Former smokers have claimed that kicking the nicotine habit was more difficult than quitting hard drugs. Here's why.

Early Exposure

Heavy smokers who are addicted will face a tough battle when they quit. Researchers are gathering evidence about why some people are more likely to become addicted to nicotine than others. Some smokers say that their habit began with their first cigarette. Others can barely stand the sensation of that first cigarette—but later fall into the habit. And most people never smoke regularly. The reason seems to be partly genetic, as is the case with most substance abuse. But the age at which a person begins smoking, the smoker's mental and emotional health, and the family's smoking habits are also involved.

Let's face it: If there were no positive outcomes to smoking, no one would ever do it. “There are many motivations to smoke,” says Michael D. Stein, M.D., Professor of Medicine and Community Health at Brown University and author of The Lonely Patient and The Addict. “The dominant one is physical dependence-that is, smokers who try to stop have withdrawal symptoms, and cigarettes relieve the symptoms. But nicotine can also improve attention and vigilance. Smokers smoke when they need to concentrate or focus. Smoking helps some people feel in a better mood, or they feel a high, a buzz. Some smokers enjoy the taste and smell of a cigarette. Finally, smoking serves as an appetite suppressant. People smoke to control their weight.” While all medical experts agree that the health risks are not worth these beneficial aspects, many smokers have a real fear of losing the sense of control and other pleasurable sensations when they stop..

An important way to understand the effects of native neurochemicals in the autonomic system is in considering the effects of pharmaceutical drugs. This can be considered in terms of how drugs change autonomic function. These effects will primarily be based on how drugs act at the receptors of the autonomic system neurochemistry. The signaling molecules of the nervous system interact with proteins in the cell membranes of various target cells. In fact, no effect can be attributed to just the signaling molecules themselves without considering the receptors. A chemical that the body produces to interact with those receptors is called an endogenous chemical, whereas a chemical introduced to the system from outside is an exogenous chemical. Exogenous chemicals may be of a natural origin, such as a plant extract, or they may be synthetically produced in a pharmaceutical laboratory.

Broad Autonomic Effects

One important drug that affects the autonomic system broadly is not a pharmaceutical therapeutic agent associated with the system. This drug is nicotine. The effects of nicotine on the autonomic nervous system are important in considering the role smoking can play in health.

All ganglionic neurons of the autonomic system, in both sympathetic and parasympathetic ganglia, are activated by ACh released from preganglionic fibers. The ACh receptors on these neurons are of the nicotinic type, meaning that they are ligand-gated ion channels. When the neurotransmitter released from the preganglionic fiber binds to the receptor protein, a channel opens to allow positive ions to cross the cell membrane. The result is depolarization of the ganglia. Nicotine acts as an ACh analog at these synapses, so when someone takes in the drug, it binds to these ACh receptors and activates the ganglionic neurons, causing them to depolarize.

Ganglia of both divisions are activated equally by the drug. For many target organs in the body, this results in no net change. The competing inputs to the system cancel each other out and nothing significant happens. For example, the sympathetic system will cause sphincters in the digestive tract to contract, limiting digestive propulsion, but the parasympathetic system will cause the contraction of other muscles in the digestive tract, which will try to push the contents of the digestive system along. The end result is that the food does not really move along and the digestive system has not appreciably changed.

The system in which this can be problematic is in the cardiovascular system, which is why smoking is a risk factor for cardiovascular disease. First, there is no significant parasympathetic regulation of blood pressure. Only a limited number of blood vessels are affected by parasympathetic input, so nicotine will preferentially cause the vascular tone to become more sympathetic, which means blood pressure will be increased. Second, the autonomic control of the heart is special. Unlike skeletal or smooth muscles, cardiac muscle is intrinsically active, meaning that it generates its own action potentials. The autonomic system does not cause the heart to beat, it just speeds it up (sympathetic) or slows it down (parasympathetic). The mechanisms for this are not mutually exclusive, so the heart receives conflicting signals, and the rhythm of the heart can be affected (Figure 15.13).

Figure 15.13 Autonomic Connections to Heart and Blood Vessels The nicotinic receptor is found on all autonomic ganglia, but the cardiovascular connections are particular, and do not conform to the usual competitive projections that would just cancel each other out when stimulated by nicotine. The opposing signals to the heart would both depolarize and hyperpolarize the heart cells that establish the rhythm of the heartbeat, likely causing arrhythmia. Only the sympathetic system governs systemic blood pressure so nicotine would cause an increase.

