Tobacco dependence

00:00 / 00:00



Tobacco dependence

Psychological disorders

Bipolar and related disorders

Bipolar disorder

Feeding and eating disorders

Anorexia nervosa

Bulimia nervosa

Medication-induced movement disorders and other adverse effects of medication

Neuroleptic malignant syndrome

Serotonin syndrome

Somatic symptom and related disorders

Factitious disorder

Somatic symptom disorder

Trauma and stressor-related disorders; Abuse

Physical and sexual abuse

Post-traumatic stress disorder


Tobacco dependence


0 / 15 complete

USMLE® Step 1 questions

0 / 4 complete

High Yield Notes

11 pages


Tobacco dependence

of complete


USMLE® Step 1 style questions USMLE

of complete

A 1-day old boy is evaluated in the neonatal ICU for preterm birth and low birth weight. The patient was born via uncomplicated spontaneous vaginal delivery to a 35-year-old woman at 34 weeks gestation. The neonate has passed urine and is breastfeeding. He has not passed stool. The mother had a normal pregnancy with regular antenatal care. During her pregnancy, she had two upper respiratory tract infections and a urinary tract infection that was treated. She did not use illicit drugs or consume alcohol during her pregnancy. She did consume caffeinated energy drinks and smoked a pack of cigarettes on the weekends throughout her pregnancy. Temperature is 37.2°C (99°F), blood pressure is 70/30 mmHg, pulse is 120/min, and respiratory rate is 55/min. His weight, length and head circumference are at the 40th percentile for gestational age. Birth weight was 1500g. Abdomen is soft and nontender. Normal heart sounds are heard on cardiovascular auscultation. Which of the following intrauterine processes is most likely responsible for this patient’s clinical findings?

External References

First Aid








Cigarette smoke (carcinogen) p. 223


There are over a billion people who smoke tobacco around the world, which makes it one of the most popular psychoactive substances used in society.

The majority of tobacco users smoke cigarettes, but some smoke cigars or pipes, chew tobacco, or practice snuffing, which is where ground-up tobacco leaves are pushed up the nose.

Given the popularity of tobacco as well as its negative health consequences, it’s considered one of the leading causes of preventable death and disease worldwide.

Cigarette smoke contains over 4,000 toxic chemicals.

These toxins cause endothelial cell damage which creates inflammation along the inner lining of arteries.

The inflammation increases the risk of having a myocardial infarction (or heart attack), a stroke, and peripheral vascular disease which causes severe pain in the lower legs.

The toxins in cigarette smoke can also cause pulmonary problems when they’re deposited into the lungs, as they damage the lung tissue and increase the likelihood of developing a lung infection.

Finally, cigarette smoke contains many different carcinogens including ammonia, formaldehyde, and carbon monoxide, all of which are associated with cancers of the mouth, throat, lung, bladder, pancreas, and uterus.

Combining these effects, a heavy smoker who smokes two packs of cigarettes each day for 20 years loses about 14 years of life.

Despite the negative consequences of smoking, most people continue to smoke because tobacco contains nicotine, a tiny, fat-soluble molecule that creates pleasurable psychoactive effects and is extremely addictive.

Nicotine is considered “responsible” for the high rates of tobacco dependence and addiction, while the 4,000 other chemicals and compounds are “responsible” for the negative health effects associated with smoking.


Tobacco dependence, also known as nicotine dependence, is a chronic addiction to nicotine, a substance found in tobacco products such as cigarettes, cigars, and chewing tobacco. Nicotine stimulates the release of dopamine in the brain, which creates a pleasurable sensation and reinforces the behavior of smoking, leading to dependence.

Symptoms of tobacco dependence may include strong cravings for nicotine, difficulty quitting, withdrawal symptoms such as irritability, anxiety, and difficulty concentrating, and a continued use of tobacco despite negative consequences on health, social life, or finances.

Tobacco dependence is a serious health concern and increases the risk for heart attacks, strokes, chronic obstructive pulmonary disease (COPD), emphysema, and cancer (particularly lung cancer, cancers of the larynx and mouth, esophageal cancer and pancreatic cancer). Treatment for tobacco dependence includes nicotine replacement therapy, medications such as bupropion or varenicline, and counseling or support groups.


Copyright © 2023 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.