health-canada/services/canadian-tobacco-nicotine-survey/2020-summary.html
- Footnote 22
Reid JL, Hammond D, Rynard VL, Burkhalter R. Tobacco use in Canada: Patterns and trends, 2019 edition. Waterloo, Ont. Propel Centre for Population Health Impact, University of Waterloo. Available at: https://uwaterloo.ca/tobacco-use-canada/sites/ca.tobacco-use-canada/files/uploads/files/tobacco_use_in_canada_2019.pdf
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