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Many smokers become dependent on nicotine, an addictive drug found in all tobacco products.



Nicotine addiction has been classified as a substance abuse disorder by the World Health Organization International Classification of Diseases (ICD)-10, which lists the disorder as "tobacco dependence", and by the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR classification system, which lists the disorder as "nicotine dependence." Nicotine, like cocaine, affects the brain's dopamine reward system. Most smokers use tobacco regularly because they are addicted to nicotine. Nicotine withdrawal symptoms include a variety of unpleasant symptoms (e.g., difficult concentrating, irritability, anxiety, anger, depressed mood, sleep disturbance, and craving) which occur after use of an addictive drug is reduced or stopped. Fortunately, treatment can help people achieve lasting abstinence from tobacco (see Efficacy section).



Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

National Institute on Drug Abuse Research Report Series: Tobacco Addiction. July, 2006. NIH Publication Number 06–4342. 

Royal College of Physicians of London. Nicotine Addiction in Britain. A report of the Tobacco Advisory Group of the Royal College of Physicians. London: Royal College of Physicians of London, 2000, pp 83–87.

U.S. Department of Health and Human Services. The health consequences of smoking: nicotine addiction. A report of the Surgeon General. Washington DC: U.S. Government Printing Office, 1988.

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