How do I cope with nicotine withdrawal?

Dr. Robin Miller, MD
Internal Medicine
Fortunately there are many things that can help you cope with nicotine withdrawal.  There are nicotine replacements that come in a variety of forms; patches, gum, lozenges and inhalers and nasal sprays.  In addition, hypnotherapy and acupuncture can help with withdrawal symptoms as well as smoking cessation.
Since nicotine is highly addictive, withdrawal causes both physical and psychological symptoms that can begin as soon as two to three hours after your last cigarette. But nicotine cravings become less intense over time and, for most people, eventually go away. You can deal with nicotine cravings by avoiding your triggers -- the situations that make you want to smoke. To quit smoking successfully, you need to address both physical and psychological aspects of cravings. Find other ways to unwind, such as yoga or meditation, instead of grabbing a smoke.

You can also keep your mouth and hands busy by chewing gum, eating carrot sticks or keeping a cinnamon stick or flavored toothpick in your mouth. If none of these tricks work for you, your doctor can recommend prescription medications or a nicotine replacement product (gum, patch, nasal spray or lozenges) to take the edge off your cravings.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
There are lots of harmful chemicals in tobacco, but it's the nicotine that makes it addictive. Nicotine is a highly addictive chemical because it makes a beeline to the reward centers in the brain where it triggers the release of the happy neurotransmitter chemical dopamine. Nicotine can have a powerful hold over you, which is why it is so hard to quit smoking. Withdrawal symptoms occur when your body and brain become accustomed to getting a regular dose of nicotine. When you don't get your fix, you may become irritable, depressed, anxious and moody.

Withdrawal impacts your thinking, attention, sleep and appetite. This is why many people use nicotine-replacement therapies to slowly wean themselves in a controlled way. Nicotine replacement therapies come in many forms: chewing gum, skin patches, nasal inhalers, lozenges and nasal spray. Some are available over the counter, and some require a doctor's prescription. There are also non-nicotine smoking cessation drugs that work in other ways to quell the symptoms of withdrawal. You'll see your symptoms fade in the weeks and months after quitting.

There are several methods for coping with nicotine withdrawal. First, nicotine patches, nicotine gum, or prescription medications can help you manage withdrawal symptoms while you quit smoking. However, you may still experience withdrawal symptoms while using these methods. Other coping skills include chewing gum, drinking water, or delaying lighting a cigarette until the craving passes, finding a distraction during the craving, such as talking to a friend, relaxation and breathing exercises, taking a walk/exercising, and getting plenty of rest. Talk to your physician regarding prescription medications.
Charles J. Sophy, MD
Adolescent Medicine

Drink a lot of liquids, especially water. Try herbal teas or fruit juices. Limit coffee, soft drinks, and alcohol - they can increase your urge to smoke.

Avoid sugar and fatty food. Try low-calorie foods for snacking - carrots and other vegetables, sugarless gum, air-popped popcorn, or low-fat cottage cheese. Don't skip meals.

Exercise regularly and moderately. Regular exercise helps. Joining an exercise group provides a healthy activity and a new routine.

Get more sleep. Try to go to sleep earlier and get more rest.

Take deep breaths. Distract yourself. When cravings hit, do something else immediately, such as talking to someone, getting busy with a task, or taking deep breaths.

Change your habits. Use a different route to work, eat breakfast in a different place, or get up from the table right away after eating.

Do something to reduce your stress. Take a hot shower, read a book, or exercise.

Psychological Needs:

  • Remind yourself every day why you are quitting.
  • Avoid places you connect with smoking.
  • Develop a plan for relieving stress.
  • Listen to relaxing music.
  • Watch a funny movie.
  • Take your mind off a problem and come back to it later.
  • Rely on your friends, family, and support group for help.
  • Avoid alcohol. It lowers your chances for success.
Withdrawal from nicotine has 2 parts -- the physical and the mental. The physical symptoms, while annoying, are not life-threatening. Nicotine replacement and other medicines can help reduce many of these physical symptoms. Most smokers find that the bigger challenge is the mental part of quitting.

If you have been smoking for any length of time, smoking has become linked with nearly everything you do -- waking up in the morning, eating, reading, watching TV, and drinking coffee, for example. It will take time to "un-link" smoking from these activities. This is why, even if you are using a nicotine replacement, you may still have strong urges to smoke. One way to overcome these urges or cravings is to notice and identify rationalizations as they come up. A rationalization is a mistaken thought that seems to make sense to you at the time, but the thought is not based on reality. If you choose to believe in such a thought, it can serve as a way to justify smoking. If you have tried to quit before, you will probably recognize many of these common rationalizations:
  • I'll just have one to get through this rough spot.
  • Today is not a good day. I'll quit tomorrow.  
  • It's my only vice.
  • How bad is smoking, really? Uncle Harry smoked all his life and he lived to be over 90.
  • Air pollution is probably just as bad.
  • You've got to die of something.
  • Life is no fun without smoking.
You probably can add more to the list. As you go through the first few days without smoking, write down any rationalizations as they come up and recognize them for what they are: messages that can trick you into going back to smoking. Look out for them, because they always show up when you're trying to quit. After you write down the idea, let it go from your mind. Be ready with a distraction, a plan of action, and other ways to re-direct your thoughts to something else.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.