Fig. 11Stage 4, First weeks
is the window in which nicotine withdrawal usually peaks, inside a first week that is usually the worst.
SourceNCI, Handling Nicotine Withdrawal and Triggers When You Decide To Quit Tobacco2022
Nicotine withdrawal: when symptoms start, peak and fade
Withdrawal usually begins within hours, peaks in the first days and eases over a few weeks, but the NCI, NHS and NIDA all say the timing differs from person to person.
The first days after the last cigarette are the part of quitting that most people dread, and the dread has some basis. The US National Cancer Institute (NCI) says nicotine withdrawal symptoms are usually worst during the first week after quitting, peaking during the first 3 days, and that their intensity usually drops over the first month. Those are typical patterns, not promises, and the same sources say some people feel symptoms for months. This page lays out what the NCI, NHS, NIDA, CDC and Smokefree.gov report about when symptoms start, when they peak and when they fade, and why one person's timeline can look very different from another's.
What withdrawal is
Withdrawal is the body's reaction to doing without a drug it has become used to. Smokefree.gov describes nicotine withdrawal as the temporary discomfort your body feels when you no longer have nicotine in your system. It adds that the discomfort is not harmful. The CDC puts it more bluntly: nicotine withdrawal cannot hurt you, unless you give in and have a cigarette. If you want the science of why nicotine creates dependence in the first place, see how nicotine dependence works.
The NCI lists the common symptoms as nicotine cravings, anger, frustration and irritability, difficulty concentrating, insomnia, restlessness, anxiety, depression, and hunger or increased appetite. Less common ones include headaches, fatigue, dizziness, coughing, mouth ulcers and constipation. The NHS gives a similar list and notes that symptoms can be mild for some people and harder for others.
When symptoms start
Withdrawal can begin quickly. NIDA, the US National Institute on Drug Abuse, says symptoms may begin within a few hours after the last cigarette, and the NHS agrees that withdrawal can start within a few hours. The NCI says cravings may start within an hour or two of the last use of tobacco. Anxiety, if it occurs, can appear within 24 hours, and mild low mood usually begins within the first day.
When symptoms peak
The agencies broadly agree on the peak. NIDA says withdrawal symptoms peak within the first few days of the last cigarette. The NHS says symptoms are usually strongest during the first week, especially in the first 3 days. Smokefree.gov says symptoms are strongest in the first days or weeks for most people, and that the first week after quitting is when someone is at most risk of slipping and smoking again. For the reasons slips happen and what to do next, see relapse and slips.
When symptoms fade
Here the sources give slightly different ranges, which fits the fact that people differ. Smokefree.gov says the worst withdrawal symptoms usually last less than two weeks. NIDA says symptoms usually subside within a few weeks. The NHS says that on average symptoms last 3 to 4 weeks, but that some people feel them for longer, sometimes for a few months. The NCI says occasional mild cravings can come months or even years after quitting.
The table below collects the NCI's timing for individual symptoms. It describes typical patterns reported in studies the NCI cites, not a schedule any one person will follow exactly.
| Symptom | Onset the NCI describes | Typical course |
|---|---|---|
| Cravings | Within an hour or two of last use | Frequent for days or weeks, then farther apart |
| Anxiety | Within 24 hours | Builds over the first 3 days, may last several weeks |
| Anger, frustration, irritability | No onset time given | Peak within 1 week, may last 2 to 4 weeks |
| Mild low mood | Usually within the first day | Continues for a couple of weeks, usually gone within a month |
Why timing differs between people
Several factors move the timeline. The NCI says withdrawal is more likely to be noticeable in people who have smoked or used other tobacco products heavily for many years, and that people with a history of depression often have more severe withdrawal symptoms. NIDA reports that the severity of withdrawal appears to be influenced by a person's genes. Smokefree.gov sums it up: withdrawal is different for everyone. Habit cues matter as well. NIDA notes that the feel, smell and sight of a cigarette and the ritual of smoking can make withdrawal or craving worse, and that cravings often persist because of those cues even when medicines ease the physical side.
The NHS adds one encouraging data point. It says that once someone reaches 28 days smoke free, they are 5 times more likely to stay quit for good.
What the agencies suggest for getting through it
All of the public sources point in the same direction. Quit-smoking medicines can reduce withdrawal symptoms, according to Smokefree.gov, the NCI and the NHS; the options are covered in nicotine replacement therapy and prescription medicines for quitting. The product label and a pharmacist or clinician set the dose. Beyond medicines, the sources suggest staying active, avoiding triggers for the first weeks, keeping the mouth and hands busy, and reminding yourself that cravings pass. The CDC points out that caffeine lasts longer in the body after quitting, so cutting back on coffee, tea and other caffeinated drinks can help with jumpiness and sleep.
Mood deserves a closer watch. Smokefree.gov and the CDC both say some people feel anxious, sad or depressed after quitting, particularly if they have had those symptoms before, and the NCI says major depression after quitting is rare in people with no history of it. Our page on quitting smoking and mental health covers this in more detail.
See a doctor or pharmacist if symptoms are severe, if low mood or anxiety worsens or does not lift, if you are pregnant, have heart disease or a mental health condition, or take other medicines. If you or someone close to you has thoughts of self-harm, contact local emergency or crisis services right away. In the US, the number 1-800-QUIT-NOW connects callers to their state quitline for free coaching, as described on our page about counselling and quitlines.
Frequently asked questions
How long does nicotine withdrawal last?
The NHS says symptoms last 3 to 4 weeks on average, with some people feeling them for longer, sometimes a few months. Smokefree.gov says the worst symptoms usually last less than two weeks. NIDA says they usually subside within a few weeks.
When is withdrawal at its worst?
The NCI says symptoms usually peak during the first 3 days and are worst in the first week. NIDA says the peak comes within the first few days.
Can withdrawal symptoms come back later?
Cravings can. The NCI says occasional mild cravings may appear months or even years after quitting.
The short version
Withdrawal usually starts within hours, peaks within the first few days and eases over roughly the first month, but timing varies, and some people have symptoms for months. The first week carries the highest risk of going back to smoking. A clinician or pharmacist can help when symptoms are hard to manage, when mood worsens, or when pregnancy, heart disease, a mental health condition or other medicines are part of the picture.