Giving up is the easy part, the true test is making sure 'your last cigarette' is exactly that. Often it is said that a smoker prolongs the decision to quit because they fear the withdrawal symptoms that follow. These changes are the body's way of reacting to the disposal of nicotine and toxic substances contained within a cigarette. It is a necessary part of the cleansing process.

Some people suffer with physical and emotional after-effects more than others and are prone to a relapse, whereas a lucky minority will need no assistance in staying smoke-free. So, what makes quitting so tough?

What makes quitting smoking so difficult?

You are aware by now that nicotine is an addictive substance and responsible for many of the problems brought on by inhaling cigarette smoke. As your body grows accustomed to the effects of smoking it begins to rely on the intake of nicotine to function normally each day. A good example of this is feeling irritable or anxious when you haven't had a cigarette in some time. Your body establishes a pattern between smoking and pleasure, thus going without a cigarette becomes a difficult situation to manage.

You'll notice through experience that smokers never start on 20 cigarettes a day, but gradually build up and become hooked. This may explain why regular smokers do not social smokers, because as your body adjusts to nicotine, it will need more.

Understanding withdrawal symptoms

As with any major lifestyle change, such as abstinence from alcohol or certain foods, it's the first two weeks of giving up cigarettes that are so vital in whether an ex-smoker stays on course or falls into a relapse. In as little as four hours the first signs of nicotine withdrawal kick in, physically, mentally and emotionally.

Physical symptoms include headache, nausea, sweating, sore throats, and weight gain. Such unexpected changes can be unpleasant and stressful at first, but the good news is that they will pass with time. Most withdrawal symptoms peak 48 hours after quitting and disappear after several months.

Mental and emotional symptoms develop mainly because of the tension that builds during the withdrawal period. Insomnia, irritability, anxiety and depression are the worst offenders. Unfortunately, almost all smokers will suffer one or more mental or emotional symptoms shortly after quitting. There are however many support and advice services you can turn to if the urge to smoke is too overwhelming.

Shown below is a table that illustrates the changes that take place within the body after quitting smoking.

Changes within the body after nicotine withdrawal
Withdrawal symptom	Duration	Proportion of ex-smokers affected
Increased appetite	More than 10 weeks	70%
Nicotine cravings	More than 2 weeks	70%
Depression	Less than 4 weeks	60%
Restlessness	Less than 4 weeks	60%
Poor concentration	Less than 2 weeks	60%
Irritability or aggression	Less than 4 weeks	50%
Sleep disruption	Less than 1 weeks	25%
Dizziness	Less than 48 hours	10%
Source: ASH, Stopping smoking: the benefits and aids to quitting

Smoking and weight gain

It's true that a person can put on weight in the first few months of giving up, but it isn't inevitable. Smoking suppresses the appetite and speeds up the metabolism and so in cutting your nicotine intake the natural order of things will be restored. In addition, your senses regain their potency as nicotine levels in the body decline, this can make food seem more appealing than before.

Gaining weight as a result of quitting smoking is seen as a good enough reason, especially in young women, to take up the habit again. As soon you giver in to this mindset the vicious circle of smoking and nicotine withdrawal regains control of your life. Finding ways to occupy your mind can be the difference between a smoke-free existence and the onset of long-term illness caused by smoking.

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