Nicotine Withdrawal Timeline and Symptoms

Nicotine withdrawal can occur when a person who regularly consumes products containing nicotine (such as cigarettes, cigars, smokeless tobacco, and e-cigarettes) decides to quit. The symptoms of nicotine withdrawal can be unpleasant, but the benefits of quitting tobacco far outweigh the temporary symptoms associated with nicotine withdrawal.

This article reviews the common nicotine withdrawal symptoms as well as timelines and strategies to successfully quit.

Closeup of man holding a pack of cigarettes

Khaosai Wongnatthakan / EyeEm / Getty Images

I Quit Smoking, But Why Do I Feel Worse?

Quitting smoking comes with the promise of many health benefits, like reduced risk of cancer, heart disease, lung disease, improved quality of life, and increased life expectancy. So, why is it that when you quit, you end up feeling worse than you did when you were smoking?

The answer lies in a substance known as nicotine. Nicotine is an addictive chemical that's found in all tobacco products. It works by stimulating the reward pathways in the brain, causing the brain to release a chemical called dopamine, a feel-good hormone. Dopamine acts as a chemical messenger, carrying information from the brain to the rest of the body that equates nicotine to pleasure.

After you start to quit smoking, your brain isn't getting the regular hits of dopamine that it has become accustomed to, which can lead to nicotine withdrawal symptoms.

Expect These Withdrawal Symptoms

Most people who use nicotine regularly will experience nicotine withdrawal symptoms when they stop. The length of time a person has been smoking, as well as their smoking habits, can lead to symptoms of nicotine withdrawal. It's important to know that while these symptoms can be uncomfortable, they are not dangerous.

Some common symptoms include:

Nicotine Withdrawal Timeline

Here's what you can expect in the days, weeks, and months to come when quitting smoking.

Days

Symptoms of nicotine withdrawal can begin as soon as four hours after your last cigarette. They usually peak at or around the third day and eventually subside within three to four weeks of your quit date.

The severity of nicotine withdrawal symptoms can depend on your prior nicotine habits.

Weeks

A study that followed 572 smokers from their quit date to one year after quitting found that the study participants experienced withdrawal symptoms for two to four weeks after their quit date. However, the study also reported that some quitters experienced more prolonged withdrawal, with symptoms persisting for months.

Months

Some people who quit smoking may experience cravings months after they quit. This can happen for a number of reasons, including smoking habits, environment, and behaviors. However, symptoms of nicotine withdrawal significantly decrease in the months after quitting.

Physical and Mental Health Challenges

Quitting does come with some health challenges that can affect both physical and mental health.

Physical Health Challenges

Weight gain after quitting smoking is a common physical health concern. It is common for people who quit smoking to gain between five to 10 pounds in the months after they quit.

There are a couple of reasons for this weight increase.

Nicotine stimulates your metabolism, so quitting nicotine can reduce the number of calories you burn at rest by 7% to 15%, contributing to weight gain.

Nicotine also suppresses your appetite and dulls your taste buds, so when you ditch the nicotine, you may start to feel hungrier and begin to enjoy food more than you did when you regularly consumed nicotine.

Although there are health risks associated with gaining weight, it has been proven that the benefits of quitting tobacco far outweigh the risks of gaining weight after quitting. According to the Centers for Disease Control and Prevention (CDC), the health benefits of quitting are almost immediate and get better over time.

Health Benefits of Quitting Tobacco

Some of the health benefits of quitting tobacco products include:

  • Within 20 minutes after quitting your heart rate drops.
  • 12 hours after quitting the level of carbon monoxide in your blood drops to normal.
  • Two weeks to three months after quitting your heart attack risk begins to drop and your lung function begins to improve.
  • One to nine months after quitting your coughing and shortness of breath decrease.
  • One year after quitting your added risk of coronary heart disease is half that of a smoker’s.
  • Five years after quitting your stroke risk is reduced to that of a nonsmoker’s (between five to 15 years after quitting).
  • 10 years after quitting your lung cancer death rate is about half that of a smoker’s, and your risks of cancers of the mouth, throat, esophagus, bladder, kidney, and pancreas decrease.
  • 15 years after quitting your risk of coronary heart disease is back to that of a nonsmoker’s.

