Nicotine withdrawal symptoms are experienced differently by each person, some struggle more than others, however generally they peak after 1-3 days of abstinence and gradually decrease over a period of 3-4 weeks. Following this, nicotine should be completely flushed out of someone’s system, however psychological effects tend to keep lingering.

The brain on nicotine

When nicotine enters the bloodstream, it activates the reward and pleasure circuits in the brain by boosting the levels of the “feel-good” neurotransmitter dopamine. The substance is also known to affect areas of the brain which regulate breathing, memory (enhancing it), appetite, and heart rate, and the brain can quickly become addicted to this stimulatory effect.

Additionally, smokers tend to smoke when they are socializing with friends, when they are bored, when they need a pick me up and so on. Years of doing this conditions one’s brain to associate smoking with pleasure, hence why the psychological withdrawal symptoms of nicotine are hard to overcome, despite overcoming the physical ones.

The physical symptoms of nicotine withdrawal

When nicotinic receptors in the brain are suddenly deprived of nicotine, the release of dopamine drops. This naturally leads to an uncomfortable feeling and an intense yearning for smoking, something which the body would have grown accustomed to needing for the release of dopamine. Nicotine cravings can last for anything from 5 to 30 minutes, can be extremely uncomfortable, and will only start fading away with time, or with the use of Nicotine Replacement Therapy (NRT).

Some other main symptoms of withdrawal include:

-Snacking and constantly feeling hungry
-Trouble sleeping
-Coughing
-Mood swings and grumpiness
-Fatigue
-Memory problems and difficulty concentrating/
-Timeline of nicotine withdrawal

Timeline of withdrawal

An article on ZME Science listed a timeline of what can be expected from the moment one has their last cigarette.

  • “30 minutes to 4 hours: The effects from the nicotine will wear off and you’ll start to crave another cigarette. The heart rate drops and returns to normal. Blood pressure begins to drop, and circulation may start to improve.
  • 10 hours: Feelings of restlessness and cravings for a cigarette will start to fill your mind. You might also feel unusually sad. On the flipside, the body has already cleansed itself from all that excess carbon monoxide, increasing the oxygen levels in the blood.
  • 24 hours: Irritability kicks in and your appetite increases. In as little as one day after quitting smoking, a person’s blood pressure begins to drop, decreasing the risk of heart disease from smoking-induced high blood pressure. Exercising and physical activity, in general, becomes a lot easier.
  • 2 days: Headaches become common and intense as nicotine is flushed out of the system. You’ll also notice an improved sense of smell and taste as nerve endings responsible for these senses that were destroyed by smoking are now regenerating.
  • 3 days: Most of the nicotine in your body should be gone. This is the hardest day for quitting smoking because this is when both physical and psychological nicotine withdrawal symptoms are at their worst. The good news is that cravings start to taper off.
  • 2 to 4 weeks: You’ll still feel fatigued but at least some of the brain fog will be clearing up. Symptoms of coughing, depression, and anxiety improve. Generally, after one month, lung function begins to improve so you may notice a heightened ability for cardiovascular activities, such as running.
  • 1 to 3 months. Blood circulation continues to improve as there is no stimulant to raise blood pressure and potentially form clots. If you made this far, congratulations are in order! You’ve crossed the dangerous point in time where most people rebound.
  • 9 months. The lungs have now significantly healed themselves. As clia cells recover, the body is now able to push more mucus out of the lungs and better fight infections. You should notice a decrease in the frequency of lung infections.
  • 1 year. Your risk of coronary heart disease has now decreased by half compared to your days as a smoker.
  • 5 years. Arteries and blood vessels begin to widen. This means that blood is less likely to clot, lowering the risk of a stroke. As the body heals more and more, the risk of stroke will continue to reduce over the next 10 years.
  • 10 years. The risk of developing cancer is roughly cut in half compared to a smoker. In particular, the risk of developing mouth, throat, or pancreatic cancer is significantly reduced.
  • 15 years. The likelihood of developing coronary heart disease and pancreatic cancer is equivalent to a non-smoker.
  • 20 years. The risk of dying from smoking-relating causes (i.e. lung disease and cancer) drops to the level of a person who never smoked in their life.”

Treatments for nicotine withdrawal

A recent review of research related to NRTs, has indicated that smokers who use higher doses of nicotine are more likely to quit than those using lower doses. The review also found that some smokers may benefit from using two forms of NRT rather than one.

Additionally, the same review indicated that in smokers who intend to switch to using an NRT, it helped to start using it before quitting cigarettes. This may be because having nicotine already present in their system, smokers were getting less of a hit when they light up, and therefore can make cigarettes less enjoyable.

Similar findings were indicated by a recent study from Queen Mary University of London where researchers followed 50 smokers in a tobacco dependence clinic in Argentina, as they tried to quit smoking. This was the first study to tailor nicotine dosing according to smokers’ choices as they try to quit, and the results suggested that most smokers using stop-smoking medications can tolerate doses that are up to four times higher than the ones recommended.

Most smokers are not being weaned off nicotine in a productive manner

Study author Dunja Przulj said that when they are smoking, smokers are able to control the amount of nicotine they obtain, and that having levels restricted when they are trying to quit is counterproductive. “Smokers determine their nicotine intake while they smoke, but when they try to quit, their nicotine levels are dictated by the recommended dosing of the treatment. These levels may be far too low for some people, increasing the likelihood that they go back to smoking.”

Medicinal nicotine products may be under-dosing smokers and could explain why we’ve seen limited success in treatments, such as patches and gum, helping smokers to quit. A change in their application is now needed. Our findings should provide reassurance to smokers that it is okay to use whatever nicotine doses they find helpful,” added Przulj.

Another reason why smokers prefer e-cigs over other NRTs

Renowned stop-smoking researcher Professor Peter Hajek also from Queen Mary University of London, pointed out that these results indicate why e-cigarettes may be preferred by smokers. “Smokers are perfectly capable of determining which doses of nicotine they find helpful. There is no risk of dangerous overdose, because nicotine includes an effective safety valve in the form of nausea.”

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