The Impact of Nicotine on Mental Health

Nicotine has significant effects on the brain and can exacerbate symptoms of various mental health conditions. When consumed, it triggers the release of neurotransmitters and activates the sympathetic nervous system, causing a heightened “fight or flight” response.

Impact on Adolescents and Young Adults
Nicotine is particularly harmful during developmental periods, such as childhood and adolescence. Use during these stages is linked to lasting cognitive and behavioral impairments, including issues with memory, attention, and learning. Notably, quitting nicotine does not worsen mental health symptoms, contrary to some myths.

Connection to Other Substances
Nicotine use increases the risk of other substance use. Smokers are 3 times as likely to also struggle with the use of illicit substances. Moreover, smoking interacts with over 30 medications, including antipsychotics, antiseizure drugs, blood thinners, and birth control, potentially diminishing their effectiveness.

Nicotine use disorder (NUD), also called tobacco addiction, tobacco use disorder, and nicotine dependence, is a medical condition characterized by physical and psychological dependence on nicotine. Recognized as a public health threat, NUD can lead to severe health issues, including:

• Cardiovascular disease

• Lung disease

• Cancer

• Neuropsychiatric complications, including stroke and dementia

• Reproductive complications

• Other conditions such as cataracts, osteoporosis, and gum disease

Symptoms of NUD include:

• Inability to quit smoking despite wanting to stop

• Experiencing withdrawal symptoms when trying to quit

• Continuing to smoke despite health problems

• Avoiding social activities where smoking isn’t allowed

Nicotine’s addictive nature lies in its ability to release dopamine in the brain, creating pleasurable sensations. When nicotine levels drop, cravings and withdrawal symptoms emerge, making cessation challenging.

Smoking is a leading cause of preventable death in the U.S., and nicotine is the top cause of death among people with mental illnesses. Alarmingly, 31-44% of tobacco in the U.S. is consumed by individuals with mental health or substance use disorders. Despite these statistics, over two-thirds of smokers report wanting to quit—a rate higher than in the general population.

Additionally, quitting nicotine increases the likelihood of long-term abstinence from alcohol and other substances, highlighting the importance of addressing nicotine use as part of broader substance use disorder treatment.

Yes! There are effective treatments for NUD, including:

• Behavioral Counseling – Counseling benefits all patients and helps them develop strategies to quit.
• Pharmacotherapy – Medications, including nicotine replacement therapy (NRT) and other prescription medication, support cessation efforts. Combining medications with counseling is more effective than either approach alone.
• Social Support – Programs like Alcoholics Anonymous (AA) or SMART Recovery have shown success with substance use disorders. Studies have shown that social interventions are also useful for NUD, but unfortunately many are often not designed to address nicotine use.

Combining these three approaches—biological, psychological, and social—along with consistent follow-up, maximizes success rates. Studies have shown that participants in residential smoking cessation programs have nearly twice the rate of continuous abstinence compared to those in outpatient programs.

The Nicotine Support Program (NSP) at BrightQuest San Diego is a comprehensive, evidence-based program designed to help individuals overcome NUD using a biopsychosocial approach. The NSP provides support tailored to each participant’s goals and challenges, offering interventions at multiple stages of readiness for quitting nicotine.

Key Features of the NSP:

• Development of personalized quit plans

• Integration of biological, psychological, and social interventions in both individual and group formats

• Emphasis on goal development and sustained recovery

The NSP helps participants tackle nicotine dependence regardless of their initial motivation to quit, ensuring support for clients at every stage of their journey.

The Nicotine Support Program adheres to national guidelines for smoking cessation, including recommendations from the U.S. Preventive Services Task Force and CDC, which emphasize:

• Screening all patients for tobacco use and encouraging cessation.
• Providing interventions for every individual who smokes.
• Combining behavioral counseling with pharmacotherapy for the best outcomes.

Additionally, the NSP aligns with the American Psychiatric Association’s Position Statement on Tobacco Use Disorder and the Veterans Health Administration National Practice Guidelines for Tobacco Use Treatment.