This image describes the process of nicotine addiction. When a person smokes, nicotine is absorbed via the buccal mucosa. Nicotine then binds to the nicotinic receptor, stimulating dopamine release.

High levels of nicotine create that ‘buzz’ and over time, drops in nicotine then create cravings, thus forming the nicotine addiction cycle. Over time, these nicotine receptors become inactive, which is why it is important to highlight to the client a ‘not a puff’ rule is insisted upon. Just one puff of a cigarette can result in nicotine receptors becoming active again, causing a lapse.