Mental Health Challenges

There is a proven link between mental health and smoking. According to a 2014 study, people with mental health illnesses are more likely to smoke, more likely to become dependent on nicotine, and have a harder time quitting.

The same study found that the prevalence of mental health illness in the United States is 28%, yet smokers with mental health conditions consume up to half of all cigarettes. The study also reported that people with mental health illnesses were more likely to experience nicotine withdrawal symptoms.

Smoking rates in people with mental health conditions like depression and anxiety are nearly twice as high as in the general public. Although nicotine withdrawal symptoms do include depression and anxiety, quitting smoking can eventually improve a person's mental health the same amount as taking an antidepressant would.

Cravings and Triggers

In addition to physical symptoms of nicotine withdrawal, it's common for some people to experience psychological symptoms or cravings as well. Certain habits, like driving in the car or drinking coffee, can trigger a craving, leading to changes in mood, heart rate, and blood pressure.

The four types or categories that triggers can fall into are:

  • Emotional: Feelings of stress, anxiety, boredom, or loneliness
  • Pattern: Drinking coffee, driving, drinking alcohol, or after having sex
  • Social: Going to a party or a bar or being around others who smoke
  • Withdrawal: Smelling a cigarette or needing to do something with your hands

Identifying your triggers and learning to cope with them or avoid them altogether can help set you up for success and minimize psychological nicotine withdrawal symptoms.

How Helpful Is Nicotine Replacement Therapy?

There are different types of nicotine replacement therapies (NRT) designed to support people who are dealing with the physical symptoms of nicotine withdrawal. NRTs have shown to increase the rate of quitting by 50%–70%.

While it can be a helpful aid in reducing physical cravings, it's important to consider the emotional, social, and habitual aspects of smoking in addition to using NRT to quit.

Short-Term Brain Changes From Nicotine

Tobacco use typically begins in adolescence and can have a significant impact on both short- and long-term brain health.

In the short-term, nicotine consumption can negatively impact decision-making and attention in adolescents. Over time, nicotine consumption can lead to an increased rate of cognitive decline or memory loss.

Celebrate Your Milestones

Quitting tobacco and overcoming nicotine dependence is personal; there is no right or wrong way to go about it. There is simply the way that works best for you.

Regardless of your approach, it's important to celebrate the small wins along the way to maintain momentum. If quitting was easy, everyone would do it, so take time to acknowledge that you're actually doing it!

Summary

Nicotine withdrawal symptoms can be uncomfortable, but they are not dangerous to your health and they don't last forever. On the contrary, the benefits of quitting tobacco far outweigh the risks of withdrawal symptoms.

Some withdrawal symptoms include cravings, irritability, increased appetite, restlessness, sleep issues, and more. If you're worried about the symptoms of nicotine withdrawal, you may benefit from using nicotine replacement therapy. Talk to your healthcare provider or local pharmacist about your options.

A Word From Verywell

Managing symptoms of nicotine withdrawal is not easy. It can be simultaneously physically and mentally taxing. Understanding the symptoms that may lie ahead and mapping out strategies to help you identify possible triggers and cope with cravings is a great way to tackle those challenges head-on.

Frequently Asked Questions

  • Should you do a nicotine detox cold turkey?

    It is safe to detox from nicotine without the use of medications or NRT. Consult with your healthcare provider to determine a strategy that's right for you.

  • How long does nicotine stay in your system?

    Nicotine can stay in your blood and be detected in your urine for between one to three days.

  • How do you support someone going through nicotine withdrawal?

    You can support someone going through nicotine withdrawal by keeping an open line of communication, listening without judgment, and providing distractions when possible.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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