Caffeine and nicotine are not found naturally within the body. Both of these nonregulated drugs have an excitatory effect on membranes of neurons in general and have a stimulatory effect on the cardiac centers specifically, causing an increase in HR. Caffeine works by increasing the rates of depolarization at the SA node, whereas nicotine stimulates the activity of the sympathetic neurons that deliver impulses to the heart.

Although it is the world’s most widely consumed psychoactive drug, caffeine is legal and not regulated. While precise quantities have not been established, “normal” consumption is not considered harmful to most people, although it may cause disruptions to sleep and acts as a diuretic. Its consumption by pregnant women is cautioned against, although no evidence of negative effects has been confirmed. Tolerance and even physical and mental addiction to the drug result in individuals who routinely consume the substance.

Nicotine, too, is a stimulant and produces addiction. While legal and nonregulated, concerns about nicotine’s safety and documented links to respiratory and cardiac disease have resulted in warning labels on cigarette packages.

Nicotine is the main addictive substance in cigarettes and other forms of tobacco. Nicotine is a drug that affects many parts of your body‚ including your brain.

Over time‚ your body and brain get used to having nicotine in them. About 80−90% of people who smoke regularly are addicted to nicotine. When you stop smoking‚ your body has to get used to not having nicotine. That’s withdrawal. Withdrawal can be uncomfortable.

Craving cigarettes, feeling sad or irritable, or trouble sleeping are some common symptoms. Some people say it feels like a mild case of the flu. For most people, the worst symptoms last a few days to a few weeks. Managing withdrawal symptoms will help you feel better and be prepared for those tougher moments.

You Can Prepare for Withdrawal

Withdrawal feelings usually are the strongest in the first week after quitting. Many people don’t like how withdrawal feels. So some people start smoking again to feel better. The first week after quitting is when you are most at risk for a slip. It helps your quit attempt to be prepared and know what to expect so you can stay smokefree.

One way to be prepared is to use nicotine replacement therapy (NRT). NRT can be helpful for dealing with withdrawal and managing cravings. Almost all smokers can use NRT safely.

In addition to using NRT, prepare for withdrawal with SmokefreeTXT, a mobile text messaging service that offers 24/7 encouragement, advice, and tips helps smokers quit smoking and stay quit. It is a 6−8 week program, depending on when you set your quit date. You can get messages up to a week before your quit date to help you learn what to expect what you quit and prepare for withdrawal.

Sign up for SmokefreeTXT online or text QUIT to 47848 to get started.

Check out these other ways to be prepared for withdrawal:

• Download a smartphone app. Our free apps help you track cravings and understand your smoking patterns.
• Visit Smokefree on social media. Grow your support network and stay connected.
• Talk to an expert at a quitline. Call the National Cancer Institute Quitline at 1-877-44U-QUIT (1-877-448-7848) Monday through Friday from 9:00 a.m. to 9:00 p.m. or find your state’s quitline by calling 1-800-QUIT-NOW (1-800-784-8669).
• Chat with a quit smoking counselor.LiveHelp is Monday through Friday, 9:00 a.m. to 9:00 p.m. Eastern time.

Nicotine withdrawal is different for every smoker. Every smoker feels different during withdrawal.

The most common symptoms include:

• Having cravings for cigarettes
• Feeling down or sad
• Having trouble sleeping
• Feeling irritable‚ on edge‚ or grouchy
• Having trouble thinking clearly and concentrating
• Feeling restless and jumpy
• Having a slower heart rate
• Feeling more hungry or gaining weight

You may have tough days and easy days with these symptoms. Over time, the symptoms and cravings will fade as long as you stay smokefree. Medications and changing the things you do can help you manage withdrawal symptoms.

Nicotine Cravings

For many smokers, cravings for a cigarette last much longer than other symptoms of withdrawal. Many people are surprised when cravings sometimes happen without warning. Cravings can be set off by reminders of smoking. These reminders are often called triggers. People, places, and things can trigger a craving. This means it's important to have a plan for how you'll handle a craving when it hits.

The good news is that every craving will pass if you give it time and keep yourself busy. Finding ways to get through that period of time is a key way to deal with cravings. Anything that can distract you and keep you busy can be helpful. Getting active also can work. A short walk can help you distract yourself until the craving passes. Most smokers who try nicotine replacement therapy find it helpful for getting through withdrawal and managing cravings.

