People become addicted to nicotine because it acts quickly on the brain’s reward system, releasing chemicals such as dopamine that create feelings of pleasure, calm or improved concentration. Over time, the brain adapts to regular nicotine exposure and begins to rely on it to feel “normal.” This leads to tolerance (needing more nicotine for the same effect) and withdrawal symptoms – such as irritability, anxiety, low mood, and strong cravings – when nicotine levels drop. Social habits, routines (like smoking with coffee or during stress), and cues such as seeing others smoke further reinforce the addiction making it both a physical dependence and a learned behaviour.
What nicotine is and how it can affect health
Nicotine is a highly addictive chemical found naturally in tobacco plants and present in cigarettes, cigars and most vaping products. While nicotine itself does not cause cancer, it is far from harmless. It increases heart rate and blood pressure, constricts blood vessels and places strain on the heart and circulatory system. Nicotine can also affect brain development in young people, worsen anxiety and make it harder to quit because of its addictive properties. The most serious health harms from smoking come from other toxic chemicals in tobacco smoke but nicotine keeps people hooked and continuing to expose themselves to these dangers.
How NRT or Varenicline can help overcome addiction and stay smoke‑free
Nicotine Replacement Therapy (NRT), such as patches, gum, lozenges, sprays or inhalators works by providing controlled doses of nicotine without the harmful chemicals found in tobacco smoke. This helps reduce cravings and withdrawal symptoms making it easier to break the link between smoking and daily routines. Varenicline works differently: it targets nicotine receptors in the brain, reducing cravings while also blocking the pleasurable effects of smoking if a person does slip and have a cigarette. Both treatments can significantly increase the chances of quitting successfully especially when combined with behavioural support and help people stay smoke‑free for the long term.
Compensatory smoking
Compensatory smoking is when a person unconsciously changes how they smoke – such as taking bigger puffs, inhaling more deeply, or smoking more cigarettes – to make up for getting less nicotine than their body is used to.
It often happens when someone switches to cigarettes marketed as “light” or “low‑nicotine”, or when they try to cut down on the number of cigarettes they smoke.
People who smoke regularly tend to maintain a stable level of nicotine in their body. When nicotine levels drop, withdrawal symptoms can appear, so the body pushes the person to adjust their smoking behaviour to keep nicotine levels higher.
Get in touch
If you would like support to help stop smoking or to talk to one of our Quit Your Way team,please contact us using the self-referral form below.
You can also contact us by email or telephone or follow us on Facebook.
Freephone: 0800 783 9132
Email: QYWAyrshire@aapct.scot.nhs.uk