What is the 

extent and impact

of tobacco use?

According to the 2004

National Survey on Drug

Use and Health, an estimated 70.3 million Americans age 

12 or older reported current use

of tobacco—59.9 million (24.9

percent of the population) were

current cigarette smokers, 13.7

million (5.7 percent) smoked

cigars, 1.8 million (0.8 percent)

smoked pipes, and 7.2 million

(3.0 percent) used smokeless

tobacco, confirming that tobacco

is one of the most widely abused

substances in the United States.

While these numbers are still

unacceptably high, they represent

a decrease of almost 50 percent

since peak use in 1965.

NIDA’s 2005 Monitoring the

Future Survey of 8th-, 10th-, and

12th-graders, used to track drug

use patterns and attitudes, has

also shown a striking decrease in

smoking trends among the

Nation’s youth. The latest results

indicate that about 9 percent of

8th-graders, 15 percent of 10thgraders, and 23 percent of 12thgraders had used cigarettes in 

the 30 days prior to the survey.

Despite cigarette use being at the

lowest levels of the survey since 

a peak in the mid-1990s, the past

few years indicate a clear slowing

of this decline. And while perceived risk and disapproval of

f

r

o

m

t

h

e

dir

e

c

t

o

r

Tobacco use kills nearly half a

million Americans each year, with

one in every six U.S. deaths the result

of smoking. Smoking harms nearly

every organ of the body, causing

many diseases and compromising

smokers’ health in general. Nicotine,

a component of tobacco, is the primary reason that tobacco is addictive,

although cigarette smoke contains

many other dangerous chemicals,

including tar, carbon monoxide,

acetaldehyde, nitrosamines, and

more.

An improved overall understanding of addiction and of nicotine as

an addictive drug has been instrumental in developing medications

and behavioral treatments for tobacco

addiction. For example, the nicotine

patch and gum, now readily available at drugstores and supermarkets

nationwide, have proven effective for

smoking cessation when combined

with behavioral therapy.

Advanced neuroimaging technologies further assist this mission 

by allowing researchers to observe

changes in brain function that result

from smoking tobacco. Researchers

have also identified new roles for

genes that predispose people to 

tobacco addiction and predict their

response to smoking cessation treatments. These findings—and many

other recent research accomplishments—are affording us unique

opportunities to discover, develop,

and disseminate new treatments for

tobacco addiction, as well as scientifically based prevention programs

to help curtail the public health 

burden that tobacco use represents.

We hope this Research Report,

summarizing the latest scientific

information about tobacco addiction,

will help readers understand its

harmful effects as well as identify

best practices for its prevention and

treatment.

Nora D.Volkow, M.D.

Director

National Institute on Drug Abuse

U.S. Department of Health and Human Services • National Institutes of Health

ResearchReport NATIONAL INSTITUTE ON DRUG ABUSE

SERIES

TOBACCO

Addiction

0

5

10

15

20

25

30

35%

All 8th-Graders All 10th-Graders All 12th-Graders

1995

2000

2005

14.6

19.1

9.3

23.9

27.9

14.9

31.4

33.5

23.2

Current* Cigarette Use by 8th-, 10th-, and 12th-Graders

* Reported cigarette use in past 30 days. Source: 2005 Monitoring the Future Survey.

Percent of Adolescents
smoking had been on the rise,

recent years have shown the rate

of change to be dwindling. In

fact, current use, perceived risk,

and disapproval leveled off

among 8th-graders in 2005, 

suggesting that renewed efforts

are needed to ensure that teens

understand the harmful consequences of smoking.

Moreover, the declining prevalence of cigarette smoking among

the general U.S. population is not

reflected in patients with mental

illnesses. For them, it remains 

substantially higher, with the 

incidence of smoking in patients

suffering from post-traumatic

stress disorder, bipolar disorder,

major depression, and other 

mental illness twofold to fourfold

higher than the general population, and smoking incidence

among people with schizophrenia

as high as 90 percent. 

Tobacco use is the leading 

preventable cause of death in 

the United States. The impact of

tobacco use in terms of morbidity

and mortality costs to society is

staggering. Economically, more

than $75 billion of total U.S.

healthcare costs each year is

attributable directly to smoking.

However, this cost is well below

the total cost to society because it

does not include burn care from

smoking-related fires, perinatal

care for low birth-weight infants

of mothers who smoke, and 

medical care costs associated with

disease caused by secondhand

smoke. In addition to healthcare

costs, the costs of lost productivity

due to smoking effects are estimated at $82 billion per year, bringing

a conservative estimate of the 

economic burden of smoking to

more than $150 billion per year.

