How do I fight cigarette cravings?

DEAR DOCTOR K:

I’m doing my best to quit smoking, but I am really struggling with the symptoms of withdrawal. Do you have any advice?

DEAR READER:

You’re not alone. Beating an addiction is not easy, but you can do it. And there are new treatments today that make it easier to do.

Physical withdrawal symptoms make stopping any addictive drug uncomfortable. Nicotine — the addictive drug in tobacco — is one of the most difficult to beat. Withdrawal symptoms are the reason many people don’t manage to quit smoking. These include intense cravings, irritability, fatigue and inability to concentrate. They can begin within a few hours of the last cigarette. (Below, I’ve put a list of the most common withdrawal symptoms and ways to cope with them.)

It might help to know that withdrawal symptoms are worst during the first two or three days after quitting. Remind yourself that if you make it over this initial hurdle, you’ve already done the hardest part. Your symptoms will gradually improve over the next month or more.

When you start to crave a cigarette, try to wait out the urge by distracting yourself or taking a brisk walk. Nicotine replacement therapy (NRT) can also help you get through the cravings. Nicotine replacement products are available as patches, gums, nasal sprays, inhalers and lozenges. Two medications, varenicline (Chantix) and bupropion (Wellbutrin, Zyban) decrease the craving for nicotine and also decrease withdrawal symptoms. Ask your doctor about these drugs.

Here are some more tips for preventing and dealing with urges:

  • When you feel the urge to smoke, delay. If you can hang in there for six to 18 hours, the craving will eventually go away.
  • If you feel tense, try meditation, deep breathing or yoga.
  • Begin an exercise program. It will relieve tension, promote good sleep and help control weight gain. Walking for 30 minutes a day can really help. Many of my patients have told me that regular moderate exercise — particularly at times when they felt cravings — was extremely helpful.
  • Stay away from situations where you will be with smokers or exposed to secondhand smoke.
  • Avoid foods, beverages and situations that you strongly associate with having cigarettes. Typical examples include drinking alcohol, having a cup of coffee and going out to a bar.
  • When you feel the urge to smoke, replace it with several deep, slow breaths followed by a drink of water.
  • Do not get discouraged if your first attempt is not successful. Realize that most successful ex-smokers quit for good only after several attempts.
  • If you slip and have a cigarette, make a decision to quit again immediately.
  • Some people find that alternative therapies, such as hypnosis or acupuncture, can help.

So although it is not easy to do, you can quit smoking: There are more ex-smokers in the United States today than there are smokers.

How to Fight Common Withdrawal Symptoms
Symptom Cause Duration Relief
Craving for cigarette Body’s craving for nicotine Most intense during first week but can linger for months Wait out the urge; distract yourself; take a brisk walk.
Irritability, impatience Body’s craving for nicotine 2 to 4 weeks Exercise; take hot baths; use relaxation techniques; avoid caffeine.
Insomnia Body’s craving for nicotine temporarily reduces time spent in deep sleep 2 to 4 weeks Avoid caffeine after 6 p.m.; use relaxation techniques; exercise.
Fatigue Body adjusting to lack of stimulation from nicotine 2 to 4 weeks Take naps; do not push yourself.
Lack of concentration Body adjusting to lack of stimulation from nicotine A few weeks Reduce workload; avoid stress.
Hunger Craving for cigarettes may be confused with hunger pangs Up to several weeks Drink water or low-calorie drinks; eat low-calorie snacks.
Coughing, dry throat, nasal drip Body ridding itself of mucus in lungs and airways Several weeks Drink plenty of fluids; use cough drops.
Constipation, gas Intestinal movement decreases with lack of nicotine 1 to 2 weeks Drink plenty of fluids; add fiber to diet; exercise.