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Joseph Gladyshev
Because the nicotine in tobacco is highly addictive, people who quit may experience nicotine withdrawal symptoms, especially if they have smoked or used other tobacco products heavily for many years. Although many of the examples in this fact sheet refer to smoking, the tips are relevant for those who are quitting the use of any tobacco product.
The urge to smoke will come and go. You may start experiencing cravings within an hour or two after your last use of tobacco, and you may have them frequently for the next few days or weeks. As time passes, the cravings will get farther apart. However, you may have occasional mild cravings months or years after you quit.
Studies have found that the most common negative feelings associated with quitting are feelings of anger, frustration, and irritability. These negative feelings peak within 1 week of quitting and may last 2 to 4 weeks (1).
You may want to analyze situations in which watching others smoke triggers an urge in you to smoke. Figure out what it is about those situations that makes you want to smoke. Is it because you associate feeling happy with being around other smokers? Or is there something special about the situations, such as being around the people you usually smoked with? Is it tempting to join others for routine smoke breaks?
Most smokers report that one reason they smoke is to handle stress. Smoking cigarettes causes temporary changes in your brain chemistry that can cause you to experience decreased anxiety, enhanced pleasure, and alert relaxation. Once you stop smoking and your brain chemistry returns to normal, you may become more aware of stress.
Food often tastes better after you quit smoking, and you may have a bigger appetite. Expect to want to smoke after meals. Your desire to smoke after meals may depend on whether you are alone, with other smokers, or with nonsmokers.
You may be used to smoking when drinking beer, wine, liquor, or mixed drinks. When you quit smoking, you may feel a strong urge to smoke when you drink alcohol. Know this up front if you are going to drink because your ability to resist triggers to smoke may be impaired under the influence of alcohol.
It is far less harmful for a person to get nicotine from a nicotine replacement product than from cigarettes because tobacco smoke contains many toxic and cancer-causing substances. Long-term use of nicotine replacement products has not been associated with any serious harmful effects (12). However, nicotine replacement products are not recommended for use by people who are pregnant or trying to become pregnant.
The evidence to date is inconclusive about whether e-cigarettes can help with smoking cessation (10). In addition, FDA has not approved any e-cigarette as a smoking cessation therapy. Currently, people who smoke are advised to use evidence-based quit strategies, including FDA-approved cessation medication and smoking cessation counseling.
Almost everyone who smokes regularly has cravings or urges to smoke when they quit. They may be mild or can sometimes feel overwhelming. Figuring out how to deal with cravings is one of the most important things you can do to stay successful.
Regular doses of nicotine lead to changes in the brain, which then lead to nicotine withdrawal symptoms when the supply of nicotine decreases. Smoking temporarily reduces these withdrawal symptoms and can therefore reinforce the habit. This cycle is how most smokers become nicotine dependent.
Nicotine stimulates the release of the chemical dopamine in the brain. Dopamine is involved in triggering positive feelings. It is often found to be low in people with depression, who may then use cigarettes to temporarily increase their dopamine supply. However, smoking encourages the brain to switch off its mechanism for making dopamine, so in the long term, the supply decreases, which in turn prompts people to smoke more.
Stopping smoking can be easier with the support of family and friends. If you live with people who smoke, or have friends who smoke, suggest to them that you give up together. If other household members smoke, encourage them not to smoke around you or leave their cigarettes, ashtrays or lighters where you will see them.
Nicotine replacement therapy (NRT), anti-depressants and other medication have all been shown to help smokers without mental health problems stop smoking. They may also be helpful for people with depression or schizophrenia. NRT appears to be more effective when combined with talking therapy.
Individual, group or telephone counselling can help people to stop smoking. Talking therapies can help people change their behaviour by thinking and acting more positively. Many counselling programmes use the techniques of cognitive behavioural therapy (CBT) and social skills development. Research has shown that CBT may be particularly effective in smokers with or without mental health problems.
You may experience headaches, nausea, irritability, anxiety, craving cigarettes, feeling miserable, difficulty concentrating, increased appetite and drowsiness. Drinking more fresh fruit juice or water, eating more high-fibre foods and reducing caffeine and refined sugar in your diet can all help you cope with withdrawal symptoms.
