General Health, Health and Wellness

Surprising Effects of Nicotine Withdrawal—and How to Beat Them

29 Comments 17 November 2010

heart-health_300Feeling lonely, angry, and even constipated are some of the unexpected side effects of nicotine withdrawal. Daniel F. Seidman, Ph.D., shares strategies for overcoming them in his book Smoke-Free in 30 Days.

I have worked with many hard-core smoking addicts, and more often than not, people are pleasantly surprised by how easy day one is for them. This doesn’t mean they won’t have their issues — like forgetting and absently going for a cigarette, or getting stirred up by one of their smoking triggers. But it does show that many smokers have an exaggerated expectation of the horror of withdrawal. Most of the time, especially with the proper use of NRT, it’s just not that bad.

Nicotine Withdrawal Symptoms
Still, as you can see below, nicotine withdrawal does consist of a wide range of feelings and symptoms, many of which can make people feel emotionally raw and even like they are going through a mini-depression.

  • Depressed mood
  • Insomnia
  • Irritability, frustration, or anger
  • Anxiety
  • Difficulty Concentrating
  • Restlessness
  • Decreased heart rate
  • Increased appetite or weight gain

These symptoms illustrate how psychologically tumultuous a time nicotine withdrawal syndrome can be, and how important it is to be prepared for the experience. For some people, learning to feel normal again without cigarettes is their biggest challenge. Remember that it takes time to get through tobacco withdrawal.

According to DSM-IV, the manual of the American Psychiatric Association: “Withdrawal symptoms can begin within a few hours of cessation, typically peak in 1-4 days, and last 3-4 weeks. Depressive symptoms” (after becoming smoke-free) “may be associated with a relapse to smoking.”

Most people feel better over time, despite having their ups and downs; but if you feel worse depression and withdrawal over time, we strongly recommend contacting an appropriate health care professional. This will best help you safeguard your efforts to become smoke-free.

Cravings and What to Expect
Over time, cravings usually become further apart and less strong. They may spike, though, if you are experiencing one of your usual triggers, such as being upset, or if there is someone smoking nearby. Sometimes cravings go up for no apparent reason.

Usually around 3 weeks after a smoker quits, cravings start to feel more like thoughts about smoking. Thoughts about smoking aren’t as urgent or pressured as cravings. Thoughts also don’t usually provoke as much anxiety or concern as cravings. If your cravings don’t let up, and you are using NRT, you may need to double-check your dose.

Remember that each cigarette has approximately 1 mg of nicotine, so make sure you plan your NRT accordingly. If you’re a pack-a-day smoker, you need to get 20-mg worth of nicotine per day when you first start. Don’t be in a hurry to taper off. You can taper off later, as you become comfortable and confident.

If you elected not to use NRT, and your cravings persist, this may be a good time to reconsider NRT. Some people experience prolonged withdrawal, which is defined as cravings getting worse, not better, over time and especially after 5 weeks of being smoke-free. If this happens, consult a specialist.

Symptoms of, and Solutions for, Nicotine Withdrawal and Cravings
If you’ve ever tried and failed to quit before, these symptoms will come as no surprise to you. But the physical and emotional effects of nicotine withdrawal can be surprisingly severe. Below, you’ll find some ideas about how to address some of the more common issues ex-smokers face during their initial weeks of living smoke-free.

Even though you should be feeling great about quitting, it’s not unusual for nicotine withdrawal to lead to feelings of depression. These feelings can sometimes be intense. Here are a few tips to keep in mind if you are suffering from a case of the blues after you quit. It’s important to address this symptom since, if it persists and is left untreated, depression can trigger you to begin smoking again (among other unsavory side effects)

  • Call a trusted friend who usually cheers you up.
  • Write in your journal.
  • Consider professional help.

Lack of sleep and depression go hand in hand. Insomnia is another important symptom of nicotine withdrawal that you need to address right away to keep yourself healthy and your resolution on track. Try a few of these behaviors to help keep your slumber patterns consistent.

  • Do breathing and relation exercises for 20 minutes before going to bed.
  • Avoid caffeine after noon.
  • Exercise daily.

No, it’s not your imagination — nicotine withdrawal really does make you a little quicker to lose your cool. If you find yourself with a hair-trigger temper during your first smoke-free week, don’t despair. These symptoms usually abate, and in the meantime try a few of these techniques.

  • If your anger is directed at a specific person, write that person a letter. Decide later if it makes sense to send the letter. Sometimes just writing it is therapeutic!
  • Do breathing and relaxation exercises.
  • Count to 10, or take a walk to calm yourself.
  • Engage in an enjoyable activity that is incompatible with being angry, such as watching a funny movie.

When you’re stressed, your old instinct was to grab a smoke. That cue-and-response automatic relationship has to change. Here are a few specific behaviors so you can start to substitute healthy habits for a negative one.

