How Long Does Withdrawal From Nicotine Last?

Are you ready to quit smoking but scared of the nicotine withdrawal symptoms you know will follow? Trust us, we know it's hard. For many people, it's one of their biggest fears about giving up cigarettes. The truth is that the withdrawal process can be unpleasant. It's normal to experience symptoms such as irritability, cravings, and weight gain.

"In some cases, the most significant symptom of nicotine withdrawal is irritability, affecting both the individual trying to quit as well as their friends," says addiction medicine specialist John C. Umhau, MD, MPH, CPE.

But with the right tools in place, you can overcome these symptoms and make your next attempt at quitting a success.

What to Expect During Nicotine Withdrawal

Nicotine withdrawal is a normal physical and emotional reaction to rapidly quitting or significantly reducing your nicotine intake. It usually happens when you drastically reduce or stop smoking after you've been ingesting nicotine every day for at least several weeks.

Your body and brain adapt to the nicotine you take in regularly through smoking, chewing tobacco, snuff, or using a nicotine patch, gum, or other nicotine replacement therapy (NRT). Your body learns to expect a certain amount of nicotine each day and reacts with unpleasant symptoms without it.

For many people, daily intake of nicotine also becomes part of how they manage their emotions and affects both how they relax and how they keep themselves alert. When nicotine is suddenly absent, you tend to get nicotine withdrawal symptoms. Studies show about half of all smokers report experiencing at least four withdrawal symptoms when they quit.

Nicotine Withdrawal Timeline

People usually have several symptoms at once after they quit using nicotine, which is what makes nicotine withdrawal so unpleasant. If you prepare yourself and find ways to address them, you will increase your chance of success. Here's what you can expect in terms of symptoms of withdrawal in the hours, days, and weeks after you quit smoking.

Hours After Quitting

Withdrawal symptoms are the most severe and acute immediately after you stop using nicotine. Some of the symptoms you might experience during this type include:

• An urge to smoke: This urge may be particularly strong during the times of day when you usually have a cigarette.
• Increased hunger: Nicotine can be an appetite suppressant, and smoking also interferes with your senses of taste and smell, so some people use smoking as a snack substitute and as a way to try and control their weight. You may find your appetite begins to return after giving up cigarettes.
• Tingling in the hands and feet: Nicotine can affect blood vessels throughout the body, so you may feel tingling sensations as circulation begins to improve.
• Difficulty sleeping: Symptoms of withdrawal may make it more difficult to sleep, particularly the first night or two after quitting.
  

Days After Quitting

Once you make it past the 24-hour mark, you will continue to experience some pronounced nicotine withdrawal effects for several days.

• Strong nicotine cravings: Most people withdrawing from nicotine experience intense urges to smoke. These urges are known as cravings, common among people withdrawing from many addictive substances.
• Anxiety and restlessness: The anxiety you feel during nicotine withdrawal can range from feeling on edge to feeling fearful or even panicky at the thought of facing the future without the calming effects of nicotine. This state of anxiety is heightened during nicotine withdrawal for people who are prone to anxiety in general.
• Irritability: This mood change can range from feeling irritable or frustrated to feeling angry. Ideally, while you're in the throes of nicotine withdrawal, you should try to give yourself plenty of space from others, as you may end up treating them in ways they don't appreciate or deserve.
• Depressed mood: People often feel sad, depressed, or have a low mood during nicotine withdrawal, sometimes known as a dysphoric or depressed mood. It is important to remember that some mood changes are normal during nicotine withdrawal, and they don't necessarily indicate that anything is wrong.
• Sore throat and increased coughing: As the lungs begin to heal, you may find yourself coughing more to expel harmful compounds from the body.
• Sleep problems: Difficulty sleeping, also known as insomnia, is quite common during nicotine withdrawal. Daytime exercise, particularly outdoor exercise that exposes you to sunlight, can help you feel more relaxed and sleepy at bedtime.
  

Weeks After Quitting

After the first week, you will notice a decline in the intensity of withdrawal symptoms over the course of the next few weeks. Symptoms you may experience during this time include:

• Occasional but manageable cravings: You may still crave cigarettes from time to time, but you will find that these cravings are less intense and easier to control.
• Low mood: It is important to remember that you are also processing the loss of an activity you enjoyed, and which may have helped you cope with low mood. Many people feel some grief at losing the pleasure they felt from smoking. This is a natural part of the process of overcoming your addiction to nicotine. It will eventually turn to feelings of acceptance and then liberation from the drug.
• Difficulty concentrating: Like most stimulants, in the short term, nicotine can help with mental focus. In contrast, when you're experiencing nicotine withdrawal, you might find it difficult to concentrate without the stimulating effects of the drug.

