How to cope with 6 common nicotine withdrawal symptoms so you can quit smoking for good

• Nicotine withdrawal symptoms commonly include headaches, nicotine cravings, an increase in appetite, difficulty sleeping, irritability, and feelings of depression or anxiety.
• These symptoms may begin a few hours after your last cigarette and could last for as long as a few months.
• Nicotine replacement therapy, staying active, and eating right can help you manage withdrawal symptoms and quit smoking for good.
• This article was medically reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.

Nicotine withdrawal occurs because of tobacco's addictive qualities. The primary psychoactive ingredient in cigarettes and other tobacco products is nicotine. People become dependent on the drug because it stimulates the nervous system and binds to receptors in the brain that release dopamine — a feel-good hormone.

When you start smoking, vaping, or chewing tobacco on a regular basis, you develop more nicotine receptors in your brain. When you stop smoking, these receptors do not receive nicotine and therefore, stop releasing dopamine. This causes unpleasant side effects — known as nicotine withdrawal — and is one of the reasons why quitting can be so difficult.

What is nicotine withdrawal?

You can think of nicotine withdrawal as your body's way of protesting your decision to quit smoking. According to John Hughes, MD, a professor emeritus of psychiatry and psychological science at the University of Vermont Larner College of Medicine's Vermont Center on Behavior and Health, you will begin experiencing withdrawal symptoms within 24 hours after your last cigarette.

However, the longer you go without nicotine, the more your brain receptors will return to normal, and the less you will feel unwanted side effects. Here are some of the most common symptoms of nicotine withdrawal:

1. Nicotine cravings

Once you quit smoking, you may start experiencing a strong desire for nicotine. Distracting yourself or simply toughing it out can work, but medication combined with nicotine replacement therapy is really "sort of our first line" of defense, says Hughes.

Common treatments for nicotine cravings include:

• Prescription medications such as Chantix (varenicline) and Zyban (bupropion).
• Nicotine replacement therapy, which can be administered via patches, lozenges, nasal sprays, inhalers, and sticks of gum.

To further curb cravings, avoid triggers — locations, situations, or individuals you associate with tobacco use.

"There are many cases where people do well for six weeks, then some stressful situation comes up and they just have a craving for a cigarette and go back to smoking," says Neal Benowitz, MD, a professor emeritus of medicine and bioengineering and therapeutic sciences at the University of California San Francisco and chief of the division of clinical pharmacology at San Francisco General Hospital.

2. Insomnia or wakefulness

Many people in recovery from nicotine addiction report having difficulty falling asleep or difficulty staying asleep, known as insomnia.

To reduce your likelihood of experiencing sleep disturbances, you should develop a nightly relaxation ritual and avoid drinking caffeinated beverages after 6 p.m. Supplements such as melatonin may be able to help you sleep better, too, though you should talk with your doctor before taking any sleeping pills, even if they're over-the-counter.

3. Changes in appetite

You may also notice an increase in appetite that can persist for several months or more. Exercise and mindful eating are typically effective countermeasures.

You can also try starting nicotine replacement therapy or taking the prescription medication Zyban, as both of these have been clinically proven to prevent nicotine withdrawal-associated weight gain.

4. Depression or anxiety

Immediately after you quit, it's normal to experience a decrease in mood and an increase in anxiety. However, your mental health will likely improve within one week to a month.

In the meantime, sustained physical activity, social and spousal support, and counseling can help improve your mood.

5. Irritability

Another psychological change that often accompanies nicotine withdrawal is irritability.

If you feel on edge, try breathing deeply and engaging in a calming activity such as a massage, meditation session, or walk. Limiting your caffeine intake can also reduce irritability.

6. Difficulty concentrating

People going through nicotine withdrawal often have difficulty focusing. If you find yourself struggling to concentrate, reduce your workload, keep stress to a minimum, and have a healthy snack every few hours to ensure your blood sugar levels stay normal.

How long does nicotine withdrawal last?

Since every smoker's body is different, every smoker will experience nicotine withdrawal differently. Some may experience no adverse effects, while others can have severe ones. The majority of symptoms, however, will disappear mostly or completely within a month.

Here is a timeline of when nicotine withdrawal symptoms start after your final cigarette and how long they last:

• 1 to 2 hours: Nicotine cravings will begin and last for two to four weeks. However, you can get occasional cravings for up to six months.
• 10 hours: You may notice a change in your mood, such as feeling anxious, irritable, depressed, or having difficulty concentrating.
• 24 hours: An increase in appetite begins and may last several weeks, if not longer. This symptom "seems to take longer to go away" than the majority of others, says Hughes.
• 1 week: You may have difficulty sleeping in the first week of nicotine withdrawal, but you should be able to adjust after one week.
• 2 to 4 weeks: You may notice you are becoming less irritable, and your ability to concentrate should improve. However, "some have a hard time concentrating for weeks or longer, or months, just because they're so used to having a cigarette during their work," says Benowitz.

When to see a doctor

Unpleasant as it can be, nicotine withdrawal is never physically dangerous or life-threatening. However, reach out to your doctor if you are looking for advice on curbing symptoms as they may be able to prescribe certain medications or offer other treatment options.

Takeaways

Nicotine withdrawal can cause mental and physical symptoms that will temporarily affect your mood, sleep, appetite, and ability to focus. However, despite the unpleasant side effects, quitting tobacco will protect and improve your health, making the pain well worth it in the long-run.

Related articles from Health Reference:

• All of the amazing ways your body heals itself when you quit smoking
• Yes, nicotine patches help smokers quit — here's how to use them effectively
• Chantix may be the most effective way to quit smoking — here's how it works
• Vaping is no better or safer than smoking traditional cigarettes
• How long does nicotine stay in your system? A few days to a few months.