Nicotine Withdrawal

What is nicotine withdrawal?

Nicotine withdrawal is the collection of physical, mental and emotional symptoms you feel as nicotine leaves your body. It happens if you have nicotine dependence and stop using or reduce the substance.

When you use tobacco products, your body and brain become used to nicotine. It’s a highly addictive substance. When you cut back or quit using nicotine-containing products, the lack of nicotine in your body can cause uncomfortable symptoms. But nicotine withdrawal isn’t harmful to your health. It fades over time as long as you stay nicotine-free.

Tobacco products that contain nicotine include:

• Cigarettes and e-cigarettes (vaping).
• Cigars.
• Smokeless tobacco (dip, snuff or chew).
• Hookah tobacco.

What are the symptoms of nicotine withdrawal?

Common nicotine withdrawal symptoms include:

• Cravings or urges to use nicotine.
• Feeling frustrated, irritable or angry.
• Feeling sad or depressed.
• Feeling anxious or jumpy.
• Trouble concentrating.
• Trouble sleeping (insomnia).
• Increased appetite, which may result in weight gain.

Less common nicotine withdrawal symptoms include:

• Headaches.
• Nausea.
• Nightmares.
• Dizziness.
• Constipation.
• Cough and sore throat.
• Dry mouth.

Nicotine withdrawal symptoms vary from person to person. The severity of your symptoms depends on:

• How long you’ve used nicotine.
• How frequently you used it.
• The amount of nicotine you consumed with each use.
• Your age, genetics and overall health.

Nicotine withdrawal timeline

The timing and intensity of nicotine withdrawal varies for each person. But in general, the nicotine withdrawal timeline goes as follows:

• Withdrawal symptoms begin four to 24 hours after your last dose of nicotine if you’ve been using it long-term.
• Withdrawal symptoms peak (are most intense) on the second or third day of being nicotine-free.
• Symptoms fade over days to three to four weeks. The symptoms will get a little better every day, especially after the third day following stopping.

Can nicotine withdrawal make you sick?

Some nicotine withdrawal symptoms may make you feel like you’re sick, including:

• Nausea and vomiting.
• Sore throat.
• Cough.

These symptoms happen because of a lack of nicotine in your body, not because you caught a viral or bacterial infection. It’s possible, though, to have an infection (illness) and go through nicotine withdrawal at the same time.

What causes nicotine withdrawal?

Nicotine binds to certain receptors in your brain. It causes your brain to release dopamine, a neurotransmitter (chemical messenger). Dopamine is the “feel-good” neurotransmitter.

As long as you continue to use nicotine-containing products, your brain continues to release dopamine. When you don’t smoke or use nicotine-containing products, nicotine no longer stimulates your brain’s receptors. Your brain releases less dopamine. And your pleasure center, which affects your mood and behavior, begins to change. This causes some of the withdrawal symptoms.

Nicotine also changes the balance of other neurotransmitters in your brain. Stopping the use of nicotine disrupts the chemical balance, causing some of the other withdrawal symptoms.

How can I deal with nicotine withdrawal?

Nicotine withdrawal can feel all-encompassing. It affects how you feel physically, mentally and emotionally. Quitting nicotine products is always a good idea — no matter the timing. But having a plan for facing withdrawal symptoms before you stop nicotine may increase your odds of quitting for good.

Consider seeking out a smoking or tobacco cessation (quitting) program. There are several types, and they have many resources to help you through the process. If you don’t know where to start, reach out to your healthcare provider for help.

In general, you’ll likely need to use several strategies to combat the cravings, physical symptoms and mental symptoms of nicotine withdrawal.

Nicotine replacement therapy (NRT) for cravings

Nicotine replacement therapy (NRT) involves using products containing low doses of nicotine — like gum and skin patches — to cut down on cravings and lessen withdrawal symptoms after you quit smoking. It’s a type of medication-assisted treatment (MAT).

NRT can help with physical withdrawal and craving symptoms. But it doesn’t address all the components of quitting smoking, like the mental, emotional and social aspects.

Your healthcare provider may also recommend taking one of two prescription medications (pills) for quitting smoking alongside NRT: varenicline or bupropion. They don’t contain nicotine.

Managing physical nicotine withdrawal symptoms

Some strategies you can try to curb physical withdrawal symptoms include:

• Drinking fluid or eating fiber-rich foods to ease constipation.
• Drinking fluids, chewing gum or sucking on hard candy to ease dry mouth, cough and sore throat.
• Drinking lots of water and eating healthy snacks to try to prevent weight gain. When you eat, focus on eating rather than eating while distracted.
• Practicing good sleep hygiene to help with insomnia. Don’t drink caffeinated beverages several hours before bedtime. Listen to calming music and turn off electronic devices to help you sleep.

Managing the mental, emotional and habitual aspects of nicotine withdrawal

Strategies for managing the mental, emotional and habitual aspects of quitting nicotine use include:

• Considering psychotherapy (talk therapy): During psychotherapy, a trained therapist can help you identify and change unhealthy emotions, thoughts and behaviors related to prior nicotine use. They can help you manage the mental and emotional withdrawal symptoms as well.
• Getting active: Find some form of physical activity to keep your body — and mind — active. It can help with feelings of restlessness, boost your mood and may help with insomnia.
• Spending time with people who don’t smoke: Tell people you’re quitting so they can encourage you and provide support. It may be difficult but try to avoid being around people who do smoke to reduce temptations.
• Keeping your hands busy: Find a favorite fidget toy or stress ball that will keep your hands active.
• Keeping your mouth busy: Substitute a straw, toothpick or cinnamon stick to replace the physical sensation of having something touching your lips and mouth. Chewing gum can also help.
• Getting rid of reminders: Throw away your ashtrays, lighters and other items that you used to consume nicotine.
• Trying relaxation techniques: Try methods like yoga, deep breathing, meditation or self-hypnosis when you feel anxious or have the urge to use nicotine.
• Distracting yourself in all ways possible: Create routines for your day to keep yourself busy. Lean on loved ones to help keep your mind off nicotine. If you’re having issues concentrating, limit activities that require strong concentration. Replace your ritual or habit of using nicotine with something else.
• Giving yourself grace: Quitting nicotine is very difficult. And the mental and emotional symptoms of withdrawal can make you feel out of control. Be kind and patient with yourself. Know that it takes time — and often several tries — to quit.

Can I prevent nicotine withdrawal?

Unfortunately, everyone who’s been a regular user of nicotine experiences some degree of withdrawal when they quit.

Your healthcare provider can recommend over-the-counter or prescription products (nicotine replacement therapy) to ease your withdrawal symptoms. It may be a good idea to talk to your provider before you quit so you have a plan for addressing withdrawal symptoms.

What can I expect while going through nicotine withdrawal?

Experiencing nicotine withdrawal is the toughest part of quitting smoking or other nicotine products. The first week after quitting is when you’re the most at risk of slipping up and returning to using nicotine. It may take several tries to quit. This is very common. You’re not alone.

But quitting is possible. Ask your healthcare provider for help if you’re having a difficult time. They can provide smoking cessation aids and counseling to help you quit for good.