Nicotine withdrawal: Symptoms, timeline, and how to cope Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe Nicotine withdrawal symptoms and how to copeMedically reviewed by Alyssa Peckham, PharmD, BCPP — By Aaron Kandola and Zia Sherrell, MPH on September 28, 2022When nicotine begins to leave the body, people typically experience physical and psychological withdrawal effects. Knowing what to expect and how to manage these effects can help people cope if they decide to stop using nicotine. Nicotine is the addictive substance present in tobacco products, including cigarettes and cigars. It is a chemical that can affect a person’s brain function. Once the body adapts to regular nicotine intake, it can be challenging to give up smoking because of the uncomfortable symptoms of nicotine withdrawal. Withdrawal symptoms usually peak after a few days and then decrease over a period of a few weeks. After this time, the body has expelled most of the nicotine, and the withdrawal effects are mainly psychological. Understanding nicotine withdrawal symptoms can help people manage while they quit smoking. This article discusses nicotine withdrawal in more detail, including the symptoms and how to cope. What is nicotine withdrawal Share on PinterestBim/Getty ImagesNicotine has various effects on a person’s body. When someone uses a nicotine product, such as a cigarette, their body absorbs the nicotine through the lining of the nose, mouth, and lungs. From these locations, it enters the bloodstream. When nicotine reaches the brain, it activates areas involved in feelings of pleasure and reward. It also boosts the levels of a chemical called dopamine. Nicotine also affects areas in the brain that play a part in:breathingmemoryappetiteheart rate Using nicotine for an extended period leads to changes in the balance of chemical messengers in the brain. When a person stops using nicotine quickly, they disrupt this chemical balance. This can lead to the person experiencing physical and psychological side effects, such as cravings and low mood. Experts describe this disruption of brain chemicals as nicotine addiction, and it is part of the reason why people find it so difficult to reduce or quit smoking. Symptoms of nicotine withdrawal The symptoms of nicotine withdrawal are both physical and psychological. The physical side effects only last for a few days while the nicotine leaves the body, but the psychological side effects can continue for much longer. Although it may feel unpleasant, nicotine withdrawal, for the most part, has no associated health risks. However, if a person experiences significant changes in their blood pressure, this may affect their heart health. The psychological symptoms of nicotine withdrawal include:a strong desire or craving for nicotineirritability or frustrationlow mooddifficulty concentratinganxietymood swings People may also experience the following physical symptoms of nicotine withdrawal:headachessweatingrestlessnesstremorsdifficulty sleepingwaking at nightincreased appetiteabdominal crampsdigestive issues, including constipation Timeline of nicotine withdrawal Each person will have a different experience of nicotine withdrawal. Some individuals experience only mild symptoms for a few days, whereas others may have intense cravings and symptoms that last several weeks. Withdrawal symptoms appear 4–24 hours after someone smokes their last cigarette. The symptoms peak about 3 days after quitting and then gradually subside over the following 3–4 weeks. About 2 hours after smoking a cigarette, the body will have cleared about half of the nicotine. The level gradually decreases over the next few days until it can no longer affect the body. Alongside the withdrawal symptoms, people also begin to notice positive changes. These may include:an improved sense of smell and tasteless coughingeasier breathing, particularly when exercising How long does nicotine withdrawal last Nicotine withdrawal symptoms typically begin 4–24 hours following a person’s last cigarette and peak after about 3 days. Most people experience mild to moderate nicotine withdrawal symptoms that gradually lessen over several weeks. However, some people continue to have cravings for cigarettes months or even years after quitting. If a person visits a place where they used to smoke or spends time with friends who still smoke, they may experience a stronger craving. Can quitting cause anxiety Anxiety is one of the most common emotional effects of quitting nicotine. A person may experience anxiety and irritability as their brain adjusts to the lack of nicotine. For some people, the feeling is mild and goes away after a few days. For others, it is more intense and may persist for weeks. There are several ways to manage anxiety during nicotine withdrawal, including:practicing relaxation techniques, such as deep breathing or yogadoing enjoyable activities, such as going for a walk in natureincreasing physical exercise levelsreducing caffeine intake by limiting or avoiding coffee, soda, and teatalking with friends and family members for supportjoining a smoking cessation group or speaking with a counseloravoiding triggers, such as places where the person used to smokeusing nicotine replacement therapy If anxiety is severe or persists for more than a few weeks, it is best to speak with a doctor to rule out other underlying conditions. Treating nicotine withdrawal Quitting nicotine is difficult because the addiction is both physical and psychological. Many people benefit from nicotine replacement products and other forms of support during the period of nicotine withdrawal. Treatments for nicotine withdrawal include: Nicotine replacement therapy Nicotine replacement therapy (NRT) is an umbrella term for products that are tobacco alternatives and contain smaller amounts of nicotine. They include:chewing gumskin patchesinhalersnasal or mouth sprays No single type is necessarily better than another. However, combining different types of NRT could have a stronger effect than a single method alone. Research has found that using NRT can increase the chance of quitting by 50–60%. A person can use NRT to reduce their nicotine dosage gradually until they no longer need to use it. NRT is a common and successful treatment for nicotine withdrawal. However, many people still experience some mild to moderate withdrawal symptoms. Although NRT does produce side effects, they are usually easier to manage than the symptoms of nicotine withdrawal without NRT. Possible side