Nicotine withdrawal Health Article

Definition

Nicotine withdrawal involves irritability, headache, and craving for cigarettes or other sources of nicotine. These symptoms occur when a nicotine-dependent individual suddenly stops smoking or using tobacco, or cuts back on the number of cigarettes or tobacco products used.

See also:

• Smoking - tips on how to quit
• Smoking hazards

Alternative Names

Withdrawal from nicotine

Causes, incidence, and risk factors

Almost all people who try to quit have some form of nicotine withdrawal. Generally, people who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms.

People who are regular smokers tend to have particularly strong cravings and worsening of withdrawal symptoms at certain times, places, or situations associated with smoking.

Symptoms

How severe your symptoms are depends on how long you smoked and how many cigarettes you smoked each day. Common symptoms include:

• An intense craving for nicotine
• Tension
• Irritability
• Headaches
• Difficulty in concentrating
• Drowsiness and trouble sleeping
• Increased appetite and weight gain

A milder form of nicotine withdrawal, involving some or all of these symptoms, can occur when a smoker switches from regular to low-nicotine cigarettes or significantly cuts down on the number of cigarettes smoked.

Symptoms of nicotine withdrawal can mimic, disguise, or aggravate the symptoms of other psychiatric problems, according to the American Psychiatric Association.

Treatment

There are several strategies for treating nicotine withdrawal. Nicotine supplements can help. They come in several forms:

• Gum
• Inhalers
• Nasal spray
• Skin patch

All work well if used properly. People are more likely to use the gum and patches correctly than other forms.

Nonhabit forming prescription medications may help you quit smoking and keep you from starting again. Such medicines include:

• Bupropion (Wellbutrin, Zyban)
• Varenicline (Chantix)

Short-term use of the antidepressant medication bupropion (Wellbutrin, Zyban), along with a quit-smoking program, may help you quit. Using bupropion or nicotine replacement therapies alone doubles the odds of successful quitting. A combination of these methods increases success rates even more.

Varenicline (Chantrix) is a newer smoking cessation medicine. It blocks the effects of nicotine and eases withdrawal symptoms. There is some evidence that it may be more helpful in quitting smoking than buspirone.

Other medications include clonidine, antidepressants such as fluoxetine (Prozac), and buspirone (Buspar). Since nicotine itself has antidepressant effects -- and many smokers unknowingly smoke to self-medicate depression -- use of antidepressants to relieve withdrawal may be particularly helpful.

A screening test for depression may also be helpful to ensure proper treatment and increase the odds of maintaining smoking abstinence.

People trying to quit smoking often become discouraged when they don't succeed at first. Research shows that the more times you try, the more likely you are to succeed -- so don't give up! If you aren't successful the first time you try to quit, look at what occurred or what didn't work, think of new ways to quit smoking, and try again. Many attempts are often necessary to finally "beat the habit."