Tobacco Dependency

What Causes Tobacco Dependence?

Tobacco use disorder develops through a combination of biological, psychological, and environmental factors, including:

• Nicotine’s effects on brain chemistry, especially dopamine pathways
• Genetic vulnerability to addiction
• Co-occurring mental health conditions, such as anxiety, depression, ADHD, PTSD, or OCD
• Stress, trauma, or emotional regulation challenges
• Habit formation and daily routines
• Social and environmental exposure

Many people use nicotine to manage focus, calm anxiety, regulate mood, or cope with distress—often without realizing how strongly dependence has taken hold.

While cigarettes are the most well-known form of tobacco use, many people today struggle with dependence related to:

• Cigarettes and cigars
• E-cigarettes and vaping devices
• Nicotine pouches
• Smokeless tobacco (chewing tobacco, snuff)
• Heated tobacco products

Because nicotine directly affects brain circuits involved in reward, mood, attention, and stress regulation, stopping use can feel overwhelming without the right support.

What Are Symptoms of Tobacco Dependence?

Tobacco use disorder often shows up in ways people don’t immediately recognize as a medical condition. You might notice strong cravings or urges to use nicotine, or find yourself wanting to cut back or quit but struggling to follow through.

When you’re not using, you may feel irritable, anxious, low, restless, or just “off,” and nicotine can start to feel like the quickest way to feel normal again.

Many people rely on it to cope with stress, emotions, or daily pressure, even while worrying about the impact on their health. You might spend more time than you’d like thinking about nicotine – when you’ll use it next, how to get it, or how to make sure you don’t run out – and continue using despite clear negative consequences.

If quitting feels much harder than you expected, it’s often a sign that nicotine dependence is at work and that professional support could make a real difference.

How is Tobacco Use Disorder Treated?

“At Bonmente, we treat tobacco use disorder as part of the bigger mental health picture, because addiction and mental health are deeply connected,” says Mottsin Thomas, a psychiatrist at bonmente. “With medication, therapy, support, and even transcranial magnetic stimulation, we have more tools than ever to support recovery from tobacco dependence.”

Care is always individualized and treatment plans for overcoming tobacco dependence have to be collaborative between provider and patient. Psychiatric evaluation and medication management can help reduce cravings, ease withdrawal symptoms, and address underlying conditions like anxiety, depression, ADHD, or OCD that often make quitting harder in the first place.

Therapy plays a key role as well, helping you understand your triggers, break long-standing habits, and build healthier ways to cope with stress and emotions through approaches like cognitive behavioral therapy, motivational support, and emotion regulation skills.

For some patients, we may also recommend Transcranial Magnetic Stimulation (TMS) – a non-invasive, FDA-cleared treatment that shows promise in reducing nicotine cravings, decreasing compulsive use patterns, and improving mood and cognitive control. Because tobacco use disorder is often chronic and relapsing, the focus isn’t on perfection – it’s on steady progress, long-term support, and helping you build a healthier, more sustainable life without nicotine.