Nicotine withdrawal

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Nicotine withdrawal
Classification and external resources
ICD-10 F17.2
ICD-9 292.0

Nicotine withdrawal is the group of symptoms that occur upon the abrupt discontinuation or decrease in intake of nicotine. The effects of nicotine withdrawal can include anxiety, depression, feelings of restlessness or frustration, headaches, an increase in appetite and difficulty concentrating.[1] A smoking cessation program may improve one’s chance for success in quitting nicotine.[2]


Nicotine withdrawal is the effect that nicotine dependent individuals feel after they discontinue or decrease nicotine intake. Nicotine is an addictive substance[citation needed] found most commonly in cigarettes, cigars, pipe tobacco, chewing tobacco, snus, snuff and electronic cigarettes. The symptoms of nicotine withdrawal usually appear approximately 2 or 3 hours after last dose of the drug. The common symptoms are an intense craving for nicotine, anxiety, depersonalization, drowsiness, depression, headaches, increase in appetite, irritability, weight gain[3] and difficulty with concentration. Approximately 75% to 80% of smokers who attempt to quit relapse before achieving 6 months of abstinence.[4] However the more attempts a smoker makes, the greater the likelihood of quitting, because each attempt makes an individual more familiar with nicotine withdrawal symptoms.[5]

Short-term and long-term effects of withdrawal[edit]

Early effects of withdrawal from nicotine addiction include deficiencies in basal dopamine levels that might initiate drug-seeking and use. Additionally, withdrawal from nicotine creates a hypo-functional state in the body which results in low brain activity. Other withdrawal symptoms that last for 3 to 7 days include irritability, insomnia, acute headaches, restlessness, depressed mood, fatigue, increased appetite and dizziness. Repeated exposures to nicotine, followed by withdrawal, induce a persistent increase in brain reward function and sensitivity to the nicotine and endurance of the effects in nicotinic acetylcholine receptor. Patients in a cessation program often experience craving for nicotine in the couple of months after quitting. There are many other factors like depression that are induced by nicotine withdrawal - for example, individuals who are more susceptible to depression use nicotine to mask this disease and, when quitting, have a 25% chance of becoming more depressed when they quit, a risk which endures for 6 to 7 months.[6]


A smoking cessation program may improve one’s chance for success in quitting. Additionally, nicotine replacement therapy may also be useful. This can be achieved by the use of nicotine patches, which also can prevent other diseases that other tobacco constituents produce. A health care provider can also prescribe medicines to help smokers quit and prevent former smokers from starting again. Other pharmacotherapies include bupropion (which should never be used on patients who have had seizures), varenicline, nortriptyline, clonidine and rimonabant.[6]

The most important component for full nicotine cessation is willpower.[2] This can be supplemented with medication or other means. These include behavioral therapy, which often includes developing a plan to set a date to end smoking (sometimes with the support of family and friends), anticipating obstacles that may occur during the treatment and removing all nicotine products from the patient’s environment. However, the most important factor is the coping skills for the prevention of relapse, which is why smokers need to develop behavioral and cognitive tools to prevent or solve a crisis. Clinicians use methods to help people stop this addiction like self-help materials and simple cognitive-behavioral therapy. These treatments help the smoker to detect “high-risk smoking situations”, manage stress, increase social support and develop activities to endure the nicotine withdrawal treatment. The combination of medical and behavioral treatments can increase the odds of total withdrawal from nicotine.[2]

See also[edit]


  1. ^ david c dugdale (2012-10-12). "Nicotine and Tobacco". Medline Plus. Retrieved 2013-04-17. 
  2. ^ a b c David C Dugdale (2012-10-12). "Nicotine and Tobacco". Medline Plus. Retrieved 2013-04-17. 
  3. ^ "Nicotine and Tobacco Symptoms of Withdrawal". NY Times Health. Retrieved 28 February 2015. 
  4. ^ Zhou, Xiaolei; Nonnemaker, James (2009). "Attempts to quit smoking and relapse: Factors associated with success or failure from the ATTEMPT cohort study" (PDF). Addictive Behaviors 34: 365–373. doi:10.1016/j.addbeh.2008.11.013. Retrieved May 26, 2013. 
  5. ^ piper m.e. (2011-07-23). "Tobacco withdrawal components and their relations with cessation success". ClinicalKey. Retrieved 2013-04-17. 
  6. ^ a b sarah evers-casey (2010-08-08). "Nicotine abuse and dependence". ClinicalKey. Retrieved 2013-04-17.