How does tobacco

deliver its effects? 

T here are more than 4,000

chemicals found in the

smoke of tobacco products.

Of these, nicotine, first identified

in the early 1800s, is the primary

reinforcing component of tobacco

that acts on the brain. 

Cigarette smoking is the most

popular method of using tobacco;

however, there has also been a

recent increase in the sale and

consumption of smokeless tobacco

products, such as snuff and chewing tobacco. These smokeless

products also contain nicotine, 

as well as many toxic chemicals.

The cigarette is a very efficient

and highly engineered drugdelivery system. By inhaling

tobacco smoke, the average

smoker takes in 1 to 2 mg of 

nicotine per cigarette. When

tobacco is smoked, nicotine 

rapidly reaches peak levels in 

the bloodstream and enters the

brain. A typical smoker will 

take 10 puffs on a cigarette over

a period of 5 minutes that the 

cigarette is lit. Thus, a person 

who smokes about 1-1/2 packs

(30 cigarettes) daily gets 300 “hits” 

of nicotine to the brain each day.

In those who typically do not

inhale the smoke—such as cigar

and pipe smokers and smokeless

tobacco users––nicotine is

absorbed through the mucosal

membranes and reaches peak

blood levels and the brain more

slowly.

Immediately after exposure to

nicotine, there is a “kick” caused

in part by the drug’s stimulation of

the adrenal glands and resulting

discharge of epinephrine (adrenaline). The rush of adrenaline 

stimulates the body and causes a

sudden release of glucose, as well

as an increase in blood pressure,

respiration, and heart rate.

Nicotine also suppresses insulin

output from the pancreas, which

means that smokers are always

slightly hyperglycemic (i.e., they

have elevated blood sugar levels).

The calming effect of nicotine

reported by many users is usually

associated with a decline in 

withdrawal effects rather than

direct effects of nicotine. 

2NIDA RESEARCH REPORT SERIES
Is nicotine addictive?

Yes. Most smokers use tobacco regularly because theyare addicted to nicotine.

Addiction is characterized by 

compulsive drug seeking and 

use, even in the face of negative

health consequences. It is well

documented that most smokers

identify tobacco use as harmful

and express a desire to reduce 

or stop using it, and nearly 35 

million of them want to quit each

year. Unfortunately, only about 

6 percent of people who try to

quit are successful for more than 

a month. 

Research has shown how nicotine acts on the brain to produce

a number of effects. Of primary

importance to its addictive nature

are findings that nicotine activates

reward pathways—the brain 

circuitry that regulates feelings of

pleasure. A key brain chemical

involved in mediating the desire

to consume drugs is the neurotransmitter dopamine, and

research has shown that nicotine

increases levels of dopamine in

the reward circuits. This reaction

is similar to that seen with other

drugs of abuse, and is thought to

underlie the pleasurable sensations

experienced by many smokers.

Nicotine’s pharmacokinetic 

properties also enhance its abuse

potential. Cigarette smoking 

produces a rapid distribution of

nicotine to the brain, with drug

levels peaking within 10 seconds

of inhalation. However, the acute

effects of nicotine dissipate in a

few minutes, as do the associated

feelings of reward, which causes

the smoker to continue dosing to

maintain the drug’s pleasurable

effects and prevent withdrawal.

Nicotine withdrawal symptoms

include irritability, craving, 

cognitive and attentional deficits,

sleep disturbances, and increased

appetite. These symptoms may

begin within a few hours after the

last cigarette, quickly driving people back to tobacco use. Symptoms

peak within the first few days 

of smoking cessation and may

subside within a few weeks. For

some people, however, symptoms

may persist for months.

While withdrawal is related to

the pharmacological effects of

nicotine, many behavioral factors

can also affect the severity of

withdrawal symptoms. For some

people, the feel, smell, and sight

of a cigarette and the ritual of

obtaining, handling, lighting, 

and smoking the cigarette are all

associated with the pleasurable

effects of smoking and can make

withdrawal or craving worse.

While nicotine gum and patches

may alleviate the pharmacological

aspects of withdrawal, cravings

often persist. Other forms of 

nicotine replacement, such as

inhalers, attempt to address some

of these other issues, while behavioral therapies can help smokers

identify environmental triggers of

withdrawal and craving so they

can employ strategies to prevent

or circumvent these symptoms

and urges. 

