Withdrawal

Module 1 - Preparation and the first few days

Learn to manage withdrawal symptoms with specific strategies for each symptom and understand the “pink cloud” phenomenon that can appear after the first few days of quitting smoking.

Withdrawal processes do not have to be linear. Linear improvements are those in which, gradually, cumulatively and at a steady pace, progress is made without setbacks.

However, psychological processes—and smoking cessation is one—can be discontinuous, so some people skip phases, or experience some simultaneously, go backwards, or take 2 steps at once.

Detoxification is the process by which nicotine leaves the body. It usually lasts between 1 and 3 days. After that you will be free of the drug. However, addiction does not disappear that quickly, as it leaves a mark on the brain, such as in memory, the reward circuit and nicotinic receptors.

Withdrawal syndrome usually does not last more than 28 days, but it may last less, depending on the person. This syndrome refers to the clinical picture that arises in response to deprivation of the substance, that is, the lack of the drug. Symptoms may include:

  • Nervousness, anxiety, difficulty concentrating. We recommend:

    • Walking, going for a stroll.
    • Having a bath with warm or hot water. Cold showers are useful because they provide wellbeing and relaxation afterwards, but they can increase the sensation of breath being cut off; therefore, if anxiety is very intense and includes breathing difficulties or tightness in the chest, we do not recommend them.
    • Relaxation techniques: massages, or guided breathing exercises with QuitNow. Inhalation gives us the perception of gaining inner space, the brief intermediate apnoea generates a sense of inner silence, and exhalation promotes the impression of release. While you follow the breathing, notice which of the 3 intervals you feel most in tune with your body and most aligned with your purpose. Connect with that feeling.
    • Distraction techniques: colouring mandalas, making up stories about the lives of unknown passers-by, etc.
    • Putting the feeling into words with close people and talking about everyday or trivial topics.
    • Accepting and normalising that it is an unpleasant internal state, but a temporary one.

  • Irritability, bad mood, anger. Anger is a very energetic emotion that predisposes you to action, and sometimes to defence or aggression. It is an emotion that needs to be expressed. We advise:

    • Intensive physical exercise.
    • Anger releases: hitting a cushion, shouting with your mouth covered by a cushion or inside a closed car, hitting the mattress with a pool noodle, stamping on single-use plastic cups, etc. Ideally there should be no other people nearby, and if there are, let them know that you are going to do an exercise that may be noisy, but without any intention to intimidate, threaten or break anything of value. After physical releases, it is usually easier to verbalise the emotion in an assertive and less aggressive way.
    • Putting your anger into words with other people, preferably when its intensity has decreased, or when you have done the release.
    • Writing a new letter to tobacco, emphasising the anger you feel.

  • Insomnia. We recommend:

    • Avoiding stimulants (caffeine, theine, sugar, nicotine).
    • Relaxation techniques (as in the previous section).
    • Adding relaxing drinks or supplements to your diet: consult the options in a pharmacy.
    • Doing more exercise, preferably in the morning rather than in the afternoon or evening.
    • Maintaining good sleep hygiene:
      • Going to bed and getting up at the same time every day.
      • Not doing activities in bed other than sleeping.
      • Not staying in bed for a long time if you cannot sleep.
      • Not using screens and dimming the lights 1 hour before going to bed.
      • Having dinner at least 2 hours before going to bed.

  • Constipation. We suggest:

    • A fibre-rich diet.
    • Drinking water.
    • Eating fruit.

  • Hunger. We advise:

    • Drinking water.
    • Chewing sugar-free gum.
    • Eating fruit or nuts.

These symptoms will gradually diminish, their intensity will decrease, and they will become more spaced out over time. The urge to smoke is not eternal.

Although withdrawal syndrome decreases, the consequences of psychological dependence may last longer, for example, the association of certain moments or activities with a cigarette, and the urge to smoke, the longing, etc.

In the first days of abstinence, we suggest you talk to yourself: remember the benefits you are achieving for your health.

“I’m doing it”, “One more day”. Acknowledge how difficult what you are doing is, avoid judging yourself for wanting to smoke and do not treat yourself as weak: “This is so hard…”.

A phenomenon we call the pink cloud may also appear. This is a euphoric feeling of control after the first days or weeks of abstinence. It is that experience of success, of victory, that brings vitality, joy and pride, when you feel you have achieved an important challenge. It is the emotional experience that follows the attainment of a goal or the overcoming of a difficulty. The risk is that, even if you have made progress, the addiction has probably not yet been overcome.

It is advisable to hold on to the satisfaction without it turning into a euphoria that is too intense to sustain. You deserve to feel victorious, but you must remember that the process may be longer and that the pink cloud and its euphoria can create a false sense of control, of having won too soon, which may make you let your guard down and bring you closer to a relapse.

Summary