Addiction specialist: How to manage nicotine withdrawal
May 27, 2025
Medically Reviewed | Last reviewed by Maher Karam-Hage, M.D., on May 27, 2025
There’s no debate: smoking and nicotine are not good for your health. Unfortunately, that knowledge doesn’t make it any easier to quit smoking.
As a psychiatrist who specializes in addictions, I understand the challenges of quitting a substance as addictive as nicotine. That’s why I’m sharing information about nicotine withdrawal and how to manage the discomfort that comes with it.
What to know about nicotine withdrawal
Any nicotine product can cause it
Any nicotine product can cause nicotine withdrawal symptoms. However, products with higher nicotine content can cause worse withdrawal symptoms. Products with high levels of nicotine include cigarettes, vapes, chewing tobacco and nicotine pouches.
It causes both immediate and long-term effects
Nicotine withdrawal symptoms are the opposite of what nicotine does. They include:
- Nicotine cravings
- Restlessness
- Irritability
- Trouble focusing
- Depression
- Insomnia
These symptoms usually begin a day or two after quitting nicotine, but they can also set in overnight. For example, those who smoke one pack of cigarettes or more per day crave a cigarette within minutes of waking up in the morning. If they decide not to have that cigarette, they could already be experiencing nicotine withdrawal symptoms.
Quitting nicotine can also increase appetite. This can lead to weight gain. Of course, weight gain doesn’t happen instantly; this occurs weeks to months after you quit using nicotine.
Nicotine withdrawal symptoms look different for each person. Not everyone will have the same symptoms, nor will they necessarily experience all the symptoms listed.
Nicotine withdrawal usually goes away within a few weeks
With the exception of nicotine cravings and possible weight gain, nicotine withdrawal symptoms typically go away within days to weeks of quitting. However, some people experience symptoms that last a month or more. This is called protracted nicotine withdrawal syndrome.
If you don’t start feeling relief from these symptoms within two to four weeks, I’d recommend seeing a health care professional. That way, you can rule out other underlying causes of these symptoms, such as anxiety, depression or insomnia. A professional can also connect you to resources to better manage these symptoms.
Key takeaways:
- Nicotine withdrawal can cause cravings, restlessness, irritability, trouble focusing, depression, insomnia and increased appetite.
- These symptoms can set in anywhere from several hours to several days after your last nicotine product.
- Starting nicotine replacement therapy or smoking cessation medication before you quit smoking can help manage withdrawal symptoms.
- See a doctor if your nicotine withdrawal symptoms don’t go away within 2 to 4 weeks.
Managing nicotine withdrawal starts before you quit smoking
The best way to manage nicotine withdrawal is to be on medication or over the counter (OTC) nicotine replacement products before trying to quit. This is especially true for people who have tried to quit before and had lots of withdrawal symptoms.
RELATED: Quit smoking: 6 products to strike out nicotine cravings
In the U.S., there are three types of nicotine replacement therapy you can get at pharmacies without a prescription. These products use low doses of nicotine to help your body adjust to less nicotine without going “cold turkey.” They are:
- Nicotine patches: These patches, which can be made of latex or other materials, are applied to skin on the upper body and changed once a day.
- Nicotine gum: This gum is chewed for several seconds, then parked, or held, in a user's mouth for several seconds. That sequence is then repeated for 10 to 15 minutes allowing nicotine to be released and absorbed in the lining of the mouth.
- Lozenges: These products are similar to hard candies that release nicotine. But instead of being chewed and swallowed, they are parked in the cheek where they dissolve within 15 minutes.
Often, people use a combination of nicotine-replacement therapies to achieve better results. Most often, this is a nicotine patch along with either nicotine gum or lozenges.
Several prescription medications also can be used to help you quit smoking. These include:
- Varenicline: This pill is the single most effective smoking cessation treatment. It works by both partially stimulating and blocking the brain’s nicotine receptors.
- Bupropion: This pill works by mildly blocking the brain’s nicotine receptors.
- Nicotine nasal spray: This product is sprayed into the nostril where nicotine is absorbed.
Talk to your doctor or care team to find out which option they recommend for you.
Activities that can help nicotine withdrawal
In addition to nicotine replacement therapies and medications, activities such as meditation, exercise and relaxation techniques can help you manage nicotine withdrawal symptoms.
Being distracted doesn’t always have the best reputation. Yet, when it comes to managing nicotine cravings during withdrawal, it could be a useful tool for some people. Distracting yourself can take on many different forms. It might mean using your phone, watching television or gaming. Or it might mean using your hands to cook or craft.
Find something that can take your mind off your craving. When you aren’t occupied with something, the craving is going to be in your face the whole time. Remember: a craving usually subsides after about 10 minutes if you can resist relapsing.
Learn more about MD Anderson studies to help you quit smoking.
The best way to manage nicotine withdrawal is to be on medication or over the counter nicotine replacement products before trying to quit.
Maher Karam-Hage, M.D.
Physician