Tobacco - Related Disorders

What Is Nicotine Addiction?

After you inhale smoke from a cigarette, nicotine reaches your brain in less than five heartbeats. That's faster than having it injected into your veins. When you smoke, a spike of nicotine gets to your brain and reacts with a special area of the brain, where there are receptors that respond to nicotine. When these receptors are stimulated by nicotine from your smoking, they release chemicals that give you a feeling of pleasure. When you first started smoking, your brain only had a few receptors that reacted to nicotine. However, as you continued to smoke over the years, your brain has developed more and more receptors. Millions of them.

Now, these receptors are used to that spike of nicotine. And when you aren't smoking, they can get very annoyed, causing you to have withdrawal symptoms. So, in addition to smoking for the pleasure, most people also smoke to avoid withdrawal symptoms. These brain receptor changes are the reason stopping smoking is so difficult. Smoking has actually changed the structure of your brain. It isn't just a bad habit, it's an addiction. That's why it's going to require more than just willpower for you to quit.


When you stop smoking, the receptors in your brain will decrease in number. And within a few months, they'll be back to the number you started with before you ever smoked. However, for most smokers, the receptors that are still there do not easily forget the pleasure that they got from smoking. So, even though you may not have smoked in months, a situation in which you used to smoke, like being under stress or drinking alcoholic beverages, can still trigger cravings. So, you have to be prepared. The good news is that, over time, the cravings become less frequent and less severe.*

What Are Electronic Nicotine Delivery Systems?

Electronic Nicotine Delivery Systems (ENDS) are a product category that includes disposable cigarette-like e-cigarettes, e-hookah, vape pens, and refillable tank-like or personal vaporizers that do not look like cigarettes. These devices heat a solution (usually propylene glycol or glycerin, with or without nicotine, often combined with additives and flavors) producing an aerosol mist that is inhaled without combustion. This inhalation is widely referred to as vaping.

Current evidence supports the conclusion that vaping poses significantly less risk of adverse health effects to an individual than smoking. Therefore, smokers who completely switch to ENDS as soon as possible are likely to experience a significant health benefit versus continued use of combustible tobacco products such as cigarettes, cigars, pipe, hookah and roll your own tobacco. Combustible tobacco is particularly hazardous because of the inhalation of smoke containing carbon monoxide, over 60 proven human cancer-causing carcinogens and over 4,000 other chemicals (commonly called the tars). Because ENDS do not combust tobacco, they contain far fewer, and lower concentrations of, toxicants than tobacco smoke and no carbon monoxide. But they are not without risk. Because most ENDS contain nicotine, they should not be used by youth or those with conditions that contraindicate nicotine usage (such as pregnancy).


Although vaping is substantially less harmful to an individual than smoking, it is not harmless. Indeed, because ENDS are a relatively new product, the health risks of ENDS are not fully known, particularly the long -term effects of inhaling nicotine, propylene glycol, flavors, or other ingredients in e-cigarette liquid. Moreover research shows that some ENDS products expose users to harmful constituents, including heavy metal particles, although at levels that are much lower than that of combustible cigarettes. Because ENDS are not regulated for quality or safety, the constituent profile can vary from product-to- product, and new product designs may present different individual health risks. Further, ENDS that do contain nicotine are harmful to certain populations (children, youth, pregnant women, those with heart disease and some other conditions). The likelihood of nicotine initiation through ENDS increasing the likelihood of other tobacco use (i.e. combustible tobacco forms) is not yet known. We do not yet know whether ENDS are an “on-ramp” to further tobacco use or a potential path away. More research is required to answer this question.**


For more information on Electronic Nicotine Delivery Systems click here.


*"How to Quit Smoking | How Nicotine Addiction Works: BecomeAnEX." How to Quit Smoking | How Nicotine Addiction Works: BecomeAnEX. Truth Initiative. Web. 8 Oct. 2015. <>.

**Understanding electronic nicotine delivery systems. (2015, August 26). Retrieved September 16, 2015, from


© 2019 by Phoenix Health Center

To Schedule An Appointment

Call 240.420.0000