The smoke from any fire (forest, brush, crop, structure, tires, waste or wood burning) releases particles and chemicals when carbon-containing materials burns. All smoke contains carbon monoxide, carbon dioxide, and particulate matter (PM or soot). Smoke can also contain different chemicals, like aldehydes, acid gases, sulfur dioxide, nitrogen oxides, polycyclic aromatic hydrocarbons (PAHs), benzene, toluene, styrene, metals, and dioxins. The particles and chemicals in smoke varies depending on what is burning, how much oxygen is available, and the temperature.
Inhaling smoke for a short time can cause immediate effects. Smoke irritates the eyes, nose, and throat, and its odor can be nauseating. Studies show that some people exposed to heavy smoke have temporary changes in lung function that makes breathing more difficult. People can also have changes in heart function. Carbon monoxide and small particles are two common substances in smoke responsible for these health effects.
Inhaling carbon monoxide decreases the body's oxygen supply and causes headaches, reduces alertness, and aggravates a heart condition known as angina. Fine particles from smoke (fine particulate matter, or PM 2.5) can travel deeply into the respiratory tract, reaching the lungs. Inhaling fine particles can cause a variety of health effects, like respiratory irritation and shortness of breath. It can also worsen medical conditions such as asthma and heart disease. Physical exertion can make these health effects worse. Once exposure stops, symptoms may last for a couple of days, but will likely improve.
Anyone with symptoms from smoke or bad air quality should contact their health care provider. You may also want to talk with a health care provider about your health risk when smokey air or poor air quality cannot be avoided.
Exposure to smoke can also increase your risk for long-term (chronic) health effects. People who live in areas with higher fine particulate air pollution and those who breathe air containing fine particles over long periods have a higher risk of cardiovascular disease and mortality. Frequent exposure to smoke even for brief periods can also increase your risk for long-term health effects. Scientists have studied the risk of long-term health effects in firefighters who frequently breathe smoke. Some of these show a higher rate of cancer, lung disease, and cardiovascular disease, while others do not.
Anyone who starts using tobacco can become addicted to nicotine. Studies show that smoking is most likely to become a habit during the teen years. The younger you are when you begin to smoke, the more likely you are to become addicted to nicotine.
Researchers are also looking at other chemicals in tobacco that make it hard to quit. In the brains of animals, tobacco smoke causes chemical changes that are not fully explained by the effects of nicotine.
The average amount of nicotine in one regular cigarette is about 1 to 2 milligrams (mg). The amount you actually take in depends on how you smoke, how many puffs you take, how deeply you inhale, and other factors.
Most full-size cigars have as much nicotine as several cigarettes. Cigarettes contain an average of about 8 milligrams (mg) of nicotine, but only deliver about 1 to 2 mg of nicotine. Many popular brands of larger cigars have between 100 and 200 mg, or even as many as 444 mg of nicotine. The amount of nicotine a cigar delivers to a person who smokes can vary a great deal, even among people smoking the same type of cigar. How much nicotine is taken in depends on things like:
After nicotine is absorbed into the bloodstream, it makes its way to the brain. Within seconds of inhaling cigarette smoke or vape mist, or using chewing tobacco, nicotine causes the release of dopamine in the brain, which gives people a good feeling. Over time, the brain begins to crave that feeling from nicotine and people need to use more and more tobacco to get that same good feeling.
Many health issues come from long-term nicotine use, ranging from poorer blood circulation and heart problems to digestive system issues. Pregnant women who smoke also put their baby at risk of developing serious health problems during the pregnancy and later on in life.
A variety of Nicotine Replacement Therapy (NRT) products, in the form of gums, patches, lozenges and sprays, can replace the nicotine that smokers crave. These products can also get rid of the physical withdrawal symptoms most people have when they try to quit.
When marijuana is smoked, THC and other chemicals in the plant pass from the lungs into the bloodstream, which rapidly carries them throughout the body to the brain. The person begins to experience effects almost immediately (see "How does marijuana produce its effects?"). Many people experience a pleasant euphoria and sense of relaxation. Other common effects, which may vary dramatically among different people, include heightened sensory perception (e.g., brighter colors), laughter, altered perception of time, and increased appetite.
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