【Medical Q&A】Is tobacco addiction a disease?

Planner: Chinese Medical Association

Reviewer: Xiao Dan, Researcher, China-Japan Friendship Hospital

Tobacco addiction is an important reason why smokers continue to smoke. It is not a behavioral habit but a chronic disease.

When smokers smoke, nicotine will quickly enter the brain center of smokers through blood circulation within 10 seconds, bind to nicotine receptors in the brain, and stimulate the rapid and short-term release of dopamine. Dopamine can make people feel euphoric, but this effect will soon disappear, causing smokers to have psychological reactions such as irritability and irritability when they are not smoking. Then, the instinctive desire is to smoke again, which is tobacco addiction. Imaging studies have found that the structure and function of the brain of tobacco addicts will change, manifested as gray and white matter atrophy, abnormal neural activity in the frontal lobe, temporal lobe and limbic lobe, and significant reduction in the function of the insular related brain area. In this way, tobacco addiction is a chronic disease, and its lesions are located in the brain. Although the harm of tobacco to health has been fully confirmed, many smokers know that smoking is harmful to health, but they still "smoke it anyway"; some tobacco addicts cannot quit smoking even after suffering from smoking-related diseases; and some smokers want to quit smoking, but they will not choose to go to the hospital for treatment. The fundamental reason for these phenomena is that they have not established the concept that "tobacco addiction is a disease that needs treatment." Only by receiving standardized diagnosis and treatment for tobacco addiction can we fundamentally reduce the risk of smoking-related diseases.