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Nicotine is the main addictive substance in tobacco. When a person uses tobacco, many parts of the body get used to having nicotine in them. When a person quits tobacco, they also quit nicotine and will likely have withdrawal from it. This is because the body has to get used to not having nicotine.
Withdrawal can be uncomfortable. Withdrawal from nicotine has 2 parts – the physical and the mental. The physical symptoms are annoying but not life-threatening. Still, if you’re not ready to resist them, they can tempt you to go back to smoking or chewing. Nicotine replacement and other medicines can help reduce many of these symptoms. Most people who use tobacco find that the mental part of quitting is the bigger challenge.
If you’ve been using tobacco for any length of time, it has become linked with a lot of the things you do – waking up in the morning, eating, reading, watching TV, and drinking coffee, for example. It will take time to “un-link” tobacco from these activities. This is why, even if you’re using nicotine replacement therapy, you may still have strong urges to smoke or chew.
One way to overcome urges or cravings is to notice and identify rationalizations as they come up. A rationalization is a mistaken thought that seems to make sense at the time, but isn’t based on reality. If you choose to believe in such a thought even for a short time, it can serve as a way to justify using tobacco. If you’ve tried to quit before, you might recognize many of these common rationalizations:
You may be able to add more to the list. As you go through the first few days without tobacco, write down rationalizations as they come up and recognize them for what they are – messages that can trick you into going back to smoking/chewing. Look out for them, because they always show up when you’re trying to quit. After you write down the thought, let it go and move on. Be ready with a distraction, a plan of action, and other ways to re-direct your thoughts.
You can also reward yourself in ways that don’t cost money: Visit a park or go to the library. Check local news listings for museums, community centers, and colleges that have free classes, exhibits, films, and other things to do.
Maybe you’ve quit many times before. If so, you know that staying quit is the final, longest, and most important stage of the process. You can use the same methods as you did to help you through withdrawal. Think ahead to those times when you may be tempted to smoke or chew, and plan on how you’ll use other ways to cope with those situations.
More dangerous, perhaps, are the unexpected strong desires to smoke or chew that can sometimes happen months or even years after you’ve quit. Rationalizations can show up then, too. To get through these without relapse, try these:
What if you do smoke or chew? Here’s the difference between a slip and a relapse: A slip is a one-time mistake that’s quickly corrected. A relapse is going back to using tobacco. You can use the slip as an excuse to go back, or you can look at what went wrong and renew your commitment to staying away from cigarettes and/or smokeless tobacco for good.
Even if you do relapse, try not to get too discouraged. Very few people are able to quit for good on the first try. In fact, it takes most people several tries. What’s important is figuring out what helped you when you tried to quit and what worked against you. You can use this information to make a stronger attempt at quitting the next time.
Some people who smoked cigarettes gain weight when they quit. For some, this is enough of a concern to make them decide not to quit. But the weight gain that follows quitting is usually small. Even when nothing is done to try to prevent it, the average gain is less than 10 pounds in most studies. Remember that it’s much more dangerous to keep smoking than it is to gain a small amount of weight.
You’re more likely to quit tobacco for good if you deal with the smoking first, and then later take steps to lose weight. While you’re quitting, try to focus on ways to help you stay healthy, rather than on your weight. Stressing about your weight may make it harder to quit. Get regular physical activity. Try to follow a healthy eating pattern, which includes a variety of colorful fruits and vegetables and whole grains, and which avoids or limits red and processed meats, sugar-sweetened beverages, and highly processed foods. Be sure to drink plenty of water and get enough sleep.
Try walking. Walking is a great way to be physically active and increase your chances of not smoking. Walking can help you by:
All most people need for walking is a pair of comfortable shoes is, and most people can walk pretty much anytime. You can use these ideas as starting points and come up with more of your own:
The American Cancer Society recommends getting 150-300 minutes of moderate intensity or 75-150 minutes of vigorous physical activity each week. Getting more is even better. But if you don’t already exercise regularly, check with your health care provider before you start.
Tobacco users often mention stress as one of the reasons for going back to using. Stress is part of life for people who use tobacco and for those who don’t. The difference is that people who use tobacco use nicotine to help cope with stress and unpleasant emotions. When quitting, you have to learn new ways of handling stress. Nicotine replacement can help for a while, but over the long term you’ll need other methods.
As mentioned before, physical activity is a good stress-reducer. It can also help with the short-term sense of depression or loss that some people have when they quit. There are also stress-management classes and self-help books. Check your community newspaper, library, or bookstore.
Spirituality can give you a sense of purpose and help you remember why you want to stay tobacco-free. Spiritual practices involve being part of something greater than yourself. For some, this includes things like religious practices, prayer, or church work. For others, it may involve meditation, music, being outside in nature, creative work, or volunteering to help others.
Think about how you can deal with stress and not use tobacco. Look at the resources around you and plan on how you will handle the stressors that will come your way.
It’s important for your health care provider to know if you use any type of tobacco now or have in the past, so that you’ll get the preventive health care you need. It’s well known that using tobacco puts you at risk for certain health-related illnesses, so part of your health care should focus on related screening and preventive measures to help you stay as healthy as possible.
For instance, regularly check the inside of your mouth for any changes. Have your doctor or dentist look at your mouth, tongue, gums, and throat if you have any changes or problems. This way, you may find changes such as leukoplakia (white patches on the mouth tissues) early, and maybe prevent oral cancer or find it at a stage that’s easier to treat.
Smokers should also be aware of any of these changes:
Any of these could be signs of lung cancer or a number of other lung problems and should be reported to a health care provider right away.
Lung cancer screening is recommended for certain people who smoke or used to smoke, but don't have any signs or symptoms. This includes people who are between the ages of 50 and 80, formerly smoked heavily or currently smoke, and are in fairly good health. There are guidelines on the use of low-dose computed tomography (CT) to screen for lung cancer in certain people at high risk. If this describes you, talk with your health care provider about your lung cancer risk and the potential benefits and risks of lung cancer screening.
Remember that tobacco users have a higher risk for many other cancers, too. If you have any health concerns that may be related to your tobacco use, please see a health care provider as soon as possible. Taking care of yourself and getting treatment for problems early on will give you the best chance for successful treatment. But the best way to take care of yourself and decrease your risk for life-threatening health problems is to quit using tobacco.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Centers for Disease Control and Prevention. Quit smoking. Available at https://www.cdc.gov/tobacco/quit_smoking/index.htm. Accessed October 10., 2020.
National Cancer Institute. How to handle withdrawal symptoms and triggers when you decide to quit smoking. Available at https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/withdrawal-fact-sheet. Accessed on October 10, 2020..
Rigotti N. Overview of smoking cessation management in adults. UpToDate. 2020.
Rock CL, Thomson C, Gansler T, et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin. 2020;70(4). doi:10.3322/caac.21591. Accessed at https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21591 on June 9, 2020.
Smokefree.gov. Understanding withdrawal. Available at https://smokefree.gov/challenges-when-quitting/withdrawal/understanding-withdrawal. Accessed October 10, 2020.
Smoking Cessation Leadership Center. Behavioral health: Fact sheets and reports. Available at https://smokingcessationleadership.ucsf.edu/behavioral-health/resources/factsheets. Accessed October 10, 2020.
US Preventive Services Task Force. Tobacco smoking cessation in adults, including pregnant women: Behavioral and pharmacotherapy interventions. 2015. Available at https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions. Accessed October 10, 2020.
Last Revised: August 27, 2021