Understanding Nicotine Withdrawal

We know about chronic bronchitis, smokers’ cough and recurring colds. Friends and family members are nagging, scolding, joking and cajoling. Enough, we say, let’s quit!

Most people who smoke started when they were young. They probably knew that smoking could cause health problems down the road, but that road seemed awfully long, and those health problems seemed far away. More important back then was bonding with friends and being cool. Perhaps smoking gave young people a distinction and definition that they needed.

Now we have traveled a ways down the road, and we have seen acquaintances, friends and perhaps even ourselves coping with smoking-related illness. We understand more clearly the health consequences of smoking: greater risks of heart disease, cancer and emphysema. We know about chronic bronchitis, smokers’ cough and recurring colds. Friends and family members are nagging, scolding, joking and cajoling. Enough, we say, let’s quit!

Why do some smokers have a harder time quitting?

No one knows why some people have little trouble quitting, while others struggle for years and make many attempts to quit smoking before they are successful. Many factors are involved. One of the most important is how dependent your body has become on nicotine. In general, the longer you have been a smoker and the more cigarettes you smoke per day, the greater the chance that quitting will be difficult.

Your personal situation may also affect how difficult it is for you to quit. For example, if your close friends smoke and you are often in places and situations where people are smoking, it may be more challenging for you to kick the habit. If you smoke to take a break from work, you will need to find new ways to take a break and relax. People recovering from an addiction to alcohol or other drugs may find quitting especially difficult. If smoking has helped you through recovery from a more serious addiction, you may be worried about an alcohol or drug relapse if you quit smoking.

Some people may have a difficult time quitting because nicotine withdrawal symptoms are especially troublesome for them. These symptoms include not only strong cravings for cigarettes, but emotional symptoms as well, such as depression, anger, irritability, tension and anxiety. Some people have difficulty concentrating and feel more restless than usual. Difficulty sleeping, increased hunger and weight gain can also occur during nicotine withdrawal.

What happens during nicotine withdrawal?

The physical and psychological effects of nicotine are not totally understood, but scientists do know that nicotine has powerful effects on our bodies and brains. Like other strongly addictive drugs (nicotine is as chemically addictive as heroin), nicotine affects brain chemicals, called neurotransmitters, that affect our moods and our emotions. For example, nicotine may disrupt the regulation of serotonin, the neurotransmitter affected by many antidepressants. When nicotine is withdrawn, changes in brain chemistry lead to powerful cravings and emotional distress.


What are some ways to cope with feelings of stress during quitting?

Since negative feelings are the main reason people begin smoking again after they have tried to quit, it is very important for people who want to quit to figure out ways to reduce this stress. Many people find that smoking cessation programs are extremely helpful. Check with your doctor to find one near you. These programs help you design a quit-smoking strategy that will work for you.

Studies have found that people who exercise regularly have better success at quitting smoking than non-exercisers. Exercise can relieve feelings of depression, anxiety, irritability and tension. Exercise helps combat the negative health effects of smoking, especially by reducing risk for heart disease. Regular physical activity improves sleep quality and helps to prevent or reduce weight gain that sometimes occurs when quitting smoking.

What exercise is best?

If you have had difficulty quitting smoking in the past, consider exercising almost every day for maximal stress reduction. Find some kind of moderately-vigorous exercise that is convenient and enjoyable. Exercise that occurs in a nonsmoking environment, such as a fitness center, can be especially reinforcing. Getting a friend to walk or do some other form of exercise with you can help you stick to your plans to exercise. Check with your doctor to be sure exercise is safe for you, and get some advice from an exercise instructor or personal trainer if you need help.

Barbara A. Brehm, Ed.D., is professor of exercise and sport studies at Smith College, Northampton, Mass.

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