Nicotine Withdrawal Isn’t Dangerous

Withdrawal can be uncomfortable and some people may feel high levels of symptoms. But there is no health danger from nicotine withdrawal. In fact‚ quitting smoking is the best thing you can do for your health. Even extreme withdrawal symptoms will fade over time.

Some people feel increased sadness after they quit smoking. Watch for this, especially if you’ve ever had depression. If you become depressed or are having extreme sadness, let a friend or family member know, and think about talking to your doctor.

What are tobacco, nicotine, and vaping (e-cigarette) products?

Tobacco is a leafy plant grown around the world, including in parts of the United States. There are many chemicals found in tobacco leaves but nicotine is the one that can lead to addiction. Other chemicals produced by smoking tobacco, such as tar, carbon monoxide, acetaldehyde, and nitrosamines, also can cause serious harm to the body. For example, tar causes lung cancer and other serious diseases that affect breathing, and carbon monoxide can cause heart problems.

These toxic chemicals can be dangerous. In fact, tobacco use is the leading preventable cause of disease, disability, and death in the United States. According to the Centers for Disease Control and Prevention (CDC), cigarettes cause more than 480,000 premature deaths in the United States each year—from smoking or exposure to secondhand smoke. This represents about 1 in every 5 U.S. deaths, or 1,300 deaths every day. An additional 16 million people suffer with a serious illness caused by smoking. So, for every 1 person who dies from smoking, 30 more suffer from at least 1 serious tobacco-related illness.

How Tobacco and Nicotine Products Are Used

Tobacco and nicotine products come in many forms. People can smoke, chew, sniff them, or inhale their vapors.

• Smoked tobacco products.
  • Cigarettes: These are labeled as regular, light, or menthol, but no evidence exists that “lite” or menthol cigarettes are safer than regular cigarettes.
  • Cigars and pipes: ​Some small cigars are hollowed out to make room for marijuana, known as "blunts," often done to hide the fact that they are smoking marijuana. Either way, they are inhaling toxic chemicals.
  • Bidis and kreteks (clove cigarettes): Bidis are small, thin, hand-rolled cigarettes primarily imported to the United States from India and other Southeast Asian countries. Kreteks—sometimes referred to as clove cigarettes—contain about 60-80% tobacco and 20-40% ground cloves. Flavored bidis and kreteks are banned in the United States because of the ban on flavored cigarettes.
  • Hookahs or water pipes: Hookah tobacco comes in many flavors, and the pipe is typically passed around in groups. A recent study found that a typical hookah session delivers approximately 125 times the smoke, 25 times the tar, 2.5 times the nicotine, and 10 times the carbon monoxide as smoking a cigarette.
• Smokeless tobacco products. The tobacco is not burned with these products:
  • Chewing tobacco. It is typically placed between the cheek and gums.
  • Snuff: Ground tobacco that can be sniffed if dried or placed between the cheek and gums.
  • Dip: Moist snuff that is used like chewing tobacco.
  • Snus: A small pouch of moist snuff.
  • Dissolvable products: These include lozenges, orbs, sticks, and strip.
• Vaping/electronic cigarettes (also called e-cigarettes, electronic nicotine delivery systems, vaping devices, e-cigs, or JUULing). Vaping products are battery-operated devices that deliver nicotine and flavorings without burning tobacco. In most products, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The resulting vapor is then inhaled (called “vaping”).

Government Regulation of Tobacco Products

In 2016, the FDA announced that nationwide tobacco regulations be extended to all tobacco products, including:

• e-cigarettes and their liquid solutions
• cigars
• hookah tobacco
• pipe tobacco

In December 2019, the federal government raised the legal minimum age of sale of tobacco products from 18 to 21 years, and in January 2020, the FDA issued a policy on the sale of flavored vaping cartridges. Therefore:

• It is illegal to sell vaping products (e-cigarettes), hookah tobacco, or cigars in person or online to anyone under age 21.
• Buyers have to show their photo ID to purchase vaping products (e-cigarettes), hookah tobacco, or cigars, verifying that they are 21 years or older.
• These products cannot be sold in vending machines (unless in an adult-only facility).
• It is illegal to hand out free samples.

FDA regulation also means that the Federal government will now have a lot more information about what is in vaping products, the safety or harms of the ingredients, how they are made, and what risks need to be communicated to the public (for example, on health warnings on the product and in advertisements). They will also be able to stop manufacturers from making statements about their products that are not scientifically proven.