  • Do breathing and relaxation exercises.
  • Play some of your favorite calming music.
  • Say the “serenity prayer” and remember that this too shall pass.
  • Call a positive and helpful friend for support.
  • Do some self-hypnossis.

You may feel you’re “in a fog” as your body detoxifies from smoking. Do not be reluctant to take it easy on yourself during your first smoke-free week. Give your mind and your body the time and priority they need to recover.

  • Make a to-do list.
  • Limit or decrease your commitments

Once your go-to cigarette is out of the picture, you may not know what to do with yourself or your hands. It’s normal to feel a bit jumpy or restless during the initial quit period. Moving your body is a good way to address these symptoms. Take stock of your body in other ways and consciously notice your movements, large and small.

  • Go out for daily walking.
  • Continue daily deep-slow breathing and relaxation exercises.
  • Stretch your arms and legs.

Some of the physical symptoms of nicotine withdrawal can be alarming. If you experience dizziness, fainting spells, shortness of breath, and chest discomfort, call a doctor.

It’s only natural to want to replace that cigarette with a doughnut. But the physical sensation of hunger is also a very real symptom of nicotine withdrawal. Don’t be too worried about your weight at the beginning of your quitting period, but do try to address this with some basic behaviors that promote wellness.

  • Avoid excess sugar and starches.
  • Chew nicotine gum.
  • Eat low-calorie snacks such as cut-up vegetables.
  • Drink some water
  • Exercise in a new way.

No matter how carefully you plan, it’s normal to have some cravings for a cigarette as you’re breaking free from smoking. You can be prepared for this. Be conscious of how your body feels and what actions you are taking to ride this out.

  • Time the craving.
  • Distract yourself with reading, music, or taking a walk.
  • Try chewing a cinnamon stick
  • Read over or remember your reasons for quitting

For many people, smoking is not only a physical behavior — it’s also a social one. Don’t be surprised if you find yourself facing some tough emotions during your initial week of smoke-free living.

  • Join a self-help group in person or online.
  • Call a friend.
  • Spend time with a pet or a child!
  • Volunteer.

Smoking tobacco has coated your lungs in sticky tar. The good news is that as it begins leaving your body, your lungs will feel so much better. But the bad news is that in the short term, your smoker’s cough will continue — and it may even get worse as your lungs clear up. Here are a few ideas to help alleviate some of these painful physical symptoms.

  • Try a hot drink like tea with honey.
  • Try sugarless cough drops.
  • Call a doctor if your cough persists.

Nicotine is a drug, after all, and you are in withdrawal from smoking it. Be sure to eat and drink properly to promote good overall health as your body detoxifies itself.

  • Try over-the-counter remedies.
  • Increase the fiber in your diet.
  • Drink plenty of water.
  • Call a doctor if your constipation persists.

Take care of yourself, and treat your body right.

  • Try over-the-counter remedies.
  • Try a cold pack on your neck or forehead.
  • Get a massage.
  • Alternate heat and cold on your neck and forehead.
  • Get some fresh air.
  • Call a doctor if your headaches persist.


  • Prepare to quit smoking with Dr. Daniel Seidman

Smoke-Free in 30 Days: The Pain-Free, Permanent Way to Quit

Smoke-Free in 30 Days: The Pain-Free, Permanent Way to Quit

Daniel F. Seidman

Daniel F. Seidman, Ph.D., is the director of the smoking cessation service at Columbia University Medical Center whose revolutionary techniques for quitting have been featured on Oprah, in The Wall Street Journal, and

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29 Comments so far

  1. Aaron says:

    There is no pain free way to quit. I quit cold turkey 2 weeks ago and it was the worst experience of my life. Using nicotine replacements it seems, are more a last ditch effort to make money off of the addiction. I knew I wanted to quit and I challenge my withdrawals to kill me if they are so bad. Low and behold I’m still alive.

  2. John says:

    Quitting smoking is painful, it hurts, stings, burns, and can do some wear and tear the first 2 months. I just turned 21 a week ago and Ive been smoking since I was 13. Ive tried to quit atleast 15 times and am still tryin to figure out how to beat the sadness, constipation, insomnia, ect. Yes its very hard. I think the best way to completely stop is to go talk to a doctor about some meds you could possibly take to get past the first 6 months to a year. You could also go see a physcologist and figure out a personal plan to STAY smoke free. Anyone can quit for a month. Most need help to abstain from nicotine for good. It is possible though and life really smells and taste better too. And if you never smoked and are interested in trying it, DONT!

  3. kojala says:

    Thanks for sharing your honest experience. It’s a very hard thing to quit smoking, and some people do best with cold turkey while others need meds. We also are fans of acupuncture and exercise (for all that nervous energy and ushering toxins out quickly). Good luck staying smoke-free!

