Smoking withdrawal symptoms

Hi Alice...

I would like to know all the withdrawal symptoms of quitting smoking. Also how long do these symptoms last and do they come all at once or one by one? Without using nicotine replacements, how does one deal with them? Plus, any suggestions to avoid weight gain?

How long does it take to get rid of withdrawal symptoms? What do you do if you have a headache — have a normal pain killer or what?

Dear Reader,

Quitting smoking can certainly be a challenge, but with some preparation, some of the more common setbacks can be anticipated and avoided. When it comes to withdrawal symptoms, people can experience both physical and emotional symptoms (more on these in a bit), and they can last from a few days to a few weeks depending on the person. Each person experiences withdrawal differently, so the intensity and the types of symptoms any given person may experience could vary. While nicotine replacement therapies can be helpful aids for those trying to quit smoking, some people have found help through alternatives such as mindfulness, acupuncture, and hypnosis, among others. Additionally, while weight gain may occur with quitting smoking, maintaining a healthy lifestyle that includes a balanced diet and physical activity can help reduce any weight gain that may occur. If headaches occur from withdrawal, speaking with a health care provider about pain relief options is likely the best bet, as the most appropriate option may vary depending on using any cessation aids and what type(s) are used to help quit.

Most of the physical symptoms that result from quitting stem from nicotine withdrawal. Nicotine, an addictive drug naturally occurring in tobacco and added to most cigarettes and tobacco products, produces pleasant feelings in the body. When the body doesn't receive the nicotine it craves, uncomfortable withdrawal symptoms can set in. These typically include:

  • Intense craving for nicotine
  • Irritability
  • Headaches
  • Difficulty concentrating
  • Trouble sleeping
  • Increased appetite and weight gain
  • Anxiety
  • Restlessness

Most smokers who quit experience some form of nicotine withdrawal. Luckily, the discomfort of withdrawal is often short-lived, lasting from a few days to a few weeks. Withdrawal symptoms are usually most noticeable within the first few days after quitting and gradually subside. Although this experience can be highly uncomfortable for many, there aren’t health risks associated with nicotine withdrawal. However, some nicotine replacement therapies can help manage these symptoms. Nicotine supplementation in the form of gum, a patch, or pills can be helpful in mitigating the physical dependence in the short-term and lessening the symptoms of withdrawal. The U.S. Food and Drug Administration (FDA) has also approved several medications for smoking cessation, including antidepressants.

For those not interested in using nicotine replacements or other medications, there are a number of other strategies people have used. Some people decide to go cold turkey, where they stop using cigarettes entirely and don’t use any nicotine replacement. Others start to wean their bodies off gradually to reduce the amount they smoke each day. Altough the research is still mixed, some people have found the use of e-cigarettes to be helpful as a cessation tool. However, these devices are still not approved by the FDA for this purpose and their use has been associated with severe lung illness and death. While there wasn’t much evidence in favor of these methods, some people reported that acupuncture, hypnosis, yoga, or meditation have helped them quit.

When it comes to weight gain, most studies indicate that the average amount when quitting smoking is less than ten pounds. For most people, it's pretty small, and it can be beneficial to focus on quitting smoking first and then managing any weight that may have been gained. If you’re looking to mitigate any weight gain from quitting, it may be helpful to include physical activity in your daily routine, and pay extra attention to eating nutritious meals and snacks. Not only may these lifestyle behaviors help prevent weight gain, but they can also be forms of stress relief, which can make it easier to quit.

In addition to the physical symptoms of withdrawal, there are behavioral components of quitting that may make it challenging to quit. For people who have been smoking for any length of time, it may have become an activity linked to many parts life, such as waking up, eating, or taking breaks at school or work. It will take time and strategizing to un-link smoking from these activities. Because some people experience strong cravings in certain situations associated with smoking, the American Cancer Society suggests that it might be helpful, at least in the beginning, to keep these suggestions in mind:

  • Try to avoid people and places where smoking may be tempting. This may mean taking a different route to work or school, or going for a walk at breaks instead of going to the area where people smoke.
  • Replace cigarettes with oral substitutes, such as sugar-free gum, carrot or celery sticks, or sunflower seeds.
  • Get up and move! Being physically active can help reduce stress and avoid weight gain. Additionally, doing something that keeps hands busy can help distract from the tobacco cravings.
  • Stall before lighting up. Rather than lighting a cigarette when feeling a craving, waiting at least ten minutes will help the craving to pass.
  • Take deep breaths. Smoking involved deep breaths in order to inhale the smoke. If that urge strikes, take deep breaths of clean air to emulate that deep breathing feel and remember why the decision to quit was made in the first place, which may help.
  • Reward hard work. Quitting smoking is hard, so taking the money or the time that would’ve been used smoking to do something else with those resources can be a nice way to stay committed to quitting.

Although quitting can be tough, there are benefits to quitting almost immediately. Check out the these benefits to see how health can improve after taking that last puff:

  • Twenty minutes after quitting: Heart rate and blood pressure drops.
  • Twelve hours after quitting: The carbon monoxide level in the blood drops to normal.
  • Two weeks to three months after quitting: Blood circulation improves and lung function increases.
  • One to nine months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.
  • One year after quitting: The excess risk of coronary heart disease is half that of a smoker's.
  • Five years after quitting: Risk of stroke is reduced to that of a nonsmoker two to five years after quitting. The risk of mouth, throat, esophagus, and bladder cancers are cut in half. The risk of cervical cancer is equivalent to that of a non-smoker.
  • Ten years after quitting: The lung cancer death rate is about half that of a continuing smoker's. The risk of larynx and pancreatic cancers decrease.
  • Fifteen years after quitting: The risk of coronary heart disease is that of a nonsmoker's.

List adapted from the American Cancer Society

Some other benefits can be noticed that may affect day-to-day life. For example, sense of taste and smell may return to their usual state, teeth and fingernails no longer yellow, and lung capacity improves, making it easier to do ordinary activities such as climb the stairs.

Smokers wanting to quit can make use of another non-medical strategy: getting support from an array of groups and phone counseling programs. Smokefree.gov is an example of an online resource that provides information on smoking, quitting techniques, and withdrawal and cessation support. If you're a student looking to quit, check out your campus's health services, as many schools have similar programs. Additionally, if you're an employee at a company that offers benefits to their employees, it may be worth investigating whether or not they offer help with smoking cessation. 

All the best,

Last updated Apr 19, 2019
Originally published Jun 20, 2008

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