Regulation does not mean that vaping products are necessarily safe for all adults to use, or that all of the health claims currently being made in advertisements by manufactures are true. But it does mean that vaping products, hookah tobacco, and cigars now have to follow the same type of rules as cigarette manufacturers.

What happens in the brain when you use tobacco and nicotine?

Like many other drugs, nicotine increases levels of a neurotransmitter called dopamine. Dopamine is released naturally when you experience something pleasurable like good food, your favorite activity, or spending time with people you care about. When a person uses tobacco products, the release of dopamine causes similar “feel-good” effects. This effect wears off quickly, causing people who smoke to get the urge to light up again for more of that good feeling, which can lead to addiction.

A typical smoker will take 10 puffs on a cigarette over the period of about 5 minutes that the cigarette is lit. So, a person who smokes about a pack of 25 cigarettes a day gets 250 “hits” of nicotine.

Studies suggest that other chemicals in tobacco smoke, such as acetaldehyde, may increase the effects of nicotine on the brain.

When smokeless tobacco is used, nicotine is absorbed through the mouth tissues directly into the blood, where it goes to the brain. Even after the tobacco is removed from the mouth, nicotine continues to be absorbed into the bloodstream. Also, the nicotine stays in the blood longer for users of smokeless tobacco than for smokers.

What happens to your body when you use tobacco and nicotine?

Short-Term Effects

When nicotine enters the body, it initially causes the adrenal glands to release a hormone called adrenaline, which stimulates the body and gives it a pleasurable “kick.” But the rush of adrenaline also causes the following:

• increased blood pressure
• increased heart rate
• faster breathing

Long-Term Effects

The nicotine is addictive, and as people keep using tobacco, they are continually exposed to many toxic chemicals found in the tobacco (or produced by burning it). These include carbon monoxide, tar, formaldehyde, cyanide, and ammonia. Tobacco use harms every organ in the body and can cause many serious health problems, listed below.

Smoking Tobacco

• Cancers. Cigarette smoking can be blamed for about one-third of all cancer deaths, including 90% of lung cancer cases. Tobacco use is also linked with cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, ureter, bladder, and bone marrow (leukemia).
• Lung Problems. Bronchitis (swelling of the air passages to the lungs), emphysema (damage to the lungs), and pneumonia have been linked to smoking. People who smoke can’t exercise or play sports for as long as they once did.
• Heart disease and stroke. Smoking increases the risk for stroke, heart attack, and other diseases of the blood’s heart and circulation system that can lead to death.
• Cataracts. People who smoke can get cataracts, which is clouding of the eye that causes blurred vision.
• Loss of sense of smell and taste. This also includes bad breath.
• Aging skin and teeth. After smoking for a long time, people find their skin ages faster and their teeth discolor.
• Risk to unborn baby. Pregnant women who smoke are at increased risk for delivering their baby early, having smaller babies, or suffering a miscarriage, stillbirth, or experiencing other problems with their pregnancy. Smoking by pregnant women also may be associated with learning and behavior problems in children.
• Fire-related deaths. Smoking is the leading cause of fire-related deaths—more than 600 deaths each year, in some cases caused by people falling asleep with a lit cigarette that causes a house fire.

Secondhand Smoke

People who do not smoke but live or hang out with smokers are exposed to secondhand smoke—smoke that is exhaled or given off by the burning end of tobacco products. Just like smoking, regularly standing near smokers increases your risk for disease. The Centers for Disease Control and Prevention reports that there is no risk-free level of exposure to secondhand smoke. Each year, an estimated 58 million Americans are regularly exposed to secondhand smoke and more than 42,000 nonsmokers die from diseases caused by secondhand smoke exposure. Since the 1964 Surgeon General’s Report, 2.5 million adults who were nonsmokers died because they breathed secondhand smoke. It is unclear what long- term side effects there are from exposure to e-cigarette vapor, but one in four U.S. middle and high school students say they've been exposed to unhealthy secondhand aerosol from e-cigarettes.Long-term effects can include:

• Cancer. People exposed to secondhand smoke increase their risk for lung cancer by 20% to 30%. About 7,300 lung cancer deaths occur per year among people who do not smoke but were exposed to second hand smoke.
• Lung problems. Secondhand smoke causes breathing problems in people who do not smoke, like coughing, phlegm, and lungs not working as well as they should.
• Heart disease: Secondhand smoke increases the risk for heart disease by 25% to 30%. It is estimated to contribute to as many as 34,000 deaths related to heart disease.
• Health problems for children: Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome, lung infections, ear problems, and more severe asthma.