  4. Carolyn says:

    I just quit , I am on 3 days now,and I feel like hell….I am taking the Nic replacements and I am feeling like they arn’t working, I smoke since I was 14 and I am 47 now, I have to have faith that I will succeed, I want to be here for many years…………I hate it though

  5. Carmi says:

    Today marks my 113th day of quitting cold turkey and I feel like hell everyday. Headaches, constipation, anxiety, irritable and short-temoered, concentration problems, migraine and the worst thing is feeling dizzy everyday since a month after I quit right after new year’s eve. I already tried to quit last year around July and I felt the same dizziness and headaches but I relapsed arounf October so everything went back to normal, my sickness was all gone. It was just a few months ago that I realized I had felt these symptoms already when I was trying to quit last year. This time though I’m very eager to fight the withdrawals. I wanna give up at times but I’ve come this far already and I don’t wanna try quitting forever. I have faith that one day all of these will be gone. I’ve been staying at home since these symptoms, scared to drive or even go to the mall coz I get very dizzy. I also noticed today that everytime I drink red wine, it makes me feel worst. Maybe that’s because of the alcohol content. Maybe it had something to do. I’m trying to exercise at home since 4 days ago and I hope it’ll make me feel better. If I only knew that quitting will be this hard, I wouldn’t have smoked in the first place. I just wanna quit because I’m turning 30 this year and I want to start living healthier. I hope I win and I can’t wait to tell the world that I’m a successful EX-SMOKER!

  6. kojala says:

    Please don’t give up! Quitting at 30 is a great thing, especially because you’ll look back and be so glad you didn’t become a 40-year-old smoker! Good luck, and stay strong. The symptoms will subside, and there are many foods and teas that can help you. Sleep is also healing!

  7. Carmi says:

    Here I am again… I decided to force myself to smoke 3 sticks a day just until I get better. I don’t know what else to do for my dizziness to subside so I’m trying it again but this time I’m gonna try to decrease the nicotine dosage like 3 sticks down to 2 to 1 then nothing. I hope this will work. I have been smoking for a week now and honestly I don’t like it anymore. I can’t believe I’m forcing myself to smoke. Ugh! Well, my dizziness is still there, still constant but it got better (a little). Wish me luck!

  8. kojala says:

    Perhaps you should see a doctor and find out if you have vertigo or another condition. Sometimes acupuncture is also helpful for symptoms and smoking cessation. Either way, good luck, and keep us posted on your journey!

  9. Carmi says:

    I did go to the doctor 3x, theey said it’s not vertigo :( This also only started when I quit cold turkey.

  10. Al Jamal says:

    DEPRESSED MOOD : I like this comments & I am following

  11. Noreen says:

    I Quit about a week ago 3 days into it I started getting severe headaches.I couldn’t handle the pain so I am now smoking 4 cigarettes a day the headaches are gone so I will start dropping a cigarette every week and see if that will help keep the headaches away

  12. David says:

    After reading Allen Carr’s book The easy way to quit smoking, i had zero withdrawel effects and it was very easy for me to quit, its been 2 years now that i quit smoking. Smoking doesnt really have any withdrawel effects, its all in the head! I recommend everybody to read his book, it will change your life..

  13. Kristy says:

    So many people love this book! It is really reasonable and doesn’t preach. Good for you taking charge and quitting. It is one of the hardest things to stop.

  14. Chris J says:

    Allen carr’s EasyWay is the only way – read it, if you can’t quit within a week you’e a smoker for life.

  15. Julie says:

    Been nicotine-free for 5 weeks and I don’t think the withdrawl symptoms are made up. I smoked for 38 years. I am now 51 years old. Of course you are going to feel depressed. It is like losing a best friend. I have been sober for almost 8 years and these feeling are all too familiar. I quit cold turkey for I have an addicitive personlity and don’t want to substitute. I just have to realize that a 38 year old habit is not going to go away in a short period of time. I want a cigarette so badly but think I will feel too guilty if I smoke. Product called 5HTP has helped me to sleep. Have had blurry vision and feel very fatigued. Hang in there everybody.

  16. Kristy says:

    We have read The Easy Way and it’s great! The problem is, you forget some of its urgency and sensibility, so it’s a good idea to keep it handy when you are struggling with weaker moments. Good luck, everyone!

  17. Charlotte says:

    I also did the online version of Allen Carr’s Easyway and have been smokefree for about 3 weeks. I am stil fighting the urges to smoke that have gotten worse this last week . I am going to continue to fight it each day. I know it will get better. Everyone else hang in there. Cigs not your friend and its all in your head that you need one!

  18. Kristy says:

    Good for you. Keep fighting! One day at a time, as they say. I didn’t realize they had an online version of Easy Way. That’s great. You must feel so much better. Best of luck!

