Why might a person feel worse right after quitting smoking?

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Common symptoms people experience can include:

• nicotine cravings
• difficulty concentrating
• restlessness
• depression
• frustration
• anger
• irritability
• insomnia
• anxiety
• increased appetite

Less common symptoms include:

• headache
• dizziness
• tiredness
• coughing
• constipation
• mouth ulcers

Nicotine is highly addictive. Approximately 80–90% of individuals who smoke develop a dependence on it.

Once someone stops smoking, their body and brain need time to become accustomed to not having nicotine. This time of adjustment may feel uncomfortable and can result in a cluster of symptoms typical of nicotine withdrawal.

The severity of nicotine withdrawal differs among people who quit smoking. According to an older 2015 study, it depends largely on the amount of nicotine consumption. However, some genetic changes may account for 29–53% of the variation in withdrawal symptoms.

How long after quitting smoking before a person feels “normal”?

Many people feel much better after 1 month. However, some may experience symptoms for several months.

The first 72 hours — or 3 days — after the last cigarette is the most difficult.

Below is what a person can expect:

• 4 hours after a cigarette: Nicotine levels in the body drop by 90%, so the body signals it is time for a cigarette. The cravings start, and an individual may feel fidgety.
• 10 hours after a cigarette: When getting ready for bed at the end of the first day, some people feel very hungry because their blood sugar levels are lower than usual at this point. They may also feel tingling in the feet and hands, indicating that circulation is returning to these body parts.
• 24 hours after a cigarette: Someone may feel the urge to have a cigarette upon awakening. They may also feel anxious and irritable.
• 48 hours after a cigarette: Anxiety or depression may start. Headaches may also manifest. However, they should disappear within the next 24 hours. Also, cravings recur often.
• 72 hours after a cigarette: The frequency of cravings decreases considerably, and the duration should not exceed 5 minutes. Heavy smokers may experience a sore throat, excessive coughing, and chest tightness.
• 7–21 days after a cigarette: Cravings occur daily. However, they are occasional and less intense. Most people experience increased appetite and lower energy. Someone may also have constipation and flatulence.

More than 70% of individuals who quit smoking will experience cravings and increased appetite. These are the most persistent symptoms and may linger for longer than 4 weeks.

Additionally, around 60% of people experience lingering symptoms that impact their mental health — such as irritability, anxiety, or trouble concentrating — this can last 4 weeks and then gradually reduce.

The Centers for Disease Control and Prevention (CDC) provide the following coping recommendations for various symptoms:

• Experiencing cravings: Quit-smoking medications may help. It is also beneficial to remember the reasons for quitting and that a person never has to give in to cravings.
• Feeling restless or jumpy: Walking or other physical activity can reduce these symptoms. Cutting back on coffee, tea, and other caffeinated beverages may help, too.
• Feeling irritated or grouchy: Remember that this stems from the body adjusting to being without nicotine. Take a few deep breaths and think about the benefits of quitting.
• Having trouble sleeping: Avoid caffeinated beverages in the late afternoon and evening. Engage in other practices that promote better sleep, such as exercising earlier in the day and avoiding electronics in bed.
• Having difficulty concentrating: If possible, limit activities that necessitate considerable concentration for a while.
• Feeling sad or anxious: Regular exercise, connecting with others, and doing something enjoyable may help.
• Feeling hungry and gaining weight: If someone snacks between meals, they should choose healthy, low calorie options, such as carrot or celery sticks. Physical activity can help also prevent weight gain.

Learn more about smoking cessation aids here.

Quitting smoking is one of the most important things a person can do to improve their health as it leads to a reduction in the risk of premature death. It also has other very significant long-term benefits.

Cardiovascular benefits

These include:

• Cholesterol levels quickly improve.
• Inflammation and the tendency to develop blood clots decrease.
• Within 1–2 years, the risk of a heart attack drops markedly.
• Within 3–6 years, the likelihood of heart artery disease declines by 50%.
• Within 5–10 years, the risk of stroke decreases.

Respiratory health benefits

These include:

• Lung function may improve.
• The risk of developing chronic obstructive pulmonary disease (COPD) and respiratory infections — such as pneumonia and bronchitis — reduces. COPD is a group of conditions that may cause airways to narrow and breathing difficulties.
• Within 1–12 months, coughing and shortness of breath decline.

Cancer benefits

These include:

• The risk of 12 different cancers decreases.
• Within 5–10 years, the added likelihood of cancers of the voice box, mouth, and throat drops by 50%.
• Within 10–15 years, the added risk of lung cancer drops by 50%.
• Within 20 years, the following can happen:
  • The added risk of cervical cancer declines by 50%.
  • Pancreatic cancer risk decreases almost to the risk of a person who does not smoke.
  • The risk of cancers affecting the voice box, mouth, and throat reduces to almost the risk of an individual who does not smoke.

Reproductive health benefits

These include:

• Quitting smoking early in pregnancy can remove the negative effects of smoking on fetal growth.
• Quitting during pregnancy lowers the likelihood of delivering a low-birth-weight baby.
• Quitting before or early in pregnancy may reduce the risk of preterm — or early — delivery.

Nicotine withdrawal can cause symptoms such as cravings, anxiety, and insomnia. It helps to remember that people often feel much better after 1 month.

During withdrawal, several coping strategies can help with symptoms. For example, exercising can elevate mood, and avoiding caffeinated beverages late in the day can improve sleep.

It is worth persevering through nicotine withdrawal because of the long-term health benefits of quitting smoking. These include a significantly lower risk of heart attacks, strokes, lung disease, and certain cancers.