Are there other

chemicals that 

may contribute to

tobacco addiction? 

Yes, research is showing that

nicotine may not be the only

psychoactive ingredient in

tobacco. Using advanced neuroimaging technology, scientists can

see the dramatic effect of cigarette

smoking on the brain and are

finding a marked decrease in the

levels of monoamine oxidase

(MAO), an important enzyme that

is responsible for the breakdown

of dopamine. This change is likely

caused by some tobacco smoke

ingredient other than nicotine,

since we know that nicotine itself

does not dramatically alter MAO

levels. The decrease in two forms

of MAO (A and B) results in higher dopamine levels and may be

another reason that smokers 

continue to smoke—to sustain the

high dopamine levels that lead to

the desire for repeated drug use.

Recently, NIDA-funded

researchers have shown in animals

that acetaldehyde, another chemical constituent of tobacco smoke,

dramatically increases the reinforcing properties of nicotine and 

may also contribute to tobacco

addiction. The investigators further

report that this effect is age-related,

with adolescent animals displaying

far more sensitivity to this reinforcing effect, suggesting that the

brains of adolescents may be more

vulnerable to tobacco addiction.

What are 

the medical 

consequences 

of tobacco use?

Cigarette smoking kills an

estimated 440,000 U.S. 

citizens each year—more

than alcohol, cocaine, heroin,

homicide, suicide, car accidents,

fire, and AIDS combined. Since

1964, more than 12 million

Americans have died prematurely

from smoking, and another 25

million U.S. smokers alive today

will most likely die of a smokingrelated illness. 

NIDA RESEARCH REPORT SERIES3
Cigarette smoking harms every

organ in the body. It has been

conclusively linked to leukemia,

cataracts, and pneumonia, and

accounts for about one-third of 

all cancer deaths. The overall 

rates of death from cancer are

twice as high among smokers as

nonsmokers, with heavy smokers

having rates that are four times

greater than those of nonsmokers.

Foremost among the cancers

caused by tobacco use is lung

cancer—cigarette smoking has

been linked to about 90 percent

of all lung cancer cases, the 

number-one cancer killer of both

men and women. Smoking is also

associated with cancers of the

mouth, pharynx, larynx, esophagus,

stomach, pancreas, cervix, kidney,

ureter, and bladder. 

In addition to cancer, smoking

causes lung diseases such as

chronic bronchitis and emphysema, and it has been found to

exacerbate asthma symptoms in

adults and children. More than 90

percent of all deaths from chronic

obstructive pulmonary diseases

are attributable to 

cigarette smoking. 

It has also been well

documented that 

smoking substantially

increases the risk of

heart disease, including

stroke, heart attack,

vascular disease, and aneurysm. It

is estimated that smoking accounts

for approximately 21 percent of

deaths from coronary heart disease

each year. 

Exposure to high doses of 

nicotine, such as those found in

some insecticide sprays, can be

extremely toxic as well, causing

vomiting, tremors, convulsions,

and death. In fact, one drop of

pure nicotine can kill a person.

Nicotine poisoning has been

reported from accidental ingestion

of insecticides by adults and

ingestion of tobacco products by

children and pets. Death usually

results in a few minutes from 

respiratory failure caused by

paralysis.

While we often think of medical

consequences that result from

direct use of tobacco products,

passive or secondary smoke 

also increases the risk for many

diseases. Environmental tobacco

smoke is a major source of indoor

air contaminants; secondhand

smoke is estimated to cause

approximately 3,000 lung cancer

deaths per year among nonsmokers and contributes to more than

35,000 deaths related to cardiovascular disease. Exposure to tobacco

smoke in the home is also a risk

factor for new cases and increased

severity of childhood asthma 

and has been associated with 

sudden infant death syndrome.

Additionally, dropped cigarettes

are the leading cause of residential fire fatalities, leading to more

than 1,000 deaths each year.

Are there safe

tobacco products?

T he adverse health effects 

of tobacco use are well

known, yet many people do

not want to quit or have difficulty

quitting. As a result, there has

been a recent surge in the development of tobacco products that

claim to reduce exposure to 

harmful tobacco constituents or 

to have fewer health risks than

conventional products. These

“potentially reduced exposure

products” (or PREPs), which

include cigarettes and smokeless

tobacco (e.g., snuff, tobacco

lozenges), have not yet been 

evaluated sufficiently to determine

whether they are indeed associated

with reduced risk of disease.

