An Overview of Nicotine Withdrawal

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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 begin to 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 withdrawal 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.

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 feeling is the reason many people smoke when they feel anxious or stressed.

However, the effects of nicotine wear off quickly, and 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 nicotine 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 can 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 (NRT)

Nicotine replacement therapy (NRT) administers small doses of nicotine (without the other toxins in cigarettes) to help ween you off of nicotine slowly. NRT is available as patches, gum, lozenges, nasal spray, and more. Treatment usually lasts no longer than 12 weeks, after which you reduce your use and ultimately stop.

Be sure to check with your doctor before starting NRT, and it's not right for everyone. 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 patch use), irritation of the nose, throat, or eyes (with nasal spray use), 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:

  • Cold sweat
  • Confusion
  • Diarrhea
  • Dizziness
  • Irregular heartbeat
  • Pale skin
  • Restlessness
  • Seizures
  • Stomach pain
  • Tremors
  • Weakness

Medications

There are also non-nicotine pharmaceutical quit aids like Chantix (varenicline) and 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, and it is usually started one week before a person quits smoking.

Zyban is actually an antidepressant medication 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 people. Talk to your doctor to find out if you are a good 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. While some studies show mindfulness does not directly reduce smoking rates, it may help 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 recovers 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 practice 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.

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. Exercise 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.

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. Breathing can be meditative and 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 struggling with quit-related insomnia (which is also common), try taking a long walk several hours before bed to help 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.

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.

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