effects of NRT include:nauseadizzinessinsomniaheadachesabdominal discomfort Medication Several types of medication can help treat nicotine withdrawal, including:Varenicline (Chantix): This drug can reduce cravings and block the rewarding effects of smoking.Bupropion (Zyban and Wellbutrin): Doctors may prescribe the Zyban brand to reduce nicotine cravings or the Wellbutrin brand to act as an antidepressant. E-cigarettes Although e-cigarettes contain nicotine in vapor form, they do not contain the same host of harmful substances as other tobacco products. A person can use e-cigarettes instead of cigarettes, pipes, or other tobacco products. However, experts do not yet know the long-term health risks of smoking e-cigarettes. These devices may provide some relief from withdrawal and cravings when a person is trying to quit tobacco smoking. However, more research is necessary to determine whether they are truly effective. Counseling Counseling can help people cope with the psychological and physical aspects of nicotine withdrawal. People can have sessions with a therapist or join a support group. It can be a valuable addition to NRT in some cases. Counseling can help people identify and address triggers that prevent them from quitting. Tips for coping People should remember that many cravings only last for 10–20 minutes. This means that when someone feels a craving coming on, they can distract themselves until it passes. A person may find that the following tips and strategies help them cope with nicotine withdrawal symptoms:preparing themselves mentally for the reality of withdrawal symptomsmaking a list of the benefits of quitting and re-reading them when a craving hitstaking deep breaths or using other relaxation techniques exercising more regularly during withdrawal, especially as a distraction from cravingsadding social pressure by telling people about the decision to quitavoiding triggers, such as drinking alcohol or visiting specific placesbeing realistic about how long quitting can taketaking up new hobbies and keeping busyspending more time with friends who do not use nicotine Seeking help for addiction may seem daunting or even scary, but several organizations can provide support. If you believe that you or someone close to you is struggling with addiction, you can contact the following organizations for immediate help and advice:Substance Abuse and Mental Health Services Administration (SAMHSA): 800-662-4357 (TTY: 800-487-4889)National Suicide Prevention Lifeline: 800-273-8255 Summary A person may find nicotine withdrawal symptoms uncomfortable and feel overwhelmed at times, particularly in the first week after quitting. Some people return to smoking because of this or are afraid of trying to quit. However, many people successfully overcome the challenges of nicotine withdrawal to achieve the multiple health benefits of quitting. It is important not to give up, as it can take a few tries before a person kicks the habit for good. Last medically reviewed on September 28, 2022Alcohol / Addiction / Illegal DrugsSmoking / Quit Smoking 14 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.7 common withdrawal symptoms and what you can do about them. (2022). https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/7-common-withdrawal-symptoms/index.html Ashok, A. H., et al. (2019). Tobacco smoking and dopaminergic function in humans: A meta-analysis of molecular imaging studies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591186/Handling nicotine withdrawal and triggers when you decide to quit tobacco. (2022). https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/withdrawal-fact-sheet#do-nicotine-replacement-products-relieve-nicotine-cravings-and-withdrawal-symptomsHartmann-Boyce, J., et al. (2018). Nicotine replacement therapy versus control for smoking cessation. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000146.pub5/fullHealth benefits of quitting smoking over time. (2020). https://www.cancer.org/healthy/stay-away-from-tobacco/benefits-of-quitting-smoking-over-time.htmlHow to quit smoking plan - 8 steps to quitting for good. (2021). https://www.addictionsandrecovery.org/quit-smoking/how-to-quit-smoking-plan.htmManaging withdrawal. (n.d.). https://smokefree.gov/challenges-when-quitting/withdrawal/managing-withdrawalNicotine. (n.d.). https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/nicotineNicotine replacement therapy to help you quit tobacco. (2021). https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking/nicotine-replacement-therapy.htmlPerkins, K. A., et al. (2017). Effects of nicotine versus placebo e-cigarette use on symptom relief during initial tobacco abstinence. https://psycnet.apa.org/manuscript/2017-27627-001.pdfQuit smoking timeline. (n.d.). https://tobaccofreelife.org/quit-smoking/quit-smoking-timeline/Understanding withdrawal. (n.d.). https://smokefree.gov/challenges-when-quitting/withdrawal/understanding-withdrawalWhat do we know about e-cigarettes? (2022). https://www.cancer.org/healthy/stay-away-from-tobacco/e-cigarettes-vaping/what-do-we-know-about-e-cigarettes.htmlWidysanto, A., et al. (2022). Nicotine addiction.http://www.ncbi.nlm.nih.gov/books/NBK499915FEEDBACK:Medically reviewed by Alyssa Peckham, PharmD, BCPP — By Aaron Kandola and Zia Sherrell, MPH on September 28, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related Coverage11 tips for giving up smokingMedically reviewed by Timothy J. Legg, PhD, PsyD A brief description of 11 helpful tips for people giving up smoking tobacco. Learn about the most effective methods about how to stop here.READ MOREHow long does nicotine stay in your system?Medically reviewed by Alan Carter, PharmD After smoking a cigarette, nicotine and its by-products stay in a person’s urine and saliva for 4 days and blood for up to 10 days. In this article…READ MOREWhat is nicotine dependence?Medically reviewed by Timothy J. Legg, PhD, PsyD The majority of cigarette, cigar and pipe smokers have nicotine dependency. Nicotine is a highly addictive substance that leads to life-threatening…READ MOREEverything you need to know about nicotineMedically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT Nicotine is highly addictive and harmful. It is a component in cigarettes and some e-cigarette liquid. Learn more here.READ MORENicotine poisoning: What are the symptoms, and can you overdose? Nicotine poisoning can cause dizziness, vomiting, and severe cases respiratory failure. Learn more about its causes, effects, and treatment.READ MORE