Recent studies indicate that the

levels of carcinogens in these

PREPs range from relatively low 

to comparable to conventional

tobacco products. These studies

conclude that medicinal nicotine

(found in the nicotine patch and

gum) is a safer alternative than

these modified tobacco products.

Smoking and 

pregnancy—What

are the risks?

I

n the United States, it is 

estimated that 18 percent of

pregnant women smoke during

their pregnancies. Carbon monoxide and nicotine from tobacco

smoke may interfere with

the oxygen supply to the

fetus. Nicotine also readily

crosses the placenta, 

with concentrations in 

the fetus reaching as much

as 15 percent higher than

maternal levels. Nicotine

concentrates in fetal blood, 

amniotic fluid, and breast milk.

Combined, these factors can have

severe consequences for the 

fetuses and infants of smoking

mothers. Smoking during pregnancy caused an estimated 910

infant deaths annually from 1997

through 2001, and neonatal care

costs related to smoking are 

estimated to be more than $350

million per year.

4NIDA RESEARCH REPORT SERIES

WARNING: There is no safe tobacco product. The use of any 

tobacco product—including cigarettes, cigars, pipes, and spit 

tobacco; mentholated, “low tar,” “naturally grown” or “additive

free”—can cause cancer and other adverse health effects.
The adverse effects of smoking

during pregnancy can include

fetal growth retardation and

decreased birth weights. The

decreased birth weights seen in

infants of mothers who smoke

reflect a dose–dependent relationship—the more the woman smokes

during pregnancy, the greater the

reduction of infant birth weight.

These newborns also display signs

of stress and drug withdrawal consistent with what has been reported in infants exposed to other

drugs. In some cases, smoking

during pregnancy may be associated with spontaneous abortions,

sudden infant death syndrome, as

well as learning and behavioral

problems in children. In addition,

smoking more than a pack a day

during pregnancy nearly doubles

the risk that the affected child will

become addicted to tobacco if that

child starts smoking. 

Are there gender

differences in

tobacco smoking?

S everal avenues of research

now indicate that men and

women differ in their smoking

behavior. For instance, women

smoke fewer cigarettes per day,

tend to use cigarettes with lower

nicotine content, and do not

inhale as deeply as men. However,

it is unclear whether this is due to

differences in sensitivity to nicotine

or other factors that affect women

differently, such as social factors

or the sensory aspects of smoking.

The number of smokers in the

United States declined in the 1970s

and 1980s, remained relatively 

stable throughout the 1990s, and

declined further through the early

2000s. Because this decline in

smoking was greater among men

than women, the prevalence of

smoking is only slightly higher for

men today than it is for women.

Several factors appear to be contributing to this narrowing gender

gap, including increased initiation

of smoking among female teens

and women being less likely than

men to quit.

Large-scale smoking cessation

trials show that women are less

likely to initiate quitting and may

be more likely to relapse if they

do quit. In cessation programs

using nicotine replacement methods, such as the patch or gum, the

nicotine does not seem to reduce

craving as effectively for women

as for men. Other factors that may

contribute to women’s difficulty

with quitting are that withdrawal

may be more intense for women or

that women are more concerned

about weight gain.

Although postcessation weight

gain is typically modest (about

5–10 pounds), concerns about this

may be an obstacle to treatment

success. In fact, NIDA research

has found that when women’s

weight concerns were addressed

during cognitive-behavioral therapy, they were more successful at

quitting than women who were 

in a program designed only to

attenuate postcessation weight

gain. Other NIDA researchers

have found that medications used

for smoking cessation, such as

bupropion and naltrexone, can

also attenuate postcessation

weight gain and could become an

additional strategy for enhancing

treatment success. 

It is important for treatment

professionals to be aware that

standard regimens may have to be

adjusted to compensate for gender

differences in nicotine sensitivity

and in other related factors that

contribute to continued smoking.

NIDA RESEARCH REPORT SERIES5

Lung 

Cancer

Coronary

Heart

Disease

Chronic

Pulmonary

Disease/

Obstruction

Other

Diagnosis

Stroke Other

Cancers

Secondhand

Smoke

0

25,000

50,000

75,000

100,000

125,000

Source: CDC, MMWR 2005. 54(25):625–628

Number of Deaths (Thousands)

Approximately 440,000 Annual Deaths Are 

Attributable to Cigarette Smoking
Smoking and 

adolescence

T here are nearly 4 million

American adolescents who

have used a tobacco product

in the past month. Nearly 90 percent of smokers start smoking by

age 18, and of smokers under 18

years of age, more than 6 million

will die prematurely from a 

smoking-related disease. 

