Nicotine withdrawal is the physical and psychological symptoms you feel as nicotine leaves your body. Symptoms include the urge for nicotine, irritation, frustration, trouble sleeping and trouble concentrating. Treatment includes nicotine replacement therapy, other medications, non-drug remedies and coping strategies.
Nicotine withdrawal is the collection of physical, mental and emotional symptoms you feel as nicotine leaves your body. When you use tobacco products, your body and brain become used to nicotine. It’s a highly addictive drug. When you cut back or quit using nicotine-containing products, the lack of nicotine in your body can cause uncomfortable symptoms. Some include the urge to smoke again, feeling nauseous, having headaches or being grouchy.
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Yes. Tobacco products including cigarettes, cigars, smokeless tobacco, hookah tobacco and most e-cigarettes contain nicotine.
Nicotine withdrawal symptoms typically begin a few hours after your last dose of nicotine. They peak, or are most intense, on day two or three after going nicotine-free.
Nicotine withdrawal symptoms can last a few days up to several weeks. Your symptoms will get a little better every day, especially after the third day following stopping.
Nicotine withdrawal symptoms vary from person to person. How severe your symptoms are depends on how frequently you use a nicotine product and the amount of nicotine in the product you use.
Common symptoms include:
Nicotine binds to certain receptors in your brain. It causes your brain to release a chemical called dopamine. Dopamine is a “feel good” neurohormone. As long as you continue to use nicotine-containing products, dopamine continues to be released. When you don’t smoke or use nicotine-containing products, your brain’s receptors are no longer stimulated by nicotine. Less dopamine is released and your pleasure center — your mood and behavior — begin to be affected, causing some of your withdrawal symptoms.
Nicotine also changes the balance of other chemical messengers in your brain. Stopping the use of nicotine disrupts the chemical balance, causing some of the physical and other withdrawal symptoms.
When you’re ready to quit smoking, your healthcare provider is ready to discuss medications that can help. Nicotine replacement therapy can help relieve withdrawal symptoms. Replacement therapy contains a small amount of nicotine but none of the cancer-causing chemicals and other chemicals found in tobacco products. This small amount of nicotine curbs your withdrawal symptoms. You’ll feel better and more comfortable, which will make quitting tobacco products easier.
Nicotine replacement therapy is available as:
Nicotine replacement therapy is available over-the-counter (patch, gum and lozenge) and by prescription (nasal spray and oral inhaler).
Other medications used to treat withdrawal symptoms include the antidepressant bupropion (Zyban) and varenicline (Chantix). Varenicline is a smoking cessation aid that blocks the pleasant effects of nicotine on the brain.
Nicotine replacement therapy and other medications used to treat withdrawal symptoms only treat your physical dependence to nicotine. To help you cope with the emotional and mental aspects of dependence, you’ll need other help. Ask your healthcare provider about quit programs and other support groups in addition to 1.800.QUIT.NOW (1.800.784.8669). Pairing nicotine replacement therapy or medications with a program that helps change behavior can improve your chance of quitting compared with using only one quit method.
Other ways to help manage nicotine withdrawal symptoms include:
Unfortunately, everyone who has been a regular user of tobacco products experiences some degree of withdrawal when they quit. Your healthcare provider can recommend over-the-counter or prescription products to ease your withdrawal symptoms. These products, however, mostly target cravings or urges. There are some behavioral strategies you can try to curb other withdrawal symptoms. These include:
Experiencing nicotine withdrawal is the toughest part of quitting smoking. It may take several tries to quit. You’re not alone. This is very common. But it IS possible to quit. About 62% of adult smokers (55 million adults) who ever smoked have quit (2018 data). Ask your healthcare provider for help. They can provide the smoking cessation aids and counseling you need to quit.
A note from Cleveland Clinic
The nicotine in tobacco products is addictive, which can make trying to quit a hard thing to do. Not only do you have a physical nicotine dependence but you also may have an emotional dependence too. It may be your way to cope with stress or may be simply an embedded ritual, like smoking while drinking a cup of coffee.
Dealing with nicotine withdrawal symptoms is not necessarily easy either. But know that you CAN do this. You can quit. You move closer to quitting with each attempt. Nicotine withdrawal is a short-term experience. The long-term health benefits you’ll gain from quitting will be with you for the rest of your life. Know that your healthcare team is ready to help you.
Nicotine is an addictive chemical. It can be as addictive as other drugs including alcohol and cocaine. Although nicotine is the main addictive substance in tobacco products, it’s not the only one. Acetaldehyde is another chemical that reinforces nicotine dependence. Having chemicals in your body that affect your brain chemistry and cause addiction is only one part of the addiction puzzle. Other factors play a role in why some people become addicted to tobacco. These include:
Tobacco use is the leading cause of premature death. Tobacco is thought to contain at least 70 cancer-causing chemicals. One out of every three cancer deaths is caused by smoking. Smoking is harmful to almost every organ in your body. Smoking causes lung disease, cardiovascular diseases (heart attacks and strokes), diabetes, rheumatoid arthritis, immune system weakness, erectile dysfunction, age-related macular degeneration and cataracts, impairs fertility and many other health harms. Smoking during pregnancy deprives the baby of oxygen, slows fetal growth, causes withdrawal symptoms in fetuses and learning/behavioral problems in children.
Health benefits and repairs begin to happen almost immediately after quitting.
Health benefits after quitting include:
Minutes after quitting:
After 24 hours:
After several days:
After one to 12 months:
After one to two years:
After three to six years:
After five to 10 years:
After 10 years:
After 10 to 15 years:
After 15 years:
After 20 years:
Last reviewed by a Cleveland Clinic medical professional on 10/25/2021.
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