Coping With Nicotine Withdrawal

The good news is that there is much you can do to reduce cravings and manage common withdrawal symptoms. Even without medication, withdrawal symptoms and other problems subside over time.

Exercise

Research has found that short bouts of moderate-intensity exercise can help reduce withdrawal symptoms and cravings.

Exercise is a quick and easy way to boost your mood, as long as you don't overdo it by developing a substitute exercise addiction. Engage in physical activity such as taking a walk or engaging in other exercises such as jogging or swimming.

Manage Cravings

Many people find distraction can take their minds off cravings until they subside, since cravings usually only last for between five and 10 minutes, even if they're intense. Others find that cravings cause them to relapse again and again.

If this happens to you, talk to your doctor about nicotine replacement therapies (NRTs). It can take longer to quit this way, but you may have a better chance of success.

Avoid Triggers

Try to stay away from people and situations that you know will provoke your anger during this time. Over time, you'll feel less irritable, and you may even be better able to cope with annoyances than you did before you quit. For now, give yourself and others as much time and space as possible.

Relieve Stress

If you know you tend to get anxious under stress, especially if you're prone to panic attacks, try to avoid stressful situations while you're quitting nicotine. This will reduce the likelihood of your anxiety escalating.

Try to ease the pressure: Don't quit smoking when you have an exam coming up, at tax time, or during any other time that requires a lot of mental focus under pressure. Instead, do it at a time when you're under less pressure to concentrate.

Yoga, mindfulness, meditation, and relaxation exercises can all help with reducing the anxiety you feel during nicotine withdrawal.

Eat a Balanced Diet

It's all too easy to fall into the trap of comfort eating in response to cravings and increased appetite, and you may end up gaining weight or even developing a substitute food addiction. Avoiding overeating is key to preventing these pitfalls. Focus on eating a balanced diet that focuses on nutritious foods.

Remember the Benefits of Quitting

When you are tempted to give in to cravings, remind yourself about the health benefits of quitting. The longer you can stay away from cigarettes, the sooner you'll start enjoying better health. The health benefits of giving up smoking also build over time. 

• Within 24 hours, nicotine levels in the blood are eliminated. 
• After a few days, carbon monoxide levels in the body drop to normal levels.
• After a month, symptoms of coughing and shortness of breath begin to decrease.
• After a year, your risk of heart attack drops significantly. 
• After five to 10 years, your risk for many different types of cancer drops by 50%.

Find Distractions

It is normal for cravings to subside, but to still pop up occasionally months, or even years, after quitting nicotine. The trick to maintaining a smoke-free lifestyle is to distract yourself quickly and not give in to the craving.

When to Be Concerned About Withdrawal Symptoms

Occasionally, withdrawal symptoms can go on for longer than usual. If this happens, see your doctor. Sometimes, what seems to be the stubborn symptoms of nicotine withdrawal can be related to another condition. Remind yourself that these feelings are temporary.

You should be careful to only use nicotine replacement therapies as recommended. Overusing these replacements can lead to nicotine overdose.

Long-Term Treatment for Nicotine Withdrawal

Long-term treatment may include the extended use of nicotine replacement therapies. Research has shown that nicotine patches, for example, can be effective in maintaining smoking abstinence beyond the standard eight weeks of treatment. However, evidence suggests there may be little benefit in using these treatments beyond 24 weeks.

Behavioral treatments such as cognitive-behavioral therapy (CBT) may also be helpful. CBT works to change the underlying thought patterns and behaviors that contribute to smoking. Replacing these maladaptive patterns with healthier ones can improve the chances of long-term smoking abstinence.

Resources for Quitting Smoking

Withdrawal can be difficult, but there are resources that can help. The Centers for Disease Control and Prevention provide free quitting smoking plans, educational materials, and information on local resources. The American Lung Association also offers information and programs designed to help people quit smoking.

You can also visit Smokefree.gov, a website from the National Cancer Institute’s (NCI) Tobacco Control Research Branch, and use the Step-by-Step Quit Guide to learn about other tips for managing cravings. They also offer smoking cessation apps and texting programs that can also help you stay on track.

Takeaways

Coping with nicotine withdrawal is often one of the hardest parts of quitting smoking. Fortunately, there are things you can do to manage your symptoms, and nicotine replacement therapies can reduce your symptoms and improve your long-term outlook.

Identify the triggers that make you want to smoke, find ways to manage your cravings, and don't be afraid to reach out to your doctor for advice and further assistance.