Tobacco use in teens is not

only the result of psychosocial

influences, such as peer pressure;

recent research suggests that there

may be biological reasons for this

period of increased vulnerability.

Indeed, even intermittent smoking

can result in the development of

tobacco addiction in some teens.

Animal models of teen smoking

provide additional evidence of an

increased vulnerability. Adolescent

rats are more susceptible to the

reinforcing effects of nicotine than

adult rats, and take more nicotine

when it is available than do adult

animals. 

Adolescents may also be more

sensitive to the reinforcing effects

of nicotine in combination with

other chemicals found in cigarettes,

thus increasing susceptibility to

tobacco addiction. As mentioned

above, acetaldehyde increases

nicotine’s addictive properties in

adolescent, but not adult, animals.

That is, adolescent animals performing a task to receive nicotine

showed greater response rates to

nicotine when combined with

acetaldehyde. NIDA continues to

actively support research aimed at

increasing our understanding of

why and how adolescents become

addicted, and to develop prevention, intervention, and treatment

strategies to meet the specific

needs of teens.

Are there effective

treatments for

tobacco addiction?

Yes, extensive research has

shown that treatments for

tobacco addiction do work.

Although some smokers can quit

without help, many individuals

need assistance in quitting. This 

is particularly important because

smoking cessation can have

immediate health benefits. For

example, within 24 hours of quitting, blood pressure and chances

of heart attack decrease. Longterm benefits of smoking cessation

include decreased risk of stroke,

lung and other cancers, and 

coronary heart disease. A 35-yearold man who quits smoking will,

on average, increase his life

expectancy by 5.1 years.

Nicotine Replacement

Treatments

Nicotine replacement therapies

(NRTs), such as nicotine gum and

the transdermal nicotine patch,

were the first pharmacological

treatments approved by the Food

and Drug Administration (FDA)

for use in smoking cessation 

therapy. NRTs are used (in conjunction with behavioral support)

to relieve withdrawal symptoms—

they produce less severe physiological alterations than tobaccobased systems and generally

provide users with lower overall

nicotine levels than they receive

with tobacco. An added benefit is

that these forms of nicotine have

little abuse potential since they 

do not produce the pleasurable

effects of tobacco products—nor

do they contain the carcinogens

and gases associated with tobacco

smoke. Behavioral treatments, even

beyond what is recommended 

on packaging labels, have been

shown to enhance the effectiveness of NRTs and improve longterm outcomes.

The FDA’s approval of nicotine

gum in 1984 marked the availability (by prescription) of the first

NRT on the U.S. market. In 1996,

the FDA approved Nicorette gum

for over-the-counter (OTC) sales.

Whereas nicotine gum provides

some smokers with the desired

control over dose and the ability

to relieve cravings, others are

unable to tolerate the taste and

chewing demands. In 1991 and

1992, the FDA approved four

transdermal nicotine patches, two

of which became OTC products 

in 1996. In 1996 a nicotine nasal

spray, and in 1998 a nicotine

inhaler, also became available 

by prescription, thus meeting the

needs of many additional tobacco

users. All the NRT products—

gum, patch, spray, and inhaler—

appear to be equally effective. 

Additional Medications

Although the major focus of 

pharmacological treatments for

tobacco addiction has been nicotine replacement, other treatments

are also being studied. For example, the antidepressant bupropion

was approved by the FDA in 1997

to help people quit smoking, and

6NIDA RESEARCH REPORT SERIES

■ Behavioral Therapy

■ Nicotine Replacement

● Patch

● Gum

● Nasal Spray

■ Other Medications

Numerous Forms of

Treatment Are Available:
is marketed as Zyban. Varenicline

tartrate (Chantix) is a new medication that recently received FDA

approval for smoking cessation.

This medication, which acts at 

the sites in the brain affected by

nicotine, may help people quit by

easing withdrawal symptoms and

blocking the effects of nicotine if

people resume smoking.

Several other nonnicotine 

medications are being investigated

for the treatment of tobacco

addiction, including other antidepressants and an antihypertensive medication, among others.

Scientists are also investigating 

the potential of a vaccine that 

targets nicotine for use in relapse

prevention. The nicotine vaccine

is designed to stimulate the 

production of antibodies that

would block access of nicotine to

the brain and prevent nicotine’s

reinforcing effects.