Smokeless Tobacco

The health effects of smokeless tobacco are somewhat different from those of smoked tobacco, but both can cause cancer and other effects:

• Cancers. Close to 30 chemicals in smokeless tobacco have been found to cause cancer. People who use smokeless tobacco are at increased risk for oral cancer (cancers of the mouth, lip, tongue, and pharynx) as well as esophageal and pancreatic cancers.
• Heart disease and stroke. Recent research shows smokeless tobacco may play a role in causing heart disease and stroke.
• Mouth problems. Smokeless tobacco increases the chance of getting cavities, gum disease, and sores in the mouth that can make eating and drinking painful.

Can you die if you use tobacco, nicotine, and vaping (e-cigarette) products?

Reports of Deaths Related to Vaping

The Food and Drug Administration (FDA) has alerted the public to thousands of reports of serious lung illnesses associated with vaping, including dozens of deaths. They’re working with the Centers for Disease Control and Prevention (CDC) to investigate the cause of these illnesses.Many of the suspect products tested by the states or federal health officials have been identified as vaping products containing THC, the main psychotropic (mind-altering) ingredient in marijuana. Some of the patients reported vaping a mixture of THC and nicotine; and some reported vaping nicotine alone.While the CDC and FDA continue to investigate possible other contributing substances, CDC has identified a thickening agent—Vitamin E acetate—as a chemical of concern among people with e-cigarette or vaping associated lung injuries. They recommend that people should not use any product containing Vitamin E acetate, or any vaping products containing THC; particularly from informal sources like friends, family, or in-person and online dealers. They also warn against modifying any products purchased in stores, or using any vaping products bought on the street. The FDA is asking people, including health professionals, to report any adverse (negative) effects of vaping products.

Yes. Tobacco use (both smoked and smokeless) is the leading preventable cause of death in the United States. It is a known cause of cancer. Smoking tobacco cigarettes also can lead to early death from heart disease, health problems in children, and accidental home and building fires caused by dropped cigarettes. In addition, the nicotine in smokeless tobacco may increase the risk for sudden death from a condition where the heart does not beat properly (ventricular arrhythmias); as a result, the heart pumps little or no blood to the body’s organs.

According to the Centers for Disease Control and Prevention (CDC), cigarette smoking results in more than 480,000 premature deaths in the United States each year—about 1 in every 5 U.S. deaths, or 1,300 deaths every day. On average, smokers die 10 years earlier than nonsmokers. People who smoke are at increased risk of death from cancer, particularly lung cancer, heart disease, lung diseases, and accidental injury from fires started by dropped cigarettes.

The good news is that people who quit may live longer. A 24-year-old man who quits smoking will, on average, increase his life expectancy (how long he is likely to live) by 5 years.

Are tobacco, nicotine, and vaping (e-cigarette) products addictive?

Yes. It is the nicotine in tobacco that is addictive. Each cigarette contains about 10 milligrams of nicotine. A person inhales only some of the smoke from a cigarette, and not all of each puff is absorbed in the lungs. The average person gets about 1 to 2 milligrams of nicotine from each cigarette.

Studies of widely used brands of smokeless tobacco showed that the amount of nicotine per gram of tobacco ranges from 4.4 milligrams to 25.0 milligrams. Holding an average-size dip in your mouth for 30 minutes gives you as much nicotine as smoking 3 cigarettes. A 2-can-a-week snuff dipper gets as much nicotine as a person who smokes 1½ packs a day.

Whether a person smokes tobacco products or uses smokeless tobacco, the amount of nicotine absorbed in the body is enough to make someone addicted. When this happens, the person continues to seek out the tobacco even though he or she understands the harm it causes. Nicotine addiction can cause:

• Tolerance: Over the course of a day, someone who uses tobacco products develops tolerance—more nicotine is required to produce the same initial effects. In fact, people who smoke often report that the first cigarette of the day is the strongest or the “best.”
• Withdrawal: When people quit using tobacco products, they usually experience uncomfortable withdrawal symptoms, which often drive them back to tobacco use. Nicotine withdrawal symptoms include:
  • irritability
  • problems with thinking and paying attention
  • sleep problems
  • increased appetite
  • craving, which may last 6 months or longer, and can be a major stumbling block to quitting

What about vaping (e-cigarettes)?

