Nicotine withdrawal

What causes it and how do we get through it?


Nicotine is a highly addictive drug that is found in tobacco and products such as cigarettes and cigars. Nicotine can affect a person’s brain functions. When a person starts to smoke regularly, their body will adapt to the regular intake of nicotine, at which point the person will find it difficult to do without a regular ‘dose’ of nicotine. This is because of the symptoms of nicotine withdrawal which are very uncomfortable.

Order safe and effective treatment to quit smoking

Product Img
Champix from £39.25
View all treatments

What is nicotine withdrawal?

When a person has a ‘dose’ of nicotine via, for example, a cigarette, the nicotine is absorbed through the lungs and lining of the mouth and nose, entering the bloodstream this way.

The nicotine will hit the brain via the bloodstream where it activates feelings of pleasure and reward by boosting the production of dopamine. Dopamine is a neurotransmitter or chemical messenger responsible for the way we feel pleasure. In addition, nicotine affects the brain in a variety of other ways including:

  • Boosting mood
  • Reducing irritability
  • Producing a sense of well-being
  • Reducing appetite
  • Reducing levels of depression
  • Enhancing concentration and short term memory

Nicotine can affect all areas of the body including the heart and vascular system, hormones, the brain and metabolism. Over an extended period of time nicotine can bring about changes in the chemical transmitters in the brain and when the supply of nicotine stops abruptly it disrupts the chemical balance which gives rise to physical and psychological side effects, such as cravings for nicotine, low mood and a myriad of other symptoms, all of which make it difficult to quit the habit.

Addiction to nicotine has been compared with addiction to cocaine or heroin. Whilst the ‘high’ experienced from using nicotine is not as dramatic as that associated with these illegal drugs, it is said that it is just as difficult to give it up.

Symptoms of nicotine withdrawal

There are two subgroups of symptoms associated with nicotine withdrawal, physical and psychological. The physical symptoms will subside in a relatively short time when all the nicotine has left the body but psychological conditions can last for much longer. Going through nicotine withdrawal is not a pleasant experience but there are no health risks associated with it.

Physical symptoms

Exact physical symptoms will vary from person to person. Symptoms can include:

  • Headaches
  • Sweating
  • Difficulty sleeping
  • Tremors
  • Waking at night
  • Nausea abdominal cramps
  • Increased hunger
  • Restlessness
  • Digestive problems including constipation and flatulence
  • Difficulty concentrating
  • Tingling in the hands and feet
  • Coughing and sore throat
  • Weight gain
  • Reduced heart rate

Psychological symptoms

Again, psychological symptoms experienced will vary from person to person but include:

  • Nicotine cravings
  • Irritability
  • Low mood
  • Difficulty concentrating
  • Mood swings
  • Anxiety
  • Depression
  • Restlessness

It is usual for the physical withdrawal symptoms to subside within days and to be gone completely within 2 - 4 weeks. For psychological withdrawal, this time period may be substantially longer.

Nicotine withdrawal - a timeline

The act of quitting smoking entails breaking the cycle of addiction and rewriting the brain so that it no longer drives you to reach for the next cigarette. When you are at the end of the journey it is easy to look back but when you are at the beginning of the journey and are about to have your final cigarette, it is useful to know what you can expect and we are looking to cover the process here. Hopefully, this will inspire you to ensure that your last fag is just that, your last!

Twenty minutes in, what's happening?

In this very short amount of time, your pulse rate and blood pressure will begin to drop and return to normal; fibres which line your airways and are designed to deter pathogens and irritants from entering the lungs will begin to move again.

Continuing to smoke will result in increased blood pressure, the result of which could be a heart attack or stroke.

Two hours since the last fag - what now?

Circulation in the extremities or peripheral circulation is now beginning to improve. The process of inhaling smoke results in the constriction of blood vessels in general but also in the hands and feet. The result is that hands and feet may feel cold and numb. Within a short two hour period, hands and feet will begin to feel warmer.

Twelve hours in - what's the score now?

Levels of carbon monoxide in the bloodstream will have begun to drop back to the normal range whilst concurrently, oxygen levels in the bloodstream will begin to rise. At this time, nicotine withdrawal will begin to set in in earnest along with the first withdrawal symptoms which may include:

  • Headache
  • Lack of concentration
  • Irritability
  • Restlessness
  • Frustration
  • Hunger

24 hours - day 1

Just one day after you quit smoking, your risk of having a heart attack is beginning to subside. This is as a result of there being less constriction in the blood vessels of the body. Lower pulse rate, lower blood pressure and higher oxygen levels. All these factors help the heart to function more efficiently.

48 hours - day 2

By this time you may well notice that your sense of taste and smell is beginning to improve. The nerve endings in the mouth are beginning to repair themselves and this is resulting in better nerve function.

72 hours -day 3

The inflammation in the lungs that has been caused by smoking is now settling down and as a result, lung function is beginning to improve, in addition, the bronchial tubes or airways from the lungs are beginning to relax which is allowing breathing to be easier.

The small fibres, or cilia, which line the lungs, airways and nose are now beginning to grow back. Cilia are tiny hair-like structures designed to clear out debris and pathogens from the lungs. This may be accompanied by coughing as the healthier cilia begin the job of clearing the lungs of ‘gunk’. Lung capacity will now begin to increase.

One week since you last smoked

This is the first major milestone on your journey! It may have felt like a very long week but it means that you are now nine times more likely to succeed in quitting smoking.

This is a milestone for another good reason in that nicotine cravings are now beginning to subside and will continue to do so from here on in. Mucous production is dropping and whilst the cilia will continue to heal, you will be coughing less.

