Nicotine is the addictive compound present in tobacco products. Prolonged use of nicotine products results in physical and psychological dependence on nicotine. This development involves changes in brain regions, including the reward centers of the brain, that lead to the sustained intake of nicotine.
Discontinuation of nicotine use results in withdrawal symptoms that involve intense drug cravings, depression, irritability and anxiety. These symptoms of nicotine withdrawal can lead to the resumption of nicotine use, treatment at an outpatient or inpatient detox can help avoid a relapse.
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Signs of Nicotine Withdrawal
Certain diagnostic criteria must be fulfilled for an individual to be diagnosed with nicotine withdrawal. Any four of the following signs must be present upon cessation of nicotine use for it to be considered withdrawal:
- Irritability or anger
- Difficulty concentrating
- Decreased heart rate
- Depressed mood
- Increased appetite
It is essential to be honest with one’s physician in the case of the resumption of nicotine due to withdrawal symptoms. The physician can recommend a different over-the-counter or prescription nicotine replacement products to ease the withdrawal symptoms. There are also other medications like bupropion or varenicline that can reduce cravings and ameliorate withdrawal symptoms.
Nicotine Withdrawal Symptoms
The symptoms of nicotine withdrawal are generally not life-threatening. However, these symptoms can be severe and cause significant discomfort, often leading to a relapse. These symptoms may feel like a bad flu.
- Physical Symptoms of Nicotine Withdrawal:
Some of the physical symptoms of nicotine withdrawal include:
- Increased appetite and weight gain
- Decreased heart rate
- Drug cravings
- Psychological Symptoms of Nicotine Withdrawal:
Some of the psychological symptoms of nicotine withdrawal include:
- Depressed mood
- Difficulty concentrating
- An inability to feel pleasure
How to Ease Nicotine Withdrawal Symptoms
Quitting nicotine cold-turkey can result in more severe withdrawal symptoms. Nicotine replacement therapy is helpful in alleviating withdrawal symptoms and reducing cravings. It involves the use of products that contain low doses of nicotine and include nicotine patches, lozenges, gum, inhalers and sprays. These products are safe when used over a limited period and deliver small doses of nicotine without the toxic chemicals present in tobacco products. Nicotine replacement therapy involves using higher doses of these products at the onset and tapering off the nicotine dose amount over time.
Other medications, such as varenicline and the antidepressant bupropion, are also effective in reducing cravings for nicotine.
Natural Remedies to Ease Nicotine Cravings
Some of the natural ways to cope with nicotine withdrawal symptoms may include engaging in exercise, distracting oneself by engaging in pleasurable activities and avoiding triggers that lead to nicotine use. Avoiding triggers includes maintaining a nicotine-free environment and may require asking friends and family members to refrain from smoking around the individual. This necessity may also involve avoiding public places where smoking is common and avoiding foods or drinks (such as coffee) that would trigger cravings. Many individuals use nicotine products to cope with stress and managing stress may be important to avoid a relapse.
Intake of plenty of water and getting adequate rest may also be helpful.
How Long Does Nicotine Withdrawal Last?
The onset of symptoms of nicotine withdrawal occurs within the first 4 to 24 hours after abstinence from smoking or the use of other nicotine products. These symptoms peak within the first week after the onset of abstinence and persist for around two to four weeks. Cravings for nicotine may last for a longer duration and gradually decrease over weeks or months.
Nicotine Withdrawal Timeline
The symptoms of nicotine withdrawal appear within the first few hours when quitting nicotine cold-turkey. The general timeline of the symptoms of nicotine withdrawal are:
- 4 to 24 hours: Withdrawal symptoms start to emerge during this period.
- 2 to 3 days: The withdrawal symptoms peak during this period and include anxiety, depression, intense cravings, headaches, restlessness and irritability.
- 3 to 4 weeks: Most of the withdrawal symptoms mentioned gradually disappear during this time. The total duration of withdrawal symptoms may depend on the frequency, dose and duration of nicotine use.
Factors Influencing Nicotine Withdrawal
The most important factors that influence the severity of symptoms of nicotine withdrawal include the individual’s physiological characteristics and the history of nicotine use. The physiological characteristics of an individual determined by an individual’s genetics, sex and health. The severity of nicotine dependence, determined by the frequency and duration of nicotine use, is one of the primary factors that determine the severity of withdrawal symptoms.
Co-occurring psychiatric disorders like depression and simultaneous dependence on other substances can also influence nicotine withdrawal. Exposure to triggers such as other individuals smoking or stressful situations can determine the intensity of cravings.
Although many individuals attempt to quit smoking or using nicotine products, most efforts are unsuccessful due to the addictive qualities of nicotine. The withdrawal symptoms caused due to abstinence from nicotine are not life-threatening but they cause considerable discomfort. These withdrawal symptoms often lead to the resumption of nicotine use. Many people require multiple attempts to overcome nicotine dependence. Gradually reducing the dose of nicotine can reduce the severity of withdrawal symptoms and nicotine cravings. Nicotine replacement therapy utilizes such an approach and involves the use of products like nicotine gum, nicotine patches and nicotine sprays that deliver small doses of nicotine. These nicotine products are used more frequently at the onset of treatment and then are gradually tapered off.
Baker, Timothy B.; Breslau, Naiomi; Covey, Liliro; Shiffman, Saul. “DSM criteria for tobacco use disorder and tobacco withdrawal: A critique and proposed revisions for DSM‐5.” Addiction, February 2012. Accessed September 13, 2019.
McLaughlin, Ian; Dani, John; De Biasi, Mariella. “Nicotine withdrawal.” The Neuropharmacology of Nicotine Dependence. 2015. September 13, 2019.
National Institute on Drug Abuse. “Tobacco, Nicotine, and E-Cigarettes.” January 2018. September 13, 2019.
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