Nicotine Withdrawal: Symptoms and How Long It Lasts
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026
Nicotine withdrawal peaks in the first 3 days and usually lasts 3 to 4 weeks. Symptoms, coping tips and which quit-smoking medicines Spain funds.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Nicotine withdrawal usually starts within a few hours of your last cigarette. It is strongest in the first week, especially the first 3 days. On average it lasts 3 to 4 weeks, says the NHS. Cravings, irritability, poor sleep and hunger are common. They fade, and medicines can make them easier.
- Symptoms start a few hours after the last cigarette and peak in the first 3 days.
- Most people feel them for 3 to 4 weeks. Some feel them for a few months.
- Cravings always pass. Low mood that lasts more than a couple of weeks needs a doctor.
- In Spain, nicotine patches, gum, lozenges and sprays are sold without a prescription. Cytisinicline, varenicline and bupropion need one.
- The public health system (SNS) funds those three medicines under set conditions, one attempt a year.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
What are the symptoms of nicotine withdrawal?
Nicotine is addictive. When it stops, the brain needs time to adjust. MedlinePlus and the NHS list these symptoms:
- Strong urges or cravings to smoke.
- Feeling irritable, frustrated or angry.
- Feeling restless, tense or anxious.
- Low mood.
- Trouble concentrating.
- Trouble sleeping, and bad dreams.
- Headaches.
- More appetite, and some weight gain.
People who smoked for longer, or smoked more each day, are more likely to get symptoms, says MedlinePlus. In Spain you will hear it called síndrome de abstinencia.
How long does nicotine withdrawal last?
| When | What to expect |
|---|---|
| First few hours | Withdrawal starts. MedlinePlus says within 2 to 3 hours. |
| Days 1 to 3 | Usually the hardest days. MedlinePlus places the peak at 2 to 3 days. |
| First week | Symptoms are still at their strongest (NHS). |
| Weeks 2 to 4 | Most symptoms ease. On average they last 3 to 4 weeks (NHS). |
| Months | Some people feel them for a few months. Cravings can return with stress or old routines. |
The CDC adds that anxiety and low mood are often lower after a few months smoke-free. So the hard part is real, but it is short.
How can I cope with cravings and withdrawal?
A craving feels strong, but it passes. These tips come from the NHS and the CDC:
- Move. A quick burst of activity takes the edge off a craving.
- Keep your mouth busy. Chew carrots, celery or sugar-free gum.
- Breathe slowly. In through your nose, then gently out through your mouth.
- Avoid triggers. For the first 28 days, stay away from places that make you want to smoke.
- Cut back on coffee, especially later in the day. Caffeine lasts longer in your body after you quit.
- Protect your sleep. Keep regular hours. Avoid screens, heavy meals and alcohol before bed.
- Write down your reasons and keep them where you can see them.
Which medicines help with nicotine withdrawal?
Medicines ease cravings and withdrawal. That gives you a better chance of staying smoke-free. The options in Spain:
- Nicotine replacement (terapia sustitutiva de nicotina): patches, gum, lozenges and mouth spray. CIMA lists them as sold without a prescription. The NHS says combining a fast form, such as a spray, with a patch works well.
- Cytisinicline (citisiniclina; Todacitan, Recigarum): a prescription tablet. The UK now offers it as cytisine.
- Varenicline (Champix and generics; Chantix in the US): a prescription tablet.
- Bupropion (Zyntabac): a prescription tablet.
A Cochrane review found that cytisine and varenicline both help more people quit than a placebo. Varenicline helped more people than bupropion or a single form of nicotine replacement. It may work about as well as two forms of nicotine replacement used together. Each medicine has its own cautions, so a doctor checks your health first.
Finding the first weeks hard, or want to talk about quit-smoking medicines?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He goes through your smoking history, your health and your options, and agrees a plan with you.
Does the Spanish health system pay for quit-smoking medicines?
Partly. The Ministry of Health has funded bupropion and varenicline since 2020. Cytisinicline has been funded since February 2023. Varenicline was dropped in 2021 after supply problems and funded again from June 2024, according to a 2026 guide from Castilla y León's health service.
Funding has conditions. You must:
- Be enrolled in a quit-smoking support programme in the public system.
- Show you want to quit, with at least one attempt in the last year.
- Smoke 10 or more cigarettes a day.
- Score 7 or more on the Fagerström dependence test.
The system funds one attempt per person per year. Each prescription covers one pack, and a doctor checks progress before the next. Nicotine replacement is not funded: you pay the pharmacy price. A private prescription is not covered by this public funding, so ask your public health centre (centro de salud) about its programme too.
Is it safe to quit when pregnant, or with heart or mental health problems?
- Pregnancy: quitting is one of the best things you can do. The NHS says you can use nicotine replacement in pregnancy if it helps you stop, and that it is much better than smoking. Speak to a midwife, GP or pharmacist first. The Spanish label for cytisinicline (Todacitan) rules it out in pregnancy and breastfeeding.
- Heart problems: the same label rules it out after a recent heart attack or stroke, and with unstable angina or some heart rhythm problems.
- Mental health: low mood, and rarely thoughts of suicide, can be part of withdrawal itself. The label asks doctors to watch closely in anyone with a mental health history, with or without medicine.
When should I get help?
See a doctor if:
- Low mood or anxiety has not improved after a couple of weeks (CDC), or feels hard to manage.
- You cannot sleep for weeks.
- You have tried to quit before and gone back to smoking.
- You take regular medicines and plan to quit. A doctor can check if anything needs changing.
Call 112 if you feel you might harm yourself and are in danger now. In Spain you can also call 024, the free Ministry of Health line for suicidal thoughts, at any time of day or night.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Ask how much you smoke, how soon after waking, and how past attempts went.
- Check your health, your mood and the medicines you take.
- Explain the options, with or without medicine, and what fits you.
- Tell you how the public programme works if you may qualify for funding.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace a consultation with your doctor.
Frequently asked questions
How long does nicotine withdrawal last?
On average 3 to 4 weeks, according to the NHS. It is strongest in the first week, especially the first 3 days. Some people feel symptoms for a few months.
What is the worst day of nicotine withdrawal?
Usually day 2 or 3. MedlinePlus says symptoms peak about 2 to 3 days after you stop.
Can nicotine withdrawal cause anxiety or low mood?
Yes. Anxiety, irritability and low mood are common in the first weeks. The CDC says they are often lower after a few months smoke-free. See a doctor if low mood lasts more than a couple of weeks.
Can I buy nicotine patches without a prescription in Spain?
Yes. Nicotine patches, gum, lozenges and mouth spray are sold in pharmacies without a prescription. They are not funded by the public system.
Is cytisinicline free in Spain?
It is funded by the public system for people in a quit-smoking programme who meet set conditions, with one funded attempt per year. A private prescription is not covered by public funding.
Why am I so hungry after quitting smoking?
More appetite is a common withdrawal symptom. Healthy snacks, regular meals and daily activity help keep weight gain small.
Sources
- NHS Better Health: Managing nicotine withdrawal symptoms
- MedlinePlus: Nicotine and tobacco
- CDC: 7 common withdrawal symptoms
- Cochrane review: Nicotine receptor partial agonists for smoking cessation (2023)
- Ministerio de Sanidad: public funding of quit-smoking medicines (in Spanish)
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
