Withdrawal from nicotine

Alternative names
Nicotine withdrawal

Nicotine withdrawal involves irritability, headache, and craving associated with the sudden cessation or reduction of smoking or other tobacco use by a nicotine-dependent individual.

Causes, incidence, and risk factors

Almost all people who try to quit have some form of nicotine withdrawal. Generally, the longer one has been a smoker and the more nicotine and higher number of cigarettes consumed, the more likely it is that withdrawal symptoms will occur and the more severe they are likely to be.

Furthermore, people who are regular smokers tend to have particularly strong cravings and worsening of withdrawal symptoms at certain times, places, or situations associated with smoking.


The common symptoms include an intense craving for nicotine, tension, irritability, headaches, difficulty in concentrating, drowsiness and trouble in sleeping, increased appetite and weight gain.

A milder form of nicotine withdrawal involving some or all of these symptoms can occur when a smoker switches from regular to low-nicotine cigarettes or significantly cuts down.


There are several strategies for treating nicotine withdrawal. Nicotine supplementation in the form of gum or patch can be helpful. A variety of other agents have also been used with some success in maintaining abstinence and reducing withdrawal symptoms.

These agents include clonidine, antidepressants such as fluoxetine (Prozac), and buspirone (Buspar). Bupropion (Zyban) was approved in 1996 by the Food and Drug Administration as a treatment for nicotine dependence.

Using buproprion or nicotine replacement therapies alone doubles the odds of successful quitting. Using a combination of these methods increases success rates even more.

Buproprion and other antidepressants are not habit-forming, and may help reduce the possibility that nicotine withdrawal may lead to depression.

Since nicotine itself has antidepressant effects - and many smokers unknowingly smoke to self-medicate depression - use of antidepressants to relieve withdrawal may be particularly helpful.

A screening for depression may also be helpful to ensure proper treatment and increase the odds of maintaining abstinence.

People trying to quit smoking often become discouraged when they don’t succeed at first. Research shows that the more times you try, the more likely you are to succeed - so don’t give up!

Expectations (prognosis)

Nicotine withdrawal is short-lived and should pass in time. While withdrawal is the most uncomfortable part of quitting, the real challenge is beating long-term cravings and staying abstinent.


The most likely complication will be a return to smoking. Weight gain due to increased eating also may occur. This is much less unhealthy than continuing to smoke, and those with concerns about weight should address them while quitting so that they do not undermine their attempts to stay away from cigarettes.

Calling your health care provider

See your health care provider if you wish to stop smoking, or have already done so and are experiencing withdrawal symptoms. Your provider can help provide treatments, some of which are only available by prescription.

Johns Hopkins patient information

Last revised: December 3, 2012
by Levon Ter-Markosyan, D.M.D.

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