Addiction Nicotine Use Nicotine Withdrawal 7 Common Nicotine Withdrawal Symptoms Knowing what to expect can help you prepare By Terry Martin Terry Martin Facebook Twitter Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. Learn about our editorial process Updated on March 27, 2023 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print Table of Contents View All Table of Contents Definition Symptoms Causes Treatment Frequently Asked Questions Verywell / Laura Porter Many smokers fear nicotine withdrawal symptoms when embarking on a smoking cessation plan. In fact, these symptoms are one of the main reasons why quitting smoking (or other forms of tobacco) is so difficult. From cravings to muscle and joint pain after quitting smoking, withdrawal symptoms can make the process more challenging. This experience can be a distressing experience for some, triggering a host of physical and psychological symptoms. But it doesn't mean that everyone will experience withdrawal in the same way. For example, people who quit "cold turkey" tend to have more severe nicotine withdrawal symptoms than those using an approach that involves counseling, support systems, and quit-smoking aids such as nicotine replacement therapy (NRT). You can experience nicotine withdrawal symptoms no matter what type of nicotine you're quitting—whether smoking, vaping, chewing tobacco, or any other form of tobacco use. What Is Nicotine Withdrawal? Nicotine withdrawal refers to what happens in the body when someone who has been using nicotine regularly stops or reduces their intake. This reduction or elimination of nicotine can result in experiencing nicotine withdrawal symptoms that are physical and psychological in nature. As far as a timeline is concerned, nicotine withdrawal symptoms can begin within two to three hours after you last used this drug. Though, they are often strongest a few days after stopping nicotine completely. The Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) outlines the criteria for tobacco withdrawal. The title of this condition was changed from "nicotine withdrawal," which is what it was called in the DSM-IV. The nicotine withdrawal symptoms discussed here are not all the same criteria as listed in the DSM-5. Nicotine Withdrawal Symptoms By understanding some of the signs and symptoms of nicotine withdrawal, you can better prepare for them and know how to respond if and when they occur. Here are a few of the most common, along with several ways to avoid them. While nicotine withdrawal symptoms can be challenging, it's important to remember that these effects are only temporary. With a little preparation and persistence, you will get through them. 1 Nicotine Cravings Smoking urges, commonly known as nicotine cravings, are one of the most challenging and persistent nicotine withdrawal symptoms. The cravings you feel are caused by nicotinic receptors in the brain. A craving is a physiological response in which the body yearns for something to which it has adapted and become tolerant. When suddenly deprived of nicotine, the brain no longer releases the "feel-good" hormone dopamine, which the body has grown accustomed to. Nicotine cravings typically last for five to 10 minutes and may be extremely uncomfortable. To cope with this nicotine withdrawal symptom, remind yourself that the feeling will pass. Chewing nicotine gum or taking a long, brisk walk can also help as you wait them out. 2 Weight Gain The urge to snack is a nicotine withdrawal symptom that involves more than just replacing cigarettes with food. Nicotine causes changes to cells that make them not respond as well to insulin, which can increase your body's blood sugar levels. As a result, when quitting smoking, you may feel the need to consume carbs, or crave sweets and other foods to satiate this sudden and often unexplained hunger. Thankfully, this effect will stabilize as your body adjusts to being nicotine-free. Research shows that people who quit cigarettes gain an average of 10 pounds after one year, with most of the gain occurring during the first three months. In the meantime, to keep from gaining weight when quitting smoking, it helps to control your snacking. Do something to distract yourself instead eating, such as engaging in physical exercise. And if you do snack, choose healthy foods that won't contribute to weight gain. Fruits and vegetables are good options to consider. 3 Sleep Disturbances Sleep problems are common nicotine withdrawal symptoms and can run the gamut from insomnia to needing extra sleep during the day. These symptoms are also closely linked to the dysregulation of dopamine, which is involved in sleep regulation. While sleep disturbances and insomnia are symptoms of nicotine withdrawal, research has indicated that smokers tend to experience worse sleep than non-smokers. To relieve insomnia when quitting smoking, consider any other factors that may be contributing to your sleep issues. If you drink caffeine later in the day, for instance, changing this habit can make it easier to get and stay asleep. It can also be helpful to develop a pre-sleep routine that helps you relax. This might involve ending your day with a nice bath or reading a few pages in your favorite book to help calm your mind. 4 Persistent Cough Some people develop a persistent cough after they quit smoking. This can cause you to feel worse instead of better. As odd as this may seem, coughing at this stage is a sign that your lungs are getting better. When you smoke, the tiny finger-like projections in the lining of your airways (called cilia) become immobilized and eventually flatten out. After you quit, the cilia return to their normal shape and function, pushing toxic deposits out of the lungs to be coughed up. You can avoid this nicotine withdrawal symptom by staying well-hydrated and humidifying the air in your environment. It can also be helpful to use honey or an over-the-counter cough drop to ease any throat irritation. 