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Nicotine Abuse and Dependence in Children

What is nicotine abuse and dependence?

Nicotine is a chemical in cigarettes, pipe tobacco, cigars, and smokeless (chewing) tobacco. It is both a stimulant, which increases energy, and a sedative, which calms your child down.

Abuse and dependence are patterns of using tobacco that lead to serious personal, family and health problems. Abuse is when your child keeps using tobacco even though it causes problems.

If your child continues to abuse tobacco, he can become dependent. When your child is dependent, he:

  • Needs to use more and more nicotine, or use it more often to get the same effects
  • Loses control, which means he keeps using tobacco even though he knows that it is harmful to him or others, or he can't stop using tobacco when he tries
  • Craves nicotine so much that he spends a lot of time and energy getting nicotine, using nicotine, and getting over the effects
  • Has withdrawal symptoms when he stops using tobacco

Most people who use tobacco start before age 18. Children who start smoking at a young age are less likely to quit when they become adults.

What is the cause?

At first your child may use tobacco because it makes him feel good or because he wants to change something about his life. He may start smoking to fit in with friends who smoke. He may want to look cool, older, or rebellious. Or he may think it will help him relax and feel better.

The brain makes chemicals that affect thoughts, emotions, and actions. Nicotine changes the balance of these chemicals in your child’s brain. When your child uses nicotine regularly, his brain starts to get used to it. As a result, he doesn't feel right unless he uses nicotine. When he stops using nicotine, the balance of chemicals in his brain changes, which causes the symptoms of withdrawal.

Your child may like the feel, smell, and sight of a cigarette and the ritual of handling, lighting, and smoking cigarettes. If your child tries to quit smoking, giving up these rituals may make withdrawal symptoms and cravings worse.

What are the symptoms?

Signs of smoking may include:

  • Smelling like smoke
  • Bad breath
  • Sinus congestion
  • Shortness of breath and constant cough
  • Less ability to do athletic things like run or swim
  • Sore throat or hoarse voice

If you notice these signs, it does not mean that your child is smoking regularly, but you should talk with your child.

When your child tries to quit using tobacco, he may feel irritable, depressed, hungry, tired, and restless. He may have trouble sleeping or trouble concentrating.

How can I help my child?

If your child is using tobacco:

  • Talk to your child. Ask what he likes about smoking or using tobacco. Try to find a healthy substitute for tobacco. For example, if your child is smoking to "fit in," help him find another activity, such as sports or drama, where he can fit in and feel good about himself.
  • Point out that it causes bad breath, stained teeth, and stinky clothing.
  • Although the immediate problems caused by tobacco will mean more to most children than long-term risks, it is still important to tell your child that people who smoke often die at an earlier age than nonsmokers. Smokers are more likely to die from problems caused by smoking, such as cancer, heart disease, or lung disease. Using smokeless tobacco causes gum disease, mouth cancer, and heart disease.

If your child is ready to quit, help him:

  • Make a plan:
    • Set a quit date and tell his family and friends. Some people gradually use less tobacco in the days leading up to their quit date. Others use the same amount of tobacco right up to their quit date.
    • It may also help to chew sugarless gum or eat hard candy, beef jerky, or sunflower instead of smoking or chewing tobacco.
    • Throw out all tobacco products and anything used with the tobacco such as lighters and ashtrays.
    • Have your child write down his reasons for not wanting to smoke and review them whenever he feels tempted to use tobacco.
    • Make a list of the situations, places, or emotions that make him more likely to use tobacco. These things are called triggers. Being aware of these triggers can help him avoid them or be ready for them. For example, if he always uses tobacco after an argument, he can make a plan to take a walk the next time he has an argument.
  • Help your child change his daily routines and take on new activities that don't include smoking. He could join an exercise group or take up a sport. He might want to try drawing, making models, or other activities to keep his hands busy.
  • Encourage him to spend time with people who don't smoke. It is also helpful to learn ways to relax and manage stress. Talk about what he could buy with the money he would have spent on tobacco.
  • Nicotine replacements like the patch, gum, nasal spray, inhalers, or lozenges can help with the cravings that your child may have while trying to quit using tobacco.

    Electronic cigarettes, also called e-cigs, are battery-operated devices that look like a cigarette or cigar. They make a smokeless vapor that the user inhales. The vapor contains many chemicals, and often contains nicotine. E-cigs are not a good way to quit smoking because:

    • They have not been proven to be safe. Some of the chemicals are harmful. E-cigs affect lungs and breathing in some of the same ways that tobacco cigarettes do.
    • There is no proof that e-cigs help with quitting smoking. E-cigs deliver nicotine in a way that can continue nicotine and smoking addiction.
  • Hypnosis and acupuncture may help some children to quit smoking.
  • You may be able to find a program for teens through local hospitals or the American Cancer Society.
  • Encourage your child to keep trying. Many people try more than once to quit smoking before they finally succeed.

If you use tobacco:

  • Try to quit.
  • Talk about how addictive and expensive smoking is, and how hard it is to quit.
  • Get the support you need to stop smoking. Nothing you say about tobacco will be as powerful as the example you set for your child.
Developed by RelayHealth.
Pediatric Advisor 2015.2 published by RelayHealth.
Last modified: 2014-03-14
Last reviewed: 2014-03-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.
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