What is Nicotine Withdrawal?

Medically Reviewed by Sabrina Felson, MD on September 14, 2023
4 min read

Millions of people know from personal experience that smoking is a tough habit to kick. The reason is that nicotine is addictive. Even though nicotine’s high isn’t as dramatic as cocaine or heroin’s, it’s equally as addictive as those illegal drugs.

And nicotine withdrawal is very real. It’s why so many smokers try many times before they finally quit for good.

Nicotine affects all areas of your body, from your heart and blood vessels to your hormones, metabolism, and brain. When you don’t have it anymore, you go through withdrawal. You’ll physically crave that nicotine hit and become irritable if you can’t have it.

Nicotine withdrawal usually lasts only a month or so, but you could be fighting the mental battle against cigarettes for a long time.

Depending on how long you’ve smoked and how many cigarettes you have a day, symptoms of nicotine withdrawal can last anywhere from several days to several weeks.

Nicotine withdrawal involves physical, mental, and emotional symptoms. The first week, especially days 3 through 5, is always the worst. That’s when the nicotine has finally cleared out of your body and you’ll start getting headaches, cravings, and insomnia.

Most relapses happen within the first two weeks of quitting. If you can get over that hump, the physical symptoms will start to go away -- but you’ll still be dealing with mental and emotional challenges such as anxiety, depression, and irritability. Those will also taper off after a few weeks.

Everybody is different, and symptoms of withdrawal depend on many things, like how long and how many packs a day you’ve smoked. But for the most part, you can expect to have these common physical issues when you quit:

  • Appetite. Within a day or so of your last cigarette, your appetite will shoot up for a while. Cigarettes bind to receptors in the brain which augment the release of the neurotransmitters serotonin and dopamine from the brain. These two chemicals reduce hunger, so when they’re out of your system you’ll want to eat more. A lot of people also find that they eat to fill the time when they used to be smoking. And unfortunately, you might crave more carbs and sweets. The first 2 weeks are the worst -- most people gain about 5 to 10 pounds as they try to quit smoking.
  • Cravings. Nicotine cravings are the symptom you will deal with the longest, and they could start just 30 minutes after your last cigarette. Each craving will last only about 15 to 20 minutes, but they’ll keep coming. You’ll need to do your best to avoid triggers (like drinking alcohol or being around people who smoke) and find ways to get yourself through each craving.
  • Cough. Your respiratory system can’t clean itself very well when nicotine is around. As your body works it out, you’ll probably have a cough that could last for a few weeks.
  • Headaches anddizziness. These are usually on the mild side, and they’re often the first withdrawal symptom to show up and first to taper off.
  • Fatigue. Nicotine is a stimulant and perks you up, so you’ll probably feel tired without it. But you’ll also be restless and might have insomnia.
  • Constipation. For the first month, constipation can be another unpleasant side effect.

Like physical symptoms, how much you are affected mentally and emotionally when you quit smoking will be different for everybody. But assume you will deal with some or all of the following signs of withdrawal:

  • Anxiety. Smoking relieves stress, so your anxiety can skyrocket when you quit. It tends to pop up around 3 days in and can last a couple of weeks.
  • Depression. It can start the first day you quit but is generally gone within a month. But if you have a history of anxiety and/or depression, yours could last longer and you might need extra help from your doctor to manage your symptoms.
  • Irritability. You might have a short fuse -- even find yourself angry -- from time to time as you deal with the physical symptoms. It’s normal and should pass.
  • Mental fog. You’ll probably have a hard time concentrating as the nicotine wears off and leaves your body.

Here’s what you can expect after finishing your final cigarette:

  • 30 minutes to 4 hours: The effects from the nicotine will wear off and you’ll start to crave another cigarette.
  • 10 hours: You’ll be very restless, physically craving a cigarette, and wondering how to fill the time. You may feel sad and hopeless. 
  • 24 hours: Irritability kicks in and your appetite increases.
  • 2 days: You’ll have headaches as the nicotine leaves your system.
  • 3 days: The nicotine should be gone now. Your cravings taper off but anxiety will start to rise.
  • 1 week: You made it a week. Pat yourself on the back, you've made it through the worst. Keep avoiding those triggers.
  • 2 to 4 weeks: You still won’t have much energy, but the brain fog will be clearing up and your appetite will settle down. Your cough, depression, and anxiety will also improve.
  • 5 weeks on: The challenge now is keeping a strong mental game.