5 Flu-Like Symptoms While in the process of quitting, you may experience something popularly referred to as "quitter's flu." This is characterized by a mild fever, malaise, sinusitis, coughing, and body aches, and is simply your body's response to an unfamiliar state. Muscle and joint pain after quitting smoking are common sympoms of the quitter's flu. The sudden cessation of smoking can trigger an immune response, causing it to react in much the same way as it would to bacteria or a virus it considers abnormal. In most cases, quitter's flu will last for only a couple of days. Nicotine replacement therapy, along with over-the-counter pain relievers, may help ease these symptoms. 6 Mood Changes Stress and irritation are common symptoms of early nicotine withdrawal. They are triggered by the profound dysregulation of the endocrine (hormonal) and central nervous systems. This stress can not only cause extreme changes in mood, including sudden and irrational outbursts, but it can also trigger short-term physiological changes such as increased blood pressure and heart rate. Memory problems, difficulty concentrating, and dizziness are also common. So are feelings of anxiety, which often occur within three days of quitting but may last several weeks. These psychological symptoms can worsen if you are sleep-deprived, further leading to bouts of anxiety or depression. Finding ways to reduce your stress when quitting smoking can help avoid this common nicotine withdrawal symptom. This may involve journaling, talking with a friend, or finding a physical activity that you enjoy. 7 Constipation In addition to the lungs and brain, the digestive tract can also be affected when you stop smoking. Stopping the use of nicotine alters the motility and contraction of the intestines, dramatically slowing the speed by which food is digested. Older research revealed that as many as one in six people who quit cigarettes experience bouts of constipation, and it generally lasts for one to two weeks. This effect may be further exacerbated by the "munchies" some people experience while quitting. Increased food cravings can increase the volume of food you eat, along with increasing your intake of foods more likely to cause constipation—such as white bread, chocolate, potato chips, and ice cream. Drinking plenty of water can help normalize your bowel movements. Increasing your intake of dietary fiber may reduce this nicotine withdrawal symptom as well. Causes of Nicotine Withdrawal Symptoms Nicotine withdrawal occurs because the body has become dependent on this drug. Specifically, nicotine stimulates the release of dopamine in your brain. So, when you stop using it, there is less dopamine released, resulting in withdrawal symptoms. (Nicotine affects other neurotransmitters as well.) While nicotine withdrawal can be uncomfortable, it does make your body healthier versus hurting it. Behavioral factors are also thought to influence nicotine withdrawal symptoms. For example, just seeing someone smoking or smelling a cigarette can increase your cravings to do the same. Treatment for Nicotine Withdrawal Symptoms There are a few treatments to help with nicotine withdrawal, including: Nicotine replacement therapies (NRTs): Examples of NRTs include nicotine gum, patches, and lozenges, all of which are available over the counter. Nicotine nasal sprays and inhalers are available with a prescription. Prescription medications: The antidepressant Zyban (bupropion) (also sold under the brand name Wellbutrin) and the smoking cessation aid Chantix (varenicline) can help with nicotine withdrawal symptoms. Speak to a healthcare provider about what treatment might be best for you. In addition to medications and NRTs, you can also seek psychological support from a support group, quit-tobacco program, or mental health professional. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. A Word From Verywell Nicotine withdrawal symptoms can be intense and uncomfortable. But this phase of smoking cessation won't last forever. And, if prepared, you can manage and cope with the symptoms as they come. In the end, the benefits of quitting far outweigh any short-term discomfort you may experience through withdrawal. If you take it one step at a time, you'll get there. Try not to get ahead of yourself and worry about never smoking again. Just focus on today and do whatever you can to remain smoke-free. Frequently Asked Questions Does quitting smoking make your muscles ache? Yes, quitting smoking can lead to muscle ache and joint pain. This is often referred to as the "quitter's flu" and can also include symptoms such as fever, stuffy nose, coughing, and lack of energy. Can quitting smoking cause inflammation? Smoking is associated with increased inflammation, so quitting smoking can lead to significant improvements. This can take time, but it contributes to a decreased risk of cardiovascular disease. How long does it take for inflammation to go away after quitting smoking? One study reports that inflammation begins to subside just two weeks after quitting. Other research suggests that the inflammatory response associated with smoking returns to normal within five years of quitting. How long after quitting smoking does your body go back to normal? The health benefits of quitting are progressive and can take time, but start almost immediately after quitting. Within 20 minutes, your heart rate and blood pressure drop. A year after quitting, the cilia in your lung regain their normal function. By two years, your risk of heart attacks drops significantly. Between five and 10 years, your risk of different cancers drops dramatically. By 15 years after quitting, your risk of coronary heart disease has dropped to almost that of a non-smoker. 24 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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Sci Rep. 2021;11(1):24122. doi:10.1038/s41598-021-03476-5 Darabseh MZ, Maden-Wilkinson TM, Welbourne G, et al. Fourteen days of smoking cessation improves muscle fatigue resistance and reverses markers of systemic inflammation. Sci Rep. 2021;11(1):12286. doi:10.1038/s41598-021-91510-x Smoking and Inflammation. PLoS Med. 2005 Jun;2(6):e198. doi:10.1371/journal.pmed.0020198. Epub 2005 Jun 28. PMCID: PMC1160597. American Cancer Society. Health benefits of quitting smoking over time. Additional Reading McLaughlin I, Dani JA, De Biasi M. Nicotine withdrawal. Curr Top Behav Neurosci. 2015;24:99-123. doi:10.1007/978-3-319-13482-6_4 By Terry Martin Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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