Addiction Nicotine Use Nicotine Withdrawal An Overview of Nicotine Withdrawal By 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 Terry Martin Medically reviewed by Medically reviewed by Armeen Poor, MD on March 04, 2021 Armeen Poor, MD, is a board-certified pulmonologist and intensivist. He specializes in pulmonary health, critical care, and sleep medicine. Learn about our Review Board Armeen Poor, MD Updated on July 14, 2021 Print damircudic / Getty Images Table of Contents View All Table of Contents Symptoms Causes Treatment Coping Nicotine withdrawal is the term used to describe the physical and psychological symptoms you experience when you quit smoking. These discomforts are normal and temporary, as long as you stay smoke-free. Nicotine Withdrawal Symptoms The following are the most commonly reported symptoms of nicotine withdrawal: Anxiety and restlessness Appetite and weight gain Cough Crankiness Cravings to smoke Difficulty concentrating Dry mouth Fatigue Headache Insomnia Irritability Postnasal drip Sore throat Sore tongue and/or gums Tightness in the chest Most people experience symptoms of nicotine withdrawal within 24 hours after quitting. Withdrawal is usually the most severe for the first week after quitting and starts to dissipate after three to four weeks. If you're concerned about a physical reaction you're having to smoking cessation or if nicotine withdrawal symptoms persist or worsen, be sure to talk to your doctor. Cravings may last longer than other symptoms. Participants of one study reported feeling cravings for cigarettes up to a year after quitting smoking; however, their cravings were less intense at the one-year mark than when they first quit. In other words, the longer you abstain from cigarettes, the less likely you are to crave cigarettes. Know What to Expect From Nicotine Withdrawal Causes People who regularly use nicotine become psychologically and physically dependent on it. Nicotine releases dopamine, the "feel-good" hormone, into the brain and creates a pleasurable feeling. This is the reason many people smoke when they feel anxious or stressed. However, the effects of nicotine wear off quickly—you'll likely feel more irritable a few minutes after having a cigarette than before you smoked. The need to have another cigarette to feel the pleasurable effects again creates a cycle in which people smoke more to feel better. Even if you aren't addicted to nicotine, regular use over a short period of time can lead to withdrawal symptoms. American Cancer Society People who have used tobacco regularly for a few weeks or longer will have withdrawal symptoms if they suddenly stop or greatly reduce the amount they use. — American Cancer Society People who quit smoking continue to be triggered by everyday situations. It can be difficult to do things, see people, or go places that you associate with smoking without having a craving. Sometimes, intense cravings lead to smoking relapse. 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. Nicotine Withdrawal Treatment If you are planning to quit smoking, there are ways to treat nicotine withdrawal before it even begins. Talk to your doctor about the best way for you to quit and which quit smoking aids might work best for you. Nicotine Replacement Therapy Nicotine replacement therapy (NRT) administers small doses of nicotine (without the other toxins in cigarettes) to help ween you off of nicotine addiction. NRT is available as patches, gum, lozenges, nasal spray, and more. Treatment usually lasts no longer than 12 weeks, after which time you reduce your use and ultimately stop. Be sure to check with your doctor if you're eligible for NRT. If you have kidney problems or you have had a heart attack or stroke, NRT may not be suitable for you. Side effects of NRT may include upset stomach, dizziness, headaches, skin irritation (with patches), irritation of the nose, throat, or eyes (with nasal spray), and sleep disturbances. In rare cases, some of these and other symptoms could indicate nicotine overdose. Nicotine Overdose Overusing nicotine replacement therapies can lead to nicotine overdose. If you experience the following symptoms, call 911 or poison control immediately: Stomach pain Diarrhea Restlessness Irregular heartbeat Cold sweat Pale skin Weakness Tremors Confusion Dizziness Seizures Medications There are non-nicotine quit aids like Chantix (varenicline) or Zyban (bupropion), that might help you avoid many of the symptoms of nicotine withdrawal. Chantix can help ease withdrawal symptoms and cravings. Side effects may include headache, nausea, and dizziness. Treatment with Chantix doesn't usually exceed 12 weeks. It is usually taken one week before a person quits smoking. Zyban is actually an antidepressant that may help with smoking cessation by affecting the part of the brain that is addicted to nicotine. Treatment usually lasts about 9 weeks. Side effects may include dry mouth, sleep disturbances, headaches, feeling sick, constipation, and dizziness. Chantix and Zyban are not recommended for pregnant or breastfeeding women. Talk to your doctor to find out if you are an eligible candidate for these medications. Mental Health Support Since smoking has a significant psychological impact, taking care of your mental health is important. You can try any—or a combination—of the following treatments that have been shown to have a positive impact on withdrawal: Cognitive-behavioral therapy (CBT): With CBT, A therapist will help you identify triggers to help you avoid relapsing. You will learn healthy coping strategies to deal with tough emotions instead of reaching for a cigarette. Mindfulness: You can attend mindfulness-based therapy with a counselor, or you can practice mindfulness on your own. Either way, you will learn to detach from the cravings and thoughts you have about cigarettes. You learn to replace