Vaping products, also called e-cigarettes, are fairly new products. They’ve only been around for about ten years, so researchers are in the early stage of studying how they affect your health.

How Vaping Products Work

Vaping products are designed to deliver nicotine without the other chemicals produced by burning tobacco leaves. Puffing on the mouthpiece of the cartridge activates a battery-powered inhalation device (called a vaporizer). The vaporizer heats the liquid inside the cartridge which contains nicotine, flavors, and other chemicals. The heated liquid turns into an aerosol (vapor) which the user inhales—referred to as "vaping.”

How Vaping Affects the Brain

Nicotine from vaping products activates the brain’s reward circuits and increases levels of a chemical messenger in the brain called dopamine. Dopamine causes the brain to remember the behavior associated with that increase and reinforces the desire to vape nicotine. This can cause a person to seek out nicotine and use it again and again, despite the risks to their health.

Why Do Teens Vape?

Public health experts have been studying why so many teens are vaping. One recent study showed that teens are enticed by the flavors offered by the vaping companies---especially mint and fruity flavors like mango. NIDA’s 2019 Monitoring the Future survey asked teens why they vape and more than 40% said they tried it for the flavors. Others said they tried vaping just to experiment, or to have a good time with friends. However, more than 8% said they tried it because they are “hooked.”

The government has taken steps to discourage teens from using vaping products. In early 2020, the government banned mint and fruity flavors in hopes of discouraging teens from using vaping products. At about the same time, the government raised the legal age to purchase all tobacco products to 21.

Is Vaping Worse Than Smoking?

Regardless of how vaping compares to cigarette smoking, it is important to recognize that nicotine vaping has its own risks, which include addiction and other potentially harmful health effects. Research so far suggests that nicotine vaping might be less harmful than cigarettes when people who regularly smoke switch to them completely and no longer use tobacco cigarettes.

However, nicotine in any form is a highly addictive drug, and health experts have raised many questions about the safety of vaping devices, particularly for teens:

• Testing of some vaping products found the aerosol (vapor) to contain known cancer-causing and toxic chemicals. The health effects of repeated exposure to these chemicals are not yet clear.
• Some research suggests that nicotine vaping may increase the likelihood that teens will try other tobacco products, including cigarettes. A study showed that students who have vaped nicotine by the time they start 9th grade are more likely than others to start smoking traditional cigarettes and other smoked tobacco products within the next year. Another study has also shown a connection between vaping nicotine and smoking traditional cigarettes.These studies suggest that using vaping products can lead to cigarette smoking in adolescents.
• Some research suggests that certain vaping products contain metals like nickel and chromium, possibly coming from the heating of coils, that may be harmful when inhaled.

How many teens use tobacco, nicotine, and vaping (e-cigarette) products?

The chart below shows the percentage of teens who say they use tobacco, nicotine, and vaping (e-cigarette) products.

* Data in brackets indicate statistically significant change from the previous year.

What do I do if I want to quit using tobacco, nicotine, and vaping (e-cigarette) products?

Teens and young adults who smoke but want to quit have good options for help. If you or someone you know needs more information or is ready to quit, read more about quitting the use of tobacco and nicotine. If you have a friend who smokes, it puts you at higher risk for starting, because your friend is likely to pressure you into trying it. You might decide to step away from the friendship for a while to protect your own health. Even secondhand smoke is bad for your health.

Nearly 70 percent of people who smoke want to quit. Most who try to quit on their own relapse (go back to smoking)—often within a week. Most former smokers have had several failed quit attempts before they finally succeed.

Some people believe e-cigarette products may help smokers lower nicotine cravings while they are trying to quit smoking cigarettes. However, several research studies show that using electronic devices to help quit cigarette smoking does not usually work in the long term, and might actually discourage people from quitting.²² One recent study showed that only nine percent of people using e-vaporizers to quit smoking cigarettes had actually stopped smoking a year later.²³

If you or someone you know needs more information or is ready to quit, check out these resources:

Teens

• Visit teen.smokefree.gov/.

Adults

• Call 1-800-QUIT-NOW (1-800-784-8669), a national toll-free number that can help people get the information they need to quit smoking.
• Visit SmokeFree.gov.

Tobacco is a plant grown for its leaves, which are dried and fermented before use. Tobacco contains nicotine, an addictive chemical. Nicotine is sometimes extracted from the plant and is used in vaping devices.