Nicotine dependence is the physical and behavioural reliance that develops with regular nicotine use. Nicotine triggers dopamine release in the brain reward system, and over time the brain adapts, driving cravings and withdrawal when levels fall.
Dependence severity is often gauged by how soon after waking a person smokes and how many cigarettes they use daily. Higher dependence usually benefits from combination treatment, pairing medicines with behavioural support rather than willpower alone.