What are other Names for this Condition? (Also known as/Synonyms)

• Withdrawal from Nicotine

What is Nicotine Withdrawal? (Definition/Background Information)

• Nicotine Withdrawal is a condition experienced when a nicotine dependent individual ceases the use of nicotine products. Because the dependence of nicotine can cause mood altering effects in the brain, Nicotine Withdrawal occurs when nicotine is no longer provided
• Nicotine causes chemical changes in the brain and triggers mood changes, which typically lead to dependence. The severity of the withdrawal symptoms is mostly based on the severity of nicotine dependence
• The signs and symptoms of Nicotine Withdrawal include anxiety, irritability, weight gain, and craving of nicotine-containing products. In individuals with severe symptoms, the condition may also lead to depression
• The treatment for Nicotine Withdrawal include medications, nicotine replacement therapy, and psychotherapy (such as behavioral therapy). The support of friends and family members is helpful in avoiding any relapses
• The prognosis of Nicotine Withdrawal is mostly based on the severity of addiction to nicotine. Most withdrawal symptoms stop 2 weeks after quitting nicotine products, in a majority of individuals

Who gets Nicotine Withdrawal? (Age and Sex Distribution)

• Nicotine Withdrawal is typically observed in those who discontinue the use of nicotine (or tobacco-based products), following a long period of regular use
• Younger individuals are more likely to experience severe symptoms of Nicotine Withdrawal as compared to older adults
• No gender, racial, ethnic, or geographical predominance have been observed

What are the Risk Factors for Nicotine Withdrawal? (Predisposing Factors)

• Following a chronic and regular use of nicotine (addiction), the discontinuation of nicotine, places one at risk for withdrawal symptoms
• The genetic makeup may play a role in the severity of the withdrawal symptoms observed; some individuals experience more withdrawal symptoms compared to others

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Nicotine Withdrawal? (Etiology)

• Nicotine Withdrawal occurs after stopping the long-term use of nicotine-containing products, such as cigarettes or other tobacco-based products
• The more dependent an individual is on nicotine, the more severe the effects/symptoms of Nicotine Withdrawal would be

What are the Signs and Symptoms of Nicotine Withdrawal?

The severity of the signs and symptoms varies from individual to individual. The common signs and symptoms of Nicotine Withdrawal may include:

• Craving of nicotine products
• Feeling sad, irritable
• Trouble concentrating, sleeping
• Weight gain
• Anxiety

The less common signs and symptoms include:

• Dizziness
• Blurred vision
• Depression
• Slower hear rate (bradycardia)

For most smokers, Nicotine Withdrawal symptoms stop after about 2 weeks of quitting smoking.

How is Nicotine Withdrawal Diagnosed?

Nicotine Withdrawal can be diagnosed following a physical examination and a careful evaluation of the individual’s medical history.

• A history of nicotine use is very important
• The signs of Nicotine Withdrawal can be observed by the individual who is affected, as well as by those who are around/close to the individual. Hence, family members should prompt an individual to seek care, if the signs and symptoms are severe

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are possible Complications of Nicotine Withdrawal?

The potential complications of Nicotine Withdrawal may include:

• Severe depression
• Weight gain
• Relapse of nicotine dependence

How is Nicotine Withdrawal Treated?

The treatment for Nicotine Withdrawal is based on the affected individual’s signs and symptoms and clinical history. The treatment options can be classified into psychotherapy and administration of medication and may include the following:

• Psychotherapy: It can be either individual-based or group therapy. The techniques may include the following:
  • Cognitive behavioral therapy (CBT): It is a form of psychotherapy that focuses on changing harmful thinking patterns, feelings, and behavior
  • Dialectic behavior therapy: This form of psychotherapy is for individuals with severe personality disturbances. It is designed to help change one’s patterns of behavior that are not helpful, such as self-harm, suicidal thinking, and substance abuse
  • Interpersonal psychotherapy (IPT): This form of psychotherapy focuses on interpersonal issues. The targets of IPT include improving interpersonal communication and increased social support
• Nicotine replacement therapy by using nicotine patches, gums, lozenges, and inhalers. Nicotine replacement is meant to provide nicotine without the other harmful substances present in tobacco products
• Medications to help quit smoking include bupropion, varenicline, nortriptyline, clonidine, and rimonabant
• Smoking cessation programs: Counseling and support groups are available to support the affected individual and help avoid nicotine products
• Close monitoring of the individual after the symptoms subside is very important in preventing a relapse. Any early signs of relapse should be treated immediately

Note:

• Although the some of the above-mentioned products contain nicotine, they are used to slowly ease the individual away from heavy nicotine use
• The (above) treatment measures also help ease the symptoms of withdrawal experienced
• The severity of nicotine dependence, along with the body metabolism of an individual, will impact the choice of treatment used
• Consultation with a healthcare provider may improve the chances of successfully ending nicotine dependence

How can Nicotine Withdrawal be Prevented?

Nicotine Withdrawal is prevented through early abstinence from, or a complete avoidance of tobacco and tobacco-based products. The following measures may be beneficial in preventing recurrence of the condition:

• Surround yourself with friends and family members who can understand and support you; this can help avoid relapses
• Always keep follow-up appointments with your healthcare provider

What is the Prognosis of Nicotine Withdrawal? (Outcomes/Resolutions)

• In general, the prognosis of Nicotine Withdrawal depends on the severity of the signs and symptoms
• In many, Nicotine Withdrawal symptoms usually stop after 2 weeks of discontinuing tobacco use. For individuals, who were more dependent on the substance, it may take longer
• The chances of relapse are high in most of the cases; but, with firm determination and effective support, it can be overcome

Additional and Relevant Useful Information for Nicotine Withdrawal:

• Ending nicotine dependence typically triggers Nicotine Withdrawal symptoms, making it very difficult to stop nicotine use. The use of smokeless tobacco does not eliminate the risk of developing nicotine dependence or the associated complications
• Nicotine is as addictive as heroin, 1,000 times more potent than alcohol, and 5-10 times more potent than cocaine/morphine. It has been noted that nicotine dependence is one of the most difficult addictions to break
• Nicotine Withdrawal symptoms are common in those that use nicotine products regularly. While it is difficult to stop the use of the products due to withdrawal symptoms, it is important to be persistent and stop nicotine/tobacco use. Reaching out to friends and family members for help is highly recommended