them with healthier behaviors. Support groups: There are many smoking cessation programs that can help keep you accountable for your goal of staying smoke-free. In addition to in-person programs, there are online counseling programs, quit-lines, and quit smoking apps that can provide you with more resources and encouragement. Coping In addition to quit aids that can ease or even eliminate the discomforts, there are a number of steps you can take to make nicotine withdrawal more tolerable. Eat a Well-Balanced Diet Eating a balanced, healthy diet will help fuel your body as it recuperates from cigarette use. Some people struggle with nutrition when they quit smoking. Their tastes might change, and they might look to food as a coping mechanism to deal with uncomfortable emotions. Try eating slowly and mindfully. Notice the textures and flavors of your food in order to appreciate eating instead of using food as a distraction. This can also help avoid any unwanted weight gain when you quit smoking. Since some of the chemicals in cigarettes can deplete our bodies of essential vitamins, it's also smart to consider adding a multivitamin to your daily regimen. Healthy Coping Skills for Uncomfortable Emotions Exercise Though you might be missing the dopamine release from cigarettes, there are natural ways to increase your dopamine levels. For instance, exercise also causes our brains to release dopamine. Get out for a walk, or head to the gym. It will help reduce stress, improving your mental health as well as your physical health. Drink Water Good hydration is always important, but even more so while you're going through nicotine withdrawal. Drinking water can help provide your body with enough energy as you cope with withdrawal symptoms. Reaching for a tall glass of water is also a helpful strategy for dealing with cravings. The 5 Ds That Help With Smoking Cessation Breathe In those first days of smoking cessation, it can feel as though your day is one long craving to smoke. The truth is that most urges to smoke last three to five minutes. Rather than tensing up when a smoking urge hits, try some deep breathing. It will help you ride out the craving in a more relaxed way. Get More Rest Fatigue is common during nicotine withdrawal. If you're tired and can manage it during the day, take a nap. At the end of the day, go to bed a little earlier than usual. On the other hand, if you find yourself suddenly suffering from quit-related insomnia (also common), try taking a long walk several hours before bed to get your body ready for sleep. Distract Yourself Create a list of ways to pull yourself out of a smoking urge or negative thought pattern that you can employ at a moment's notice (water and breathing are good additions). Change what you're doing abruptly and your mind will also shift away from the downward spiral it's on. 10 Ways to Overcome Cigarette Cravings in 5 Minutes Give Yourself Time Over time, you will need to reprogram the mental associations you have with smoking. This part of recovery may take a bit more time, but as you stick to your goal of staying smoke-free, you will learn that you can perform daily tasks, see people, and go places without needing to smoke. When your withdrawal symptoms are the most intense, try changing up your daily routine—you might avoid anything that you know will trigger you to smoke. Keep yourself busy with activities that interest you, and be sure to reward yourself for not smoking. Give yourself the benefit of a full year smoke-free and you'll be well on your way to a life where not smoking is natural and comfortable. A Word From Verywell Nicotine withdrawal is intense and difficult for most people, but it is also temporary. Keep your perspective by reminding yourself that easier days are ahead. If you do your best, one day at a time, you'll soon reap the many benefits of a healthier, smoke-free life. Was this page helpful? Thanks for your feedback! So you're ready to finally quit smoking? Our free guide can help you get on the right track. Sign up and get yours today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. 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 Hughes JR. Craving among long-abstinent smokers: An internet survey. Nicotine & Tobacco Research. 2010;12(4):459-462. doi:10.1093/ntr/ntq009 American Cancer Society. Why people start smoking and why it's hard to stop. Last revised November 2020. National Health Service. Stop smoking treatments. Last reviewed July 2019. American Cancer Society. Nicotine replacement therapy to help you quit tobacco. Last revised October 2020. National Health Service. Champix (varenicline). Last reviewed October 2020. National Institutes on Drug Abuse. What are treatments for tobacco dependence? Published January 2020. American Cancer Society. Dealing with the mental part of tobacco addiction. Last revised October 2020. National Institutes of Health. Nutrition and appetite while quitting. Bello HA, Dandare A, Danmaliki GI. Effects of cigarette smoking on lipid peroxidation and serum antioxidant vitamins. Int J Pharm Biol Sci. 2017;12(2):40-44. doi:10.9790/3008-1202044044 Lin TW, Kuo YM. Exercise benefits brain function: The monoamine connection. Brain Sci. 2013;3(1):39–53. doi:10.3390/brainsci3010039 American Cancer Society. Help for cravings and tough situations while you're quitting tobacco. Last revised October 2020. Tang YY, Tang R, Posner MI. Brief meditation training induces smoking reduction. Proc Natl Acad Sci U S A. 2013;110(34):13971-13975. doi:10.1073/pnas.1311887110 Liu X, Li R, Lanza ST, Vasilenko SA, Piper M. Understanding the role of cessation fatigue in the smoking cessation process. Drug Alcohol Depend. 2013;133(2):548–555. doi:10.1016/j.drugalcdep.2013.07.025 National Institutes of Health. Steps to manage quit day. Speak to a Therapist for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.