Nicotine and Tobacco: What Is It and How to Start Your Quit Journey

Quitting nicotine and tobacco is no small feat—and sometimes quitting can be difficult to navigate. As you plan your quit journey, there are many different things to consider to make these next steps easier. This includes having an understanding of nicotine and tobacco, how to get started, and what supports you have available to you during your journey.  

What is nicotine?  

Nicotine is a stimulant that can come from the tobacco plant or created synthetically in a lab. Products that contain nicotine may include:  

• Cigarettes 
• E-cigarettes 
• Cigars or Cigarillos  
• Smokeless tobacco (dip, snuff, chew) 
• Smokeless nicotine (pouches, Zyn) 
• Hookah 

Are there risks that come with using nicotine? 

While people view some forms as safer than others, any use of nicotine comes with risks. Nicotine has a high addiction potential, so when you use it, your body and brain become used to its presence and you may start to become dependent. Nicotine can also have many different effects on the body, impacting systems such as the cardiovascular, respiratory, and reproductive systems. Nicotine use can also further worsen stress and mental health levels, including levels of anxiety and depression.  

What is sacred (traditional) tobacco and how is it different from commercial tobacco?  

Sacred tobacco has been used by Indigenous communities of North America for centuries as a part of spiritual and medicinal practices. These forms of tobacco hold cultural significance, and the relationship varies across nations and tribes. Sacred tobacco doesn’t contain additives and may be used for prayer, healing, and protection. When used in practice, it is not associated with nicotine dependence. Connection to sacred tobacco has been and continues to be disrupted by colonization and colonial practices. Indigenous nations and tribes are trying to reconnect with sacred tobacco to decrease commercial tobacco use within their communities.  

Commercial tobacco, however, is highly addictive and contains cancer-causing chemicals and additives. Commercial tobacco comes in many forms and is often mass produced with targeted advertising. Recently, there has also been a rise in lab-made synthetic nicotine being added to electronic cigarettes, vapes, and nicotine pouches. Discussions about the harmful effects of nicotine and quitting strategies, largely reference commercialized tobacco and nicotine.   

How do you start your quit journey?  

Starting your quit journey can be intimidating, but a little preparation goes a long way. Some may try quitting cold turkey, but that may not be everyone’s journey. Others may start by building a quit plan. A quit plan can include: 

• Setting a quit date, usually two to four weeks after you set the intention to quit 
• Getting social support from friends, family, and a health care provider(s) 
• Exploring nicotine replacement therapy and quit smoking medication 
• Identify potential triggers for using nicotine and come up with alternative ways to navigate those situations 
• Having a list of your motivations to quit and keep it handy for reference if you begin to feel discouraged 
• Making a contingency plan if you have a “slip” (such as start using nicotine again) during your quit journey 

What is nicotine replacement therapy?  

In your journey to quit smoking, you might also benefit from trying a form of nicotine replacement therapy (NRT).  

NRT helps manage withdrawal symptoms by providing low, controlled doses of nicotine. This can be especially helpful if you are dependent.  NRT is a safer alternative to cigarettes that allows you to gradually reduce your nicotine intake while eliminating your exposure to the harmful effects of cigarette smoke or e-cigarette vapor. This medication also helps reduce more severe withdrawal symptoms. NRT can improve chances of quitting by about 50 to 70 percent and should be started one to two weeks before quitting or immediately after you quit. 

NRT comes in many forms, including both over the counter (OTC) and prescription options. 

OTC Options: 

• Gum  
• Transdermal Patch 
• Sublingual tablets/lozenges  

Prescription Options 

• Nasal Spray  
• Inhaler 

NRT can have side effects, however, it’s less addictive than other nicotine products. To ensure it is effective, it needs to be used correctly.  Those on NRT are also encouraged to set up regular appointments with a medical professional, mental health professional, or tobacco treatment specialist to receive support with these products and increase the chances of successfully quitting. 

What are quit smoking medications? 

In addition to NRT, there are also quit smoking medications that don’t contain nicotine. The current recommended medications include varenicline (Chantix) and bupropion (Wellbutrin XL). Both medications require a prescription and work by reducing the pleasurable effects of smoking and help manage withdrawal symptoms. While they can also be used alone, consider speaking with a health care provider about using these in combination with NRT.  

Your nicotine dependence levels, medical conditions, and personal preferences all come into play when deciding which medications to use. Additionally, since some medications require a prescription, meeting with a health care provider can be helpful to decide the right step for you. 

Is there anything that can help make NRTs and quit smoking medications more effective? 

NRT and quit smoking medication are even more effective when combined with behavioral strategies. For more behavioral strategies to navigate quitting and nicotine withdrawal, check out fact sheet on navigating withdrawals when quitting. 

Additional resources  

If you would like to quit, there are many great resources to support you! Getting connected to a health care provider can be a great first step. There are also tobacco and nicotine cessation programs that pair you with a tobacco treatment specialist who can help with navigating NRT and provide behavioral counseling to support on your quit journey. You can develop a quit plan with a provider and work together to problem solve obstacles that may arise.  

You can also access resources at smokefree.gov to develop a quit plan and get tools and tips to quit!