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Withdrawal occurs as a result of dependence, when the body becomes used to having the drug in the system. Being without nicotine for too long can cause a regular user to experience:

  • Irritability
  • Craving
  • Depression
  • Anxiety
  • Cognitive and attention deficits
  • Sleep disturbances
  • Increased appetite

These withdrawal symptoms may begin within a few hours after the last cigarette, quickly driving people back to tobacco use.

When a person quits smoking, withdrawal symptoms peak within the first few days of the last cigarette smoked and usually subside within a few weeks. For some people, however, symptoms may persist for months. The severity of withdrawal symptoms appears to be influenced by a person’s genes, as well as by many behavioral factors.

Alleviating Withdrawal Symptoms

Nicotine replacement therapies and other medications approved for treating nicotine addiction may help alleviate the physiological aspects of withdrawal. However, cravings often persist because of the power of cues—the feel, smell, and sight of cigarettes and the ritual of obtaining, handling, lighting, and smoking the cigarette are all associated with the pleasurable effects of smoking and can make withdrawal or cravings worse.

Behavioral therapies can help smokers identify environmental triggers of craving so they can use strategies to avoid these triggers and manage the feelings that arise when triggers cannot be.