  19. victoria says:

    smoke free for 3 weeks Wow! never thought I would do it! Rough road at first…I have Crohn’s disease so constipation makes me very nervous…blockage! Came SO close at the end of week 1 to say hell with it and smoke but held off (with citrate mag – I am sure my GI doctor would NOT approve) and Bam!! 3 wks smoke free! I realized that all of our friends were non-smokers except 3 and they are thinking about quitting! I was actually hiding my habit from new people in my life…come on…and then $200.00+a month on cigs AND I live in Virginia! Stop the stink madness! No more fume…and I joined Gold’s Gym! 40 Yrs of smoking…darn that was a bunch of money!! If I can do this so can anybody!!!

  20. Jan K says:

    Was doing pretty well till end of 3rd week. Am having difficulty with ability to get to sleep and left arm seems tense a lot of the time. Really heading for holiday snacks with sugar content, will need to watch that. Two things T need to keep in mind-N.O.P.E.-Not one puff ever and I am one smoke away from a pack a day which I smoked for about 50 yrs.

  21. julia says:

    Hi. So i am on day 10 without nicotine .have to say its surprisingly easy ,Only downside is the hungry feelin . but other than take a piece of cake. Power of the mind. That has to be in the right place in order to succeed. Good luck to u all.

  22. Kristy says:

    Keep up the good (and hard) work, Julia! We are rooting for you. It is true that once you are over the physical cravings, the mental ones are the biggest ones to address. You can do this!

  23. Madamn Queen says:

    I have been smoke free for 89 days i still feel like hell. I feel like someone heavy issitting on my chest difficulty breathing at times.Can’t eat without feeling nauseous. Constipation and nervous and anxiety. I wake up crying feeling bad i need help dealing with these horrible feelings the headaches and dizziness not so much losing weight not eating and nausea is whats killing me i dont crave at all for a cigarette any tips please help since doctors cant.

  24. Kristy says:

    Have you tried acupuncture? That definitely could help with nausea and helping your body flush out the toxins from years of tobacco use. If you’ve already seen your doctor, did they run tests and confirm nothing else is contributing to your symptoms? Good luck, and we hope you feel better.

  25. R.K.Sharma. says:

    Really nice artical.actually descrivied withdrwal symptoms weaken the person`s will. I think this artical will motivate the people.

  26. kevin says:

    Well here I am begining almost 2 mo since quit cold turkey after 23 yrs of 2 to 2 hlf pks. a day. No real urges to smoke. Hardest thing has been the nicotine withdrawl symptoms that the brain sends almost thinking having a real heart attack with some of the anxiety attacks. But once I realized it’s in head and chest pain, sweating, and tightening in arms were all stress related it’s been easier. NOW I don’t think about going to hospital when I get a heart palpitation or a little tightness. IT’S NORMAL WHEN YOU QUIT. BUT IF YOU THINK AND THINK THE WORST YOU WILL PUT YOURSELF INTO A HORRIFIC ANXIETY ATTACK. I never looked up symptoms of withdrawl or what can happen. So the 1St. few days had me feeling like a hypochondraic. Lol. But after smoking so long I just take each day as it comes and don’t think about side effects playing with my head. DAMAGE TO BODY BEEN DONE FOR SURE. WON’T HEAL INSTANTLY. So, I find keeping my self busy and not being surrounded alone in my own thoughts helps greatly.

  27. kevin says:

    One other thing I would like to add is that keeping stress level in check is hard but can be done. Because if someone like me who is a 24.5 yr. 45 yr. Old long haul OTR trucker who not only quit cold turkey to begin this journey but did in middle of one of the worse winters here in the USA when so many times I would have smoked a pack in a few hrs. It can be done. Good luck to all who ae trying or have. I HOPE I’M A SUCCESS. At least still got my coffee. Ha ha.

  28. Ann says:

    I’m on day 6 smoke free been on the nicorette patches now 4 weeks, still feel very ill don’t even want a ciggarette but the heavy tight chest and shortness of breath his hell I have developed a constant dry cough goes all night wake up every hr sweating and coughing up mucos, feels like a slab of cement is sitting on my chest I’m 53 and did smoke since teen yrs believe me these symptoms are very real there not in my head, I have always been a very active person but at moment feel very unwell and no energy, I have stopped sugar and coffee as well as this went with the cigs I smoked
    Any tips to get my energy and breathing back sooner than later I know I need to be patient but it’s agony every night I go to bed

  29. Dee says:

    Quit on 2/11 with help of patches. I did not finish all steps. I just wanted to be done with nicotine. Been 4 days, patch free and still feel horrible. I was a 2 pack a day smoker for over 40 years. Can’t imagine trying to start all over again. Seems like 2 years instead of not even 2 months. Keep posting to give me courage to go on. Congrats to those who have been successful.

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