Two weeks since you last smoked

You are now walking and breathing more easily. Improved oxygen levels in the body along with improved lung function and capacity are the reasons for this.

Month one! You are well on your way!

At this point, you will be experiencing many changes in your health which are happening as a result of not smoking. Changes will include increased energy levels, lung function will have improved by as much as 30% and you will be able to exercise for longer periods of time. At this point, nicotine cravings and coughing are only occasional.

1 - 3 months since you last smoked a cigarette

Circulation is still improving and at this point, a woman who is hoping to become pregnant will be glad to learn that her fertility level is now beginning to improve. In addition, the risk of having a premature birth is now dropping.

6 months since you quit

At this point, the psychological effects of giving up smoking are settling down and you will be finding it easier to cope with stressful situations without the need to have a cigarette. You will be producing even less mucous and the lungs and airways are much less inflamed or congested.

Nine months on

Your lungs have now healed significantly and the cilia in the lungs have totally recovered from the damage caused by smoking. Chest infections are now less frequent as a result of the cilia being back to full function.

Year one - well done!

The risk of developing heart disease is now half what it was while you smoked. This in itself is a dramatic boost to your health but in addition, lung function and capacity will be dramatically improved.

Three years since the last cigarette

Your risk of having a heart attack has now dropped back to that of a non-smoker. Smoking restricts the blood supply and so oxygen to the heart in conjy=unctio with causing damage to the linings of the blood vessels which increases the risk of a person suffering a heart attack. These effects are now reversed.

Five years since quitting smoking

By this time your risk of getting lung cancer has dropped to half that of a nonsmoker. The body has now healed sufficiently for the previously constricted blood vessels to widen up again which will allow the blood to flow more freely. As a result, the blood is less likely to clot and cause a stroke or heart attack.

10 years since quitting smoking

Your chance of developing lung cancer is now the same as that of a non-smoker and any pre-cancerous cells have now been replaced with healthy ones. The risk of developing all smoking-related illness has now dropped as is the risk of developing the following types of cancer:

  • Oesophagus
  • Mouth
  • Bladder
  • Kidneys
  • Pancreas

Fifteen years since you quit!

The risk of developing heart disease has dropped to that of a nonsmoker as has the risk of developing pancreatic cancer.

Twenty years since the last cigarette

At the twenty-year mark, any risks associated with any disease are now the same risks as those of a person who has never smoked.

Quitting cold turkey

Quitting cold turkey describes the process of quitting smoking without the help of nicotine replacement therapy. Symptoms will be stronger but making a plan can help you through as can these tips:

  • Choose a date to quit and stick to it. In an ideal world, make this on a relatively stress-free day
  • Make a list of all the reasons that you want to quit. When withdrawal is making you tempted to smoke, look at this list and it will remind you why you mustn’t give in
  • Remind yourself regularly that withdrawal is a temporary state and it will pass
  • Get support from your friends and family
  • Join a support group

Treatment for nicotine withdrawal

There are a variety of options out there to help you through the worst withdrawal periods. They are as follows:

Nicotine replacement therapy

There are a variety of different forms of nicotine replacement products. They will release a small amount of nicotine into your system in order to minimise cravings and withdrawal symptoms. They include:

  • Nicotine patches - small, plaster-like patches that are infused with nicotine which is absorbed through the skin. The body is weaned off nicotine by reducing the strength of the patch used
  • Nicotine gum - chewing gum which is infused with nicotine is chewed when feeling nicotine cravings
  • Nicotine sprays and inhalers - these can be used whenever the quitter experiences a nicotine craving. Nicotine from inhalers is absorbed through the lungs and nicotine in sprays is absorbed through the lining of the mouth
  • A variety of nicotine lozenges and pills are available to take when cravings are bad

Medications to help with quitting

There are types of medication that can be prescribed by your GP that will help with the process of giving up smoking:

  • Varenicline (Champix) - this drug works in two ways, it reduces the pleasure felt as a result of smoking as well as helping to reduce the nicotine cravings
    • There is evidence to suggest that this is particularly effective in helping a person to give up smoking but it is not suitable for everyone:
      • Children under eighteen years of age
      • Women who are pregnant or breastfeeding
      • People with severe kidney problems
    • There are also side effects associated with this medication:
      • Nausea and vomiting
      • Insomnia
      • Dry mouth
      • Diarrhoea or constipation
      • Headaches
      • Drowsiness
      • Dizziness
  • Bupropion (Zyban) - this medication was originally designed as an antidepressant but has been found to help people to give up smoking
  • Nortriptyline - this is an older antidepressant drug that also alleviates nicotine withdrawal

Psychological and behavioural treatment

There have been a variety of treatments shown to be useful in treating addictions. They include counselling therapy, hypnotherapy, cognitive behavioural therapy (CBT) and neuro linguistic programming (NLP).

The aim of these treatments is to modify the thought processes surrounding addiction.


Overcoming nicotine withdrawal is arguably the most difficult hurdle to overcome whilst quitting smoking and many people have attempted to quit on more than one occasion.

It is important to plan the process thoroughly, avoid any triggers which may make you fall off the wagon and seek help from friends and family, their support will be invaluable

Giving up is the single most important thing you can do for yourself. It may not be easy but the benefits are massive. The sooner you have your last cigarette, the sooner you will be an ex-smoker enjoying all the benefits that it brings!

Buy effective treatment for smoking cessation from Dr Felix, your trusted online pharmacy


We’re a fully regulated UK pharmacy, with qualified
British doctors and happy customers.

Orders not approved will be fully refunded

Your trusted online doctor

Order now for delivery on Wednesday