Behavioral Treatments

Behavioral interventions play an

integral role in smoking cessation

treatment, either in conjunction

with medication or alone. They

employ a variety of methods 

to assist smokers in quitting, 

ranging from self-help materials 

to individual cognitive-behavioral

therapy. These interventions teach

individuals to recognize high-risk

smoking situations, develop alternative coping strategies, manage

stress, improve problemsolving

skills, as well as increase social

support. Research has also shown

that the more therapy is tailored

to a person’s situation, the greater

the chances are for success. 

Traditionally, behavioral

approaches were developed and

delivered through formal settings,

such as smoking-cessation clinics

and community and public health

settings. Over the past decade,

however, researchers have been

adapting these approaches for

mail, telephone, and Internet 

formats, which can be more

acceptable and accessible to

smokers who are trying to quit. 

In 2004, the U.S. Department of

Health and Human Services (HHS)

established a national toll-free

number, 800–QUIT–NOW

(800–784–8669), to serve as a 

single access point for smokers

seeking information and assistance

in quitting. Callers to the number

are routed to their state’s smoking

cessation quitline or, in states that

have not established quitlines, to

one maintained by the National

Cancer Institute. In addition, a

new HHS Web site (www.smokefree.gov) offers online advice and

downloadable information to

make cessation easier.

Quitting smoking can be difficult. While people can be helped

during the time an intervention 

is delivered, most intervention

programs are short-term (1–3

months). Within 6 months, 75–80

percent of people who try to quit

smoking relapse. Research has

now shown that extending treatment beyond the typical duration

of a smoking cessation program

can produce quit rates as high as

50 percent at 1 year.

Where can I get

further scientific

information about

tobacco addiction?

T o learn more about tobacco

and other drugs of abuse,

visit the National Institute 

on Drug Abuse Web site at

www.drugabuse.gov or call the

National Clearinghouse for

Alcohol and Drug Information 

at 800–729–6686.

Materials on the health effects

of cigarettes and tobacco products

and other drug abuse topics are

available on the NIDA Web site

(www.drugabuse.gov), and can be

ordered free of charge in English

and Spanish from NCADI at

www.health.org.

Nicotine and tobacco information can be accessed also through

these other Web sites:

NIDA RESEARCH REPORT SERIES7

NIDA Web Sites

www.drugabuse.gov

www.steroidabuse.gov

www.clubdrugs.gov

www.hiv.drugabuse.gov

www.inhalant.drugabuse.gov

NCADI

Phone No.: 800–729–6686

NICOTINE AND TOBACCO 

WEB SITES

Centers for Disease Control and Prevention:

www.cdc.gov/tobacco

National Cancer Institute:

www.cancer.gov

U.S. Department of Health & Human

Services: www.smokefree.gov

Society for Research on 

Nicotine and Tobacco: www.srnt.org

NicNet: www.nicnet.org

The Robert Wood Johnson Foundation:

www.rwjf.org

Join Together Online: www.quitnet.org

American Legacy Foundation: 

www.americanlegacy.org
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References

8NIDA RESEARCH REPORT SERIES

Glossary

Addiction: A chronic, relapsing disease characterized by compulsive drug seeking and abuse and

by long-lasting neurochemical and molecular

changes in the brain.

Adrenal glands: Glands located above each 

kidney that secrete hormones, e.g., adrenaline.

Craving: A powerful, often uncontrollable desire

for drugs.

Dopamine: A neurotransmitter present in regions

of the brain that regulate movement, emotion,

motivation, and feelings of pleasure.

Emphysema: A lung disease in which tissue 

deterioration results in increased air retention and

reduced exchange of gases. The result is difficulty

breathing and shortness of breath. 

Hyperglycemic: The presence of an abnormally

high concentration of glucose in the blood.

Neurotransmitter: A chemical that acts as a

messenger to carry signals or information from

one nerve cell to another. 

Nicotine: An alkaloid derived from the tobacco

plant that is responsible for smoking’s psychoactive and addictive effects.

Pharmacokinetics: The pattern of absorption,

distribution, and excretion of a drug over time.

Rush: A surge of euphoria that rapidly follows

administration of some drugs.

Tobacco: A plant widely cultivated for its leaves,

which are used primarily for smoking; the N.

tabacum species is the major source of tobacco

products.

Withdrawal: A variety of symptoms that occur

after chronic use of an addictive drug is reduced

or stopped.

NIH Publication Number 06-4342

Printed July 1998, Reprinted August 2001. 

Revised July 2006.

Feel free to reprint this publication.

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