Dealing with withdrawal symptoms: what is effective apart from medical treatments

Weight gain, stress, anxiety… Smokers who want to quit smoking dread the withdrawal symptoms. They can be mitigated by using medication, such as nicotine substitutes, but can also be relieved through physical activity, mind-body psychotherapy, but also through using electronic cigarettes and cognitive behavioural therapy.

Smoking withdrawal symptoms: physical activity is an effective way to relieve them

Physical activity or exercise has a complementary role to medical treatments in kicking the smoking habit. A number of studies show that practising a sports activity does reduce withdrawal symptoms. A systematic review of the literature as well as a recent meta-analysis show that even occasional physical exercise significantly reduces withdrawal symptoms, presenting negative effects such as tension, irritability, stress, difficulties in concentration, insomnia, as well as craving (irresistible urge to smoke). (1) One five-minute session of physical activity is just as efficient in reducing the sensation of craving as an oral nicotine substitute. (2) Only one study showed that regular physical activity was able to control weight gain at the end of treatment for quitting smoking. (3) However, a meta-analysis concluded that regular physical exercise whilst quitting significantly reduced weight gain (-2.07 kg) 12 months after quitting, in comparison to control groups who were not doing any exercise. (4)

Physical activity of low to medium intensity can be recommended as an aid in reducing withdrawal symptoms and craving.

Recommendations for physical activity whilst quitting smoking (5):

Physical activity should be started at the beginning of the quitting process, must last for eight weeks, should be practised two to three times per week and represent a total of 1h20 per week.  

Two types of physical activity significantly reduce craving in the short term: endurance sports (walking, running, cycling) and resistance sports (weights and abdominals). (6) A medium level of intensity is sufficient.

Smoking withdrawal symptoms: yoga and meditation techniques

Mind-body therapies (yoga, tai-chi, Qigong, relaxation methods or meditation…) have been shown to lead to a reduction of symptoms linked to emotional problems, in particular in cases of anxiety and depression as well as insomnia. (7) (8) (9) (10) (11) (12) Studies have been made to find out how these therapies aid in quitting smoking. The results seem promising.

A study carried out in 2012 found that the practice of specific yoga exercises seemed to reduce the symptoms of tobacco withdrawal, based on a six-month period, with re-evaluations after three and six months. (13) A review of the literature showed that yoga, meditation, Qigong, tai chi and breathing techniques seemed to reduce craving in the short-term. (14) However, the authors of the review stated that due to scarce evidence (4 studies) and the weak methodology of the available studies, it would be necessary to carry out further, random clinical trials with a control group and with a higher number of participants.

A random study with a control group showed that meditation using the Body Scan technique could be useful in managing the negative effects of quitting smoking. Body Scan sessions of 10 minutes reduced craving in the short-term and a saw a reduction in withdrawal symptoms such as anxiety, tension and nervousness. (15)

Recent studies on addiction suggest that the practice of mindfulness meditation could also reduce craving or the uncontrollable urge to smoke. One study from 2013 showed that mindfulness meditation could have an effect on the cognitive, neurobiological and emotional aspects of craving. (16) A review of the literature from 2015 concluded that the practice of mindfulness meditation seemed to have positive effects on mental health, which could help sustain abstinence from smoking. The authors concluded that further studies are necessary.

Undesirable effects of giving up smoking: effectiveness of electronic cigarettes

A number of studies have shown that electronic cigarettes are effective in keeping craving under control. One study published recently found that electronic cigarettes effectively reduce craving, especially in the case of those with the most addiction. (17) The best results are obtained when the strongest material is used and there is a high level of nicotine in the e-liquid. A number of studies have also shown a reduction in withdrawal symptoms. (18) (19) (20) In a study carried out by Dawkins et al. for example (2012), smokers who used an e-cigarette with different dosages and in different ways, for five minutes, noticed that their craving and withdrawal symptoms lessened within 20 minutes of vaping, both using doses of 18 mg and 0 mg.

Withdrawal symptoms: the benefit of cognitive behavioural therapy

Cognitive behavioural therapy (CBT) has been shown to be effective in combatting anxiety and depressive disