Nicotine

Nicotine causes the release of natural chemicals in the brain – and the brain begins to make strong connections between smoking and pleasure. The first rush of nicotine hits the brain within a few seconds of smoking and you feel more alert and focused. The level of nicotine begins falling quickly over the next 45 minutes. As this happens you start to feel withdrawal symptoms and become irritable, nervous and restless until you smoke again.

Over time, your brain becomes used to a certain amount of nicotine and you usually smoke enough to maintain that level.

Short term effects

Tobacco smoke is a toxic mix of more than 7,000 chemicals. These reach your lungs quickly each time you inhale. As the blood carries the toxins throughout your body it effects nearly every organ - and sometimes the damage is immediate.

For example, tobacco smoke quickly harms blood vessels and makes your blood more likely to clot. It begins to damage the lining of your lungs and causes a chronic cough, shortness of breath and higher risk of asthma and bronchitis.

Long term effects

Although people think of cancer when they think about smoking, tobacco harms even more people through heart disease and stroke than through cancer. Smoking damages nearly every organ in the body - heart, blood vessels, lungs, eyes, mouth, reproductive organs, bones, bladder, and digestive organs It strongly effects breathing, can cause birth complications, and weakens the immune system overall.

Nicotine withdrawal

Nicotine is such a powerful drug that even after smoking for only a few weeks you will still go through withdrawal when you quit. Depending on how long you’ve smoked and how many cigarettes you smoked a day, withdrawal can last from several days to several weeks.

The first 3-5 days are always the most intense. Over that time nicotine finally clears out of your body and you’ll start having symptoms such as headaches, strong cravings, cough and trouble sleeping. As these symptoms decrease, you’ll be dealing with the emotional side of quitting including feeling anxious, sad, angry and irritable. These should ease after a few weeks.

But quitting is worth it all for your long term health.

This simple tool can help you look at your smoking habits.

There are many good treatments to help you stop smoking and stay smoke-free. These include:

FDA-approved medications such as nicotine replacement therapy, bupropion and varenicline plus short-term counseling. Research shows that smokers who use counseling plus medication quit at higher rates.

Counseling uses different techniques to help you get ready to quit, recognize triggers, and learn coping and relaxation skills to deal with stress and cravings.

Motivational Interviewing is a type of counseling that focuses on overcoming doubts about quitting so it is easier to make healthy changes

Cognitive behavioral therapy (CBT) helps you recognize triggers and learn how to prevent relapse.

Mindfulness training is a type of meditation that helps you become more aware of your feelings, thoughts and cravings – but less affected by them.

Telephone quit lines, text messaging, apps and social media support are all easily available, keep you focused on quitting and help you do it.

Online treatment provides convenient and expert support on your computer or mobile phone. Below is a no-cost example.

Our TREATMENTS section has many recovery choices to help you find what works best for you.

Also see our PROGRAMS & SUPPORT section for ongoing ways to support your recovery.

There are a variety of medications to help you stop smoking. Some contain nicotine and some are nicotine-free. These include nicotine replacement products (such as gum and patches) and medications such as Bupropion and Varenicline.

It is also important to get support from others, either in 12-step or other peer-based recovery program, an app, or online support.

What they do:

Nicotine Replacement Therapy (NRT) gradually provides your body with smaller doses of nicotine, without the toxic chemicals in cigarette smoke. This helps relieve the withdrawal symptoms and cravings that can often lead to relapse. Many people use NRT in the early stages of quitting. If you have a severe addiction to nicotine you can use NRT for a longer time.

Bupropion and Varenicline
Bupropion (immediate-release and extended-release) was originally approved as an antidepressant. It stimulates the release of dopamine, the brain's natural pleasure chemical, and blocks nicotine receptors.

Varenicline is a smoking-cessation aid that helps reduce nicotine cravings by stimulating nicotine receptors in the brain but less strongly than nicotine.

Do they work?

Studies show that bupropion can increase quit rates and is as effective as NRT. Varenicline also boosts the odds of successfully quitting – and some studies find it is more effective than NRT or bupropion alone.

Combining medications has shown success. A combination of varenicline and NRT, especially using a nicotine patch before quitting, may work better than varenicline alone.

Adding bupropion to NRT also improves quit rates. For smokers who aren’t able to cut down significantly by using the NRT patch, combining extended-release bupropion and varenicline can be effective, especially in men who are very dependent on nicotine.

NICOTINE REPLACEMENT PRODUCTS

What they do:  provide smaller doses of nicotine without smoking and without the dangerous chemicals in cigarettes

How they work:  They help lessen the body's craving for nicotine and reduce withdrawal symptoms. They come in several forms: gum, patch, nasal spray, inhaler, lozenge and e-cigarettes.

Side effects:

• Gum (dizziness, headache, nausea)
• Nasal spray (runny nose, throat irritation, coughing, sneezing, watery eyes)
• Patch (dizziness, headache, nausea, vomiting, diarrhea)
• Inhaler (mouth and throat irritation, runny nose, sinus pressure, headache, gas)
• Lozenge (heartburn, sore throat, mouth problems, irregular or fast heart beat)

For a more complete list of side effects, visit this NIH page and scroll down to Nicotine.

Click here for more information on nicotine replacement products

Availability:  Nicotine gum, patch, lozenges and e-cigarettes (vaping) can be bought at most local drug stores.

Using e-cigarettes (vaping) to stop smoking
Some people use e-cigarettes to stop smoking. But vaping is also bad for your health. Regular cigarettes have about 7,000 chemicals, many that are toxic. E-cigarettes don’t have as many chemicals, but they do have heavy metals and toxic chemicals – which means you are exposing yourself to all kinds of chemicals that are unhealthy and not safe.

According to the CDC, vaping is linked to much higher risks of heart attack, coronary artery disease, lung diseases, strokes and death.

Overall, vaping is not the best tool to quit smoking. It is linked to high risks for heart attack, coronary artery disease, lung diseases, strokes and death. And while they help some people quit, they also increase the risk of relapse in former smokers.

Health alert about vaping
The growing number of cases of severe lung disease and death in people who use e-cigarettes highlights their danger. Experts believe this is most likely due to a toxin in the inhaled vapors.

Teenagers and young adults who vape also face a much higher risk of COVID-19. A Stanford University study found that they were five to seven times more likely to be infected than those who did not vape.

Click here for more information on e-cigarettes.

Availability:  Nicotine gum, patch, lozenges and E-cigarettes (vaping) can be bought at most local drug stores.

BUPROPION (brand names Zyban and Wellbutrin)

What it does:  This antidepressant medication can also be used to help some people quit smoking.

How it works:  Although it does not contain nicotine, it can help you resist the urge to smoke. It is often started 1 or 2 weeks before you stop smoking and can be used for up to 6 months to prevent relapse.

Side effects:  Insomnia, dry mouth, dizziness, headache, nausea, constipation. Serious side effects include seizures and thinking about or planning suicide.

For a more complete list of side effects, visit this NIH page.

Availability:  By prescription from a physician

VARENICLINE (Chantix)

What it does:  Varenicline is considered a smoking cessation aid. It blocks the pleasant effects of nicotine and reduces nicotine withdrawal symptoms and cravings. This helps prevent relapse by blocking the effects of nicotine if you begin to smoke again.

How it works:  Studies show that the drug stimulates dopamine (the brain's natural pleasure chemical) and blocks nicotine receptors.

Side effects:  Nausea, vomiting, gas, heartburn, vomiting, headache.

For a more complete list of side effects, visit this NIH page.

Availability:  Physician prescription

Note:  As of June 2021 Chantix is no longer on the market but the generic version (varenicline) is still available.

Warning:  Some people have had changes in behavior, mood and thoughts of suicide while taking Chantix. Its role in causing these changes is not clear. In 2016 the FDA stated that the risk of these serious side effects is lower than they thought. But the risk is still there, especially in those being treated for depression, anxiety disorders, or schizophrenia.

In 2016 the FDA stated that the risk of these serious side effects is lower than they thought.  But the risk is still present, especially in those being treated for depression, anxiety disorders, or schizophrenia.

If you have any of the following symptoms, stop taking Chantix and call your doctor right away: thoughts of killing yourself; new or worsening depression, anxiety, or panic attacks; restlessness; angry or violent behavior;  excited mood (mania); hallucinations; feeling that people are against you; feeling confused; or any other sudden or unusual changes in behavior, thinking, or mood.

You should also contact your health care professional if you have new or worsening symptoms of heart disease, such as chest pain, shortness of breath, calf pain when walking, or sudden weakness, numbness, or difficulty speaking.

Click here for more information on this medication.

Support Groups

Apps

Mobile apps give you another tool for recovery. They offer practical support that is affordable, private and always available.

Apps can track sober time, help you manage triggers and emotions, find and share meetings, contact your sponsor discretely, keep you motivated, connect you with a recovery community, and more.

Many good apps are available for both the iPhone/iPad and Google Android phones. Of note, it is estimated that 7 out of 10 free apps use ads. This can be distracting and because ads use data they can cost you money in the long run. Many apps offer a premium version as an in-app purchase which has extra useful features and usually no ads. You can try out the free version of the app and upgrade to premium if it is helping you.

BUILD A SOBER NETWORK

Connect with people socially who are also working on quitting smoking for support, sharing and encouragement.

For Smoking and vaping

ONLINE MEETING AND CHAT ROOMS

A chat room lets you communicate in real time on the Internet. Everyone who is logged in sees what you are typing, but two people can still have a private chat on the side. People from any location can join in, making them an ideal format for groups of people.

Chat meetings are chat rooms with a chairperson who introduces topics for people to address. Chat meetings are scheduled in advance for a specific period of time.

NicA Online meetings often use Zoom. The group sets them up, gets a meeting code and password and sends the information to all members of the group. Or the group sends the information to Central Office, who post the info online.

HOLISTIC APPROACHES

Smoking is not just a physical addiction. It becomes a part of your daily life and a way you use to cope. This makes it a difficult habit to break.

When you stop smoking you often feel restless, angry, sad and anxious. These feelings can sometimes last for quite a while as you get used to being a non-smoker.

For those in recovery, holistic approaches work best when they are part of professional treatment and they are often part of addiction recovery programs. Studies show that success rates improve strongly when holistic approaches are included in treatment.

Holistic therapies can ease this process. They can help you:

• Reduce stress
• Feel more relaxed
• Improve your mood
• Break the “habit” of smoking
• Reduce withdrawal symptoms and cravings

Holistic approaches can help you in the early stages of quitting and give you tools long term to build your physical and emotional health.

Yoga, meditation and exercise help lower stress and ease withdrawal symptoms. This makes it easier to cope with emotions tied to tobacco use and lowers the risk of relapse.

Through mindful awareness you begin to notice your thoughts and feelings but not react to them in the usual way. You learn how to focus on the present, stay centered and keep your mood steady. This helps you become aware of your cravings and triggers without being overwhelmed by them.

Relaxation techniques such as guided imagery, meditation, deep breathing, and hypnotherapy are simple tools that are easy to learn. You can use them whenever you need help staying calm, centered and focused on your goals.

Therapies such as acupuncture and massage can help rebalance your body, reduce anxiety, treat withdrawal symptoms, and improve your energy and mood.

Part of a holistic approach also includes being in nature. Finding a safe, quiet and natural place can refresh the soul and provide the space to explore whatever form of spirituality moves you.

Holistic approaches work best when combined with nicotine replacement therapies, behavior change techniques to learn better ways to cope, and social support. This combination has the highest long-term quit rates. Studies show that success rates improve strongly when holistic approaches are part of the treatment.

To learn more about specific holistic therapies and their place in recovery visit our HOLISTIC SUPPORT section.