Nicotine Withdrawal: How to Cope

The symptoms of nicotine withdrawal usually peak 2 to 3 days after you quit smoking.

Nicotine is a flavorless chemical compound that tobacco and other plants make as an insect repellent.

It's also highly addictive — as addictive as heroin or cocaine.

That's the main reason it can be so difficult for people to stop smoking tobacco products.

Nicotine provides the "high" smokers get from cigarettes, and it keeps them hooked with its addictive properties.

But nicotine isn't the ingredient in tobacco products that causes cancer (that dubious distinction belongs to the tar in tobacco).

How Nicotine Works

Each time you inhale cigarette smoke, nicotine goes deep into your lungs, where it's rapidly absorbed into your bloodstream.

Then nicotine makes its way, along with carbon monoxide and other toxins, to every part of your body. It affects your heart and blood vessels, hormones, brain, metabolism, and more.

Inhaled nicotine reaches your brain even faster than drugs that are administered through a vein intravenously.

Nicotine Effects

Nicotine affects your body in many ways. It:

• Stimulates your central nervous system, making you more alert
• Elevates your mood and may lead to a sense of well-being
• Decreases your appetite
• Increases your heart rate by around 10 to 20 beats per minute
• Increases your blood pressure by 5 to 10 mmHg
• May cause sweating, nausea, and diarrhea
• Increases activity of the intestines
• Makes you creates more saliva and phlegm

The pleasant feelings, along with the physical and psychological dependency, are what makes smoking so addictive.

In addition, the more you smoke, the greater your tolerance to nicotine, which means you will need to smoke more to get the same "high."

Nicotine Withdrawal

Seventy to 90 percent of tobacco users say nicotine withdrawal symptoms are the only reason they haven't given up smoking.

You'll start to experience the effects of nicotine withdrawal two to three hours after your last cigarette.

Those who smoke the longest and/or the most will notice withdrawal effects sooner and more intensely than lighter smokers. If you're quitting, withdrawal symptoms peak about two to three days after your last tobacco use. The most common symptoms are:

• Intense craving for nicotine
• Anxiety, restlessness, or boredom
• Depression
• Trouble sleeping, including bad dreams and nightmares
• Drowsiness
• Feeling tense, restless, or frustrated
• Headaches
• Increased appetite and weight gain
• Problems concentrating
• Dizziness
• Slower heart rate
• Constipation or gas
• Cough, dry mouth, sore throat, and nasal drip

Though the list of withdrawal symptoms may sound daunting, and they're certainly difficult to experience, the long-term health effects of quitting far outweigh any discomfort you may feel in the short term.

Nicotine Replacement Therapy

If you try to quit and don't succeed, don't be discouraged: Research shows that the more times you try to quit, the more likely you are to succeed, and that the average person tries about six times before succeeding.

If you find the withdrawal symptoms from nicotine are overwhelming, speak to your health care professional about nicotine replacement therapy (NRT).

NRT takes away the physical withdrawal symptoms from smoking so you can focus on handling the emotional part of quitting.

Many studies have shown using NRT can nearly double your chances of quitting successfully.

Speak to your doctor about which one is right for you and best suits your lifestyle. You may combine different forms of NRT but you should refrain from smoking while using them.

There are five different forms of NRT approved by the Food and Drug Administration (FDA):

• Patches
• Gum
• Lozenges
• Nasal spray
• Inhalers

Nicotine Patches

Nicotine patches supply a measured dose of nicotine through your skin. They are available in different strengths; the best one for you will depend on how heavy a smoker you are and your body size.

Patches are available without a prescription. To wean yourself off nicotine, you'll switch to lower-dose patches over the course of about eight weeks.

The FDA has approved using the patch for a total of three to five months.

Possible side effects of using the nicotine patch include:

• Skin irritation (redness and itching)
• Dizziness
• Racing heartbeat
• Sleep problems or unusual dreams
• Headache
• Nausea
• Muscle aches and stiffness

Nicotine Gum

Many people choose nicotine gum because it is fast-acting — the nicotine is taken in through the mucous membranes of the mouth.

You can chew on a piece of nicotine gum whenever a craving hits. It's available in two strengths and can be purchased without a prescription (over-the-counter, or OTC).

You'll want to cut back on the amount of gum you chew over the course of six to 12 weeks until you feel ready to quit. The maximum recommended length of use is six months.

If you have sensitive skin and are easily irritated by patches, you might prefer nicotine gum.

Possible side effects of nicotine gum include:

• Bad taste
• Throat irritation
• Mouth sores
• Hiccups
• Nausea
• Jaw discomfort
• Racing heartbeat

The gum can also stick to dentures and dental work.

Nicotine Lozenges

Nicotine lozenges are available in two different strengths and are sold OTC.

As with other NRT products, you'll want to wean yourself off them over the course of several weeks. Lozenges should be used for 12 weeks at the most.

Side effects of nicotine lozenge may include:

• Trouble sleeping
• Nausea
• Hiccups
• Coughing
• Heartburn
• Headache
• Gas

Nasal Sprays

Nasal spray delivers nicotine to the bloodstream quickly, easing withdrawal symptoms faster than other methods.

Nicotine nasal spray is available by prescription only. The FDA recommends that the spray be used for six months maximum.

The most common side effects include:

• Nasal irritation
• Runny nose
• Watery eyes
• Sneezing
• Throat irritation
• Coughing

Nicotine Inhalers

A nicotine inhaler looks similar to a large cigarette with a mouthpiece, but it's actually a thin plastic tube that contains a nicotine cartridge inside.

When you take a puff, the cartridge puts out a pure nicotine vapor that delivers most of the nicotine vapor to the mouth, where it's absorbed into the bloodstream. Because it looks and acts like a cigarette, it can ease some of the habitual withdrawal symptoms as well.

Nicotine inhalers are recommended for no more than six months of use.

The most common side effects, which mostly occur when first using the inhaler, include:

• Coughing
• Mouth and/or throat irritation
• Upset stomach

Whatever NRT product you choose, always speak with your healthcare provider about any side effects you may be experiencing.

You should also let him or her know if you are having a hard time quitting smoking with your NRT product. Your doctor may be able to suggest alternatives.