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Nicotine withdrawal is the effect that nicotine dependent people feel after they suppress nicotine intake in their daily basis. Short nicotine withdrawal affects brain normal functions; increase in appetite, depression and other symptoms. A smoking cessation program may improve one’s chance for success in quitting nicotine. However the most vital part of success is the willpower of people to stop smoking and the support of the patient’s family.

Definition
Nicotine withdrawal is the effect that nicotine dependent people feel after they suppress nicotine intake in their daily basis. Nicotine is an addictive substance that can be found most commonly in cigarettes, cigars, pipe tobacco or chewing tobacco. The symptoms of nicotine withdrawal usually appear approximately 2 or 3 hours after last dose of nicotine. The common symptoms for nicotine withdrawal are an intense craving for nicotine, anxiety, drowsiness, depression, headaches, increase in appetite, weight gain and concentration problems. Approximately 50% of the smokers who quit smoking usually relapse within a year of a successful cessation attempt. However the more attempts smoker makes, there is greater possibility to successfully quit smoking, because the attempts make people experience and adapt to the nicotine withdrawal symptoms.

Long-term and Short-term effects of withdrawal
Early effects of withdrawal from nicotine abuse include deficiencies in basal dopamine levels that might initiate drug seeking and taking. Additionally withdrawal of nicotine creates a hypo-functional state in the body which reflects in low brain activity. Other withdrawal symptoms from nicotine use that last for 3 to 7 days include: irritability, insomnia, acute headaches, restlessness, depressed mood, fatigue, increased appetite and dizziness .Also repeated exposures to nicotine, followed by withdrawal, induce a persistent increase in brain reward function and sensitivity to the nicotine and endurance of the effects in neuronal nicotinic receptors. Patients in the cessation program also experience craving for nicotine in the couple of months after quitting nicotine use There many other factors like depression that are affected by nicotine withdrawal, for example people who are more susceptible to depression use nicotine to mask this disease and when they quit nicotine use they face a 25% chance of becoming more depressed when they quit nicotine use, and this risk endures for 6-7 months.

Treatment
A smoking cessation program may improve one’s chance for success in quitting nicotine. This may be possible by following the fives A’S of smoking cessation: ask about tobacco use, advise quitting, assess willingness to make a quit attempt, Assist in quit attempt and arrange follow-up. Additionally nicotine replacement therapy may also be useful, this can be achieved by the use of nicotine patches which they indeed supply people with nicotine; however they help people prevent other diseases that the other tobacco substances may produce. Health care provider can also prescribe medicines to help smokers quit and prevent former smokers from starting again. Other pharmacotherapies include the use of bupropion (never use on patients who had seizures), varenicline, nortryptiline, clonidine or rimonabant.

The most important part for full nicotine withdrawal is willpower since its people´s will to quit smoking that makes the treatment successful. This can be achieved with the use of medication or other means. These methods include behavioral therapy which consists of developing a plan to set a date to end smoking with the support of the family and friends, anticipating obstacles that may occur during the treatment and removing all nicotine products in the patient’s environment. However the most important factor is the coping skills for the prevention of relapse, that’s why smokers need to develop behavioral and cognitive tools to prevents and solve any crisis. Clinicians use methods to help people stop this addiction like self-help materials and simple cognitive-behavioral therapy. These treatments help the smoker to detect “high-risk smoking situations”, manage stress, increase social support and develop activities to endure the nicotine withdrawal treatment. The combination of medical and behavioral treatments can increase the odds of total withdrawal of nicotine.