Nicotine and Tobacco

Abstract Nicotine is responsible for the psychoactive and habit-forming effects of tobacco. Approximately 30% of Americans use tobacco products; half of them are nicotine-dependent. Nicotine has mild stimulant effects. Overdose is rare in experienced users. Some may develop nausea, vomiting, weakness, and dizziness. Withdrawal symptoms include craving, irritability, anxiety, restlessness, and increased appetite. Smokers have elevated exhaled carbon monoxide and serum carboxyhemoglobin levels. Cotinine, a metabolite of nicotine, can be detected in blood and urine. Many medical conditions are associated with tobacco use (particularly smoking), including cardiovascular disease, chronic lung disease, and a variety of malignancies. A number of interventions can help increase smoking cessation rates, including physician advice, counseling, nicotine replacement, varenicline, and bupropion. Electronic cigarettes may help smokers quit or reduce their smoking.