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• Posted January 9, 2023

Coping With Nicotine Withdrawal Symptoms

Giving up nicotine can be a brutal experience that can include everything from physical symptoms, such as headache and nausea, to mood issues, including irritability, anxiety and depression.

Yet, it is still possible to get through nicotine withdrawal symptoms with a good plan and specific tools, according to a smoking cessation expert, who offered some suggestions for coping with nicotine withdrawal symptoms.

"Nicotine is highly, highly addictive,"said Emma Brett, a staff scientist at University of Chicago Medicine and a group lead in the Courage to Quit program. "Nicotine affects the brain, blood vessels, metabolism. There are effects all throughout the body."

Quitting requires an adjustment period, she stressed.

Most commonly, withdrawal symptoms happen in the first week after quitting, peaking at about day three or four, Brett said. Some may experience nicotine withdrawal symptoms for weeks. Some may have few symptoms at all.

Using nicotine replacement aids

Nicotine replacement products can be helpful to get someone through those initial days, weeks or months.

"We know from the research that when people quit and use something like a patch or lozenge or gum, that can almost double the success rate of a quit attempt,"because you're still getting some nicotine, just it's delivered in a safe way versus the combustion of a cigarette, Brett said.

She suggested staying on the products until having a high confidence you won't relapse.

These products deliver measured doses of nicotine, according to the National Cancer Institute (NCI), which lists five types that are approved by the U.S. Food and Drug Administration.

These includes a nicotine patch, gum and lozenges available over-the-counter, plus a nasal spray and inhaler available by prescription.

Non-nicotine smoking cessation products include the prescription medications varenicline, marketed as Chantix, and bupropion, marketed as Wellbutrin and Zyban.

Urges and cravings

Certain routines can trigger smoking urges. Try to avoid or plan for them in these early quitting stages.

Etta Short, director of clinical development and support at corporate tobacco cessation program Optum, said that having strategies on hand, including motivating statements and relaxation techniques, could be helpful.

Meanwhile, the NCI suggests keeping your mouth busy chewing on carrots, pickles, apples, celery, sugarless gum or hard candy.

Even breathing exercises might be helpful, according to the NCI.

Avoid other smokers while you're trying to quit. Make your house a smoke-free zone, if possible.

"The number one thing we tell to patients regarding cravings is that cravings can be really strong, but they don't last,"Brett said, typically resolving in a few minutes.

Irritability

Know that it's normal to feel grouchy when quitting smoking, the U.S. Centers for Disease Control and Prevention says. Feeling jumpy or restless is common, too.

Walk around when you feel this way, the CDC suggests. Cut back on caffeinated drinks because caffeine lasts longer in the body when someone cuts nicotine.

Try meditation, breathing techniques or anything that creates relaxation, the NCI suggests, such as getting a massage or soaking in a hot bath.

Getting adequate sleep and nutrition can help with irritability, Brett said. Set boundaries with someone you feel is unsupportive, she added.

Take the nicotine patch off an hour before bed, to help with sleep, the CDC suggests.

Maintain standard good sleep habits: not using electronics in bed, keeping the bedroom quiet and comfortable, having a consistent bedtime and avoiding alcohol or a heavy meal before bed.

Deal with temporary concentration issues by limiting activities that require strong concentration for a while, the CDC suggests.

Weight gain

Gaining weight is a common reason for stopping efforts to quit, said John Dani, chair of the department of neuroscience at the Perelman School of Medicine at the University of Pennsylvania, in Philadelphia.

He advised exercising instead of eating when battling cravings or nervous energy.

"Healthy habits like running or walking or doing yoga are great alternatives," Dani said. "I know people who started walking the steps of their building at work instead of walking out to the parking lot to smoke a cigarette."

Typically, the weight gain is minimal, about five to 10 pounds, Brett said, and that often returns to baseline a few months after quitting.

Anxiety or depression

You may be more likely to have mood changes when you quit smoking if you have a history of anxiety or depression, the CDC notes.

Be physically active to help lift mood, structure the day to stay busy, be sure you're connecting with other people and reward yourself with something you enjoy, the CDC suggests.

Talk to a health care provider if your symptoms feel greater than you can manage.

Ask your doctor about prescription medications that can help if you have a history of depression, NCI suggests.

Consider starting individual or group behavioral support, Brett suggests.

"We know that also helps with quit success, to help address some of those concerns,"she said.

"Anything you can plan in advance of that quit attempt to help treat the withdrawal symptoms before they happen, we would say is key,"Brett added.