Genetic predisposition accounts for 40-60% of the vulnerability to addiction, highlighting its nature as a medical condition.
Factors like early exposure, trauma, and socioeconomic conditions play critical roles in the development of SUD.
Tobacco use remains the leading preventable cause of death worldwide, killing 8 million people annually. Yet as traditional cigarette smoking has declined in many countries, a new phenomenon has emerged: electronic cigarettes and vaping devices. This module examines nicotine addiction across delivery systems—from combustible tobacco to modern vaporizers—and the unique public health challenges posed by e-cigarettes.
By the end of this module, you will be able to:
Mechanism of Action:
Pharmacokinetics:
Key Point: The speed of nicotine delivery determines addictive potential. Faster delivery = more reinforcing = more addictive.
Rapid Tolerance:
Withdrawal Symptoms (onset 2-12 hours):
Timeline:
Products: Cigarettes, bidis, hookah, cigars
Mechanism: Tobacco combustion produces smoke containing:
Health Consequences:
Products: Chewing tobacco, gutka, paan with tobacco, snuff, snus
Prevalence in India:
Health Consequences:
Indian Context: Smokeless tobacco causes a disproportionate burden of oral cancer in India, which has among the highest rates globally.
Products: E-cigarettes, vape pens, pod systems, mods
Technology:
Nicotine Delivery:
For Adult Smokers:
Public Health England Position:
Youth Epidemic:
Unknown Long-Term Effects:
Dual Use:
Nicotine Effects on Adolescent Brain:
What Happened:
Investigation Findings:
Symptoms of EVALI:
Clinical Approach:
Key Message: EVALI primarily associated with THC products and additives, but underscores that e-cigarettes are not without acute risk.
Flavors:
Social Media:
Design:
Messaging:
United States:
India:
European Union:
Nicotine Replacement Therapy (NRT):
| Product | Delivery | Duration | Notes | |---------|----------|----------|-------| | Patch | Transdermal | 16-24 hours | Steady state, prevents withdrawal | | Gum | Buccal | PRN | Addresses acute craving | | Lozenge | Oral | PRN | Discreet, no chewing required | | Inhaler | Oral | PRN | Hand-to-mouth habit replacement | | Nasal Spray | Nasal | PRN | Fastest NRT delivery |
Prescription Medications:
Varenicline (Chantix/Champix):
Bupropion (Wellbutrin/Zyban):
Brief Advice (5 A's):
Intensive Counseling:
Most effective: Pharmacotherapy + Behavioral Support
Evidence-Based Combinations:
Quit Rates (6-12 months, approximate):
Anika, 16, is brought by her parents after they discovered she has been vaping for 8 months. She started with friends who shared their JUUL devices. She now vapes daily, often in school bathrooms, and becomes irritable if unable to vape for several hours. She says, "It's not like smoking—it's just water vapor."
Discussion Questions:
Next Module: Depressants: Alcohol & Sedatives →
External links
Use one of the external tools below to explore "Nicotine & The Vaping Era". Check clinical claims against approved sources.
External links
Use one of the external tools below to explore "Nicotine & The Vaping Era". Check clinical claims against approved sources.