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Nicotine withdrawal


Alternative names

Withdrawal from nicotine

Definition

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. See smoking - tips on how to quit and smoking hazards .

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 (smoke at regular times each day) will tend to have particularly strong cravings and exacerbation of withdrawal symptoms at times and in places or situations where they usually smoke.

Symptoms

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

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.

Treatment

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

These agents include clonidine; antidepressants, particularly 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 and using a combination of these methods increases success rates even more.

Buproprion and other antidepressants are not habit-forming, and since nicotine withdrawal can increase the odds of depression, and can help reduce this possibility.

Since nicotine itself has antidepressant effects and many smokers unknowingly smoke to self-medicate depression, use of such medications can be particularly helpful for such people.

A screening for depression may be useful as well 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 on its own. While withdrawal is the most uncomfortable part of quitting, the real challenge is beating cravings in the long run and staying abstinent.

Complications

The most likely complication will be a return to smoking. Weight gain due to increased eating also can 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.

Update Date: 6/2/2002

Yvette Cruz, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT
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