What Is Nicotine Withdrawal?

By Sarah Malka, MD
Medically reviewed
October 13, 2021

In 2018, of the 21.5 million adults in America who tried to quit smoking⁠, 7.5% were successful.

It’s not that the others didn’t try hard enough.

The reason that it typically takes multiple tries to quit smoking for good is because tobacco is addictive, and when you stop using it, you go through nicotine withdrawal.

This phase of symptoms such as headaches, fatigue, irritability, and poor sleep can last a few weeks, though the worst of it typically occurs in the first week.

With the right plan—which can include a combination of medications, over-the-counter remedies, lifestyle changes, and counseling—you can increase your odds of overcoming nicotine withdrawal and wean yourself off of tobacco for good.

In this article, I’ll explain what nicotine withdrawal is as well as the symptoms and causes.

Then I’ll discuss nicotine withdrawal treatments as well as coping tips and how to prevent withdrawal.

Finally, I’ll address when to see a doctor to help you quit smoking and manage nicotine withdrawal successfully.

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Nicotine Withdrawal Basics

Chronic use of tobacco products like cigarettes can cause someone to develop a dependence on nicotine, the addictive chemical in tobacco.

When someone who is addicted to or abusing these products stops using them, the body needs to readjust to no longer having nicotine in the system, and withdrawal symptoms often occur. 

While nicotine withdrawal has no health dangers, it can be difficult to overcome in the weeks after your last cigarette.

Understanding what to expect can help you best navigate your withdrawal and fight through it.

Timeline

Nicotine withdrawal follows a timeline during which symptoms will unfold.

Here is what you can expect once you finish your last cigarette:

  • 30 minutes to 4 hours: Cravings for a cigarette emerge as the effects of nicotine from the last cigarette wear off.
  • 10 hours: You may find that you feel like you have extra time on your hands…and in turn battle feelings of sadness, anxiety, or depression, along with more intense cravings.
  • 2 days: As the nicotine continues to leave your body, headaches become more likely. 
  • 3 days: Symptoms often peak around this time.
  • 1 week: At this point, to avoid a relapse, it is particularly important to avoid triggers such as environments or activities where you usually engaged with smoking.
  • 2 to 4 weeks: Things will slowly start to look up as symptoms like brain fog, increased appetite, cough, depression, and anxiety begin to improve.

Nicotine Withdrawal Symptoms

Nicotine withdrawal is challenging for almost every smoker who makes the decision to quit.

Your body has to adjust to no longer receiving nicotine, and thus you experience withdrawal symptoms.

Fortunately, the worst period is about the first 72 hours. After that, symptoms should ease during the subsequent weeks. 

Below are common symptoms associated with nicotine withdrawal.

Physical

Emotional

Behavioral

  • Poor concentration
  • Restlessness 
  • Insomnia or changes in sleep patterns

Nicotine Withdrawal Causes

Nicotine is an addictive chemical with pleasurable effects found in tobacco products.

Because these pleasant effects are temporary, when they start to weaken, the desire for nicotine arises. 

Nicotine withdrawal is caused by the cessation of nicotine consumption, which forces the body to readjust to no longer having the chemical in it.

Those who smoke heavily may experience more extreme nicotine withdrawal upon quitting.

Nicotine Withdrawal Treatment

You don’t have to quit alone.

Prescription and over-the-counter medications as well as lifestyle changes can all help increase the likelihood that you successfully quit smoking.

Talk to your healthcare provider to determine the best plan for you. Oftentimes, a combination of treatments is most helpful.

Prescription

Doctors typically prescribe medication only for people who have a severe nicotine dependence. These drugs have been proven to help with nicotine withdrawal.

  • Varenicline (Chantix): This tablet blocks the effects of nicotine on the brain, in turn decreasing the craving and withdrawal that occurs when you quit. 
  • Bupropion (Zyban): This antidepressant medication also helps reduce nicotine cravings and the effects of nicotine withdrawal. Note that another brand of bupropion, Wellbutrin, is not approved for use to help with quitting smoking.

Nicotine replacement therapy

Nicotine replacement therapies (NRTs) contain small doses of nicotine, yet none of the other toxins found in cigarettes.

They may help satisfy nicotine cravings while reducing withdrawal symptoms.

  • Nicotine patches: Wearing one of these patches (usually on the upper arm, shoulder, or back) delivers a steady dose of nicotine through the skin and may help alleviate withdrawal symptoms. Nicotine patches come in three strengths (7 mg, 14 mg, 21 mg); the right dose depends on how much you usually smoke. Unless directed by your doctor, don’t wear two patches at once. 
  • Nicotine gum: This gum works in two ways: It provides nicotine to nix a craving, and it keeps your mouth busy so you’re less likely to want to smoke. Nicotine gum comes in two strengths (2 mg and 4 mg); how much you take depends on when you have your first cigarette and how frequently you smoke. You can lower the dose over time as you wean yourself off nicotine.

Managing triggers

A trigger is anything that you associate with smoking. To treat nicotine withdrawal, it helps to become aware of what activities trigger your smoking.

Common triggers include: 

  • Drinking alcohol
  • Drinking coffee or tea
  • Driving
  • Watching TV
  • Listening to music
  • Finishing a meal
  • Taking a work break
  • After having sex
  • Getting ready for bed

Lifestyle changes

Once you’ve made the decision to quit, it’s important to implement lifestyle changes that can help curb your cravings.

Consider the following:

  • Drink more water
  • Drink less coffee and tea
  • Eliminate alcohol if you smoke when you drink
  • Have a strategy prepared for when cravings arise
  • Exercise more
  • Make a list of reasons to quit
  • Reward yourself for overcoming cravings

Tips for Coping with Nicotine Withdrawal

When it comes to battling with nicotine withdrawal, unfortunately, there is no simple cure.

However, a few tips to help you cope with nicotine withdrawal:

  • Create a smoke-free environment: Remove all cigarettes, ashtrays, lighters, and matches from your home. Wash any clothes that smell like smoke. 
  • Distract yourself: When you feel the urge to smoke, fight it by finding a distraction such as physical activity, watching a TV show, playing a video game, or chatting with a friend.
  • Remove yourself from triggers: Avoid being around people who smoke or engaging in activities where you would usually smoke.
  • Find something to do with your hands: You could buy a stress ball, or simply always have an item to play with, such as a paperclip or a pen for doodling. Some people even take up a hobby such as knitting.
  • Chew on a straw, sugarless gum, or toothpick: This will help curb the oral fixation.
  • Join a support group: Talking with people who are also quitting can help you share and process your experience and feel supported.

Preventing Nicotine Withdrawal

There is no way to prevent nicotine withdrawal entirely, but the effects can be minimized with the right medicines and nicotine replacement therapies.

If you are using NRTs like nicotine gum or patches, you may need to adjust your dosage to help curb cravings and alleviate symptoms.

If you are on prescription medication, speak with your doctor before changing your dosage. 

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When to See a Doctor

People who quit smoking usually make several attempts before they succeed.

Setting up a treatment plan that evaluates both your physical and psychological aspects of nicotine dependence can help you stay on course. 

Your healthcare provider can help you create a quit plan, discuss and prescribe medications, recommend NRT options, and connect you with other resources such as support groups and therapists who specialize in nicotine and substance abuse.

Whatever your personal plan looks like, having a strong support system of professionals and friends can greatly increase your chances of success. 

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

How long does nicotine withdrawal last?
The symptoms of nicotine withdrawal reach their peak about 72 hours after quitting and then taper off in about 3-4 weeks.
What does craving nicotine feel like?
Everyone experiences a nicotine craving differently. Common symptoms include a tightness in the stomach or throat, tension, anxiety, irritability, restlessness, and feeling like you're missing something.
Can quitting nicotine make you sick?
Quitting smoking does not make you sick in the sense that it doesn’t give you a virus. However, when you quit, you will have symptoms associated with nicotine withdrawal. You may develop a cough and exhibit flu-like symptoms such as headache, sore throat, and fatigue.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Sarah Malka, MD

Dr. Sarah Malka is a board certified emergency medicine physician with K Health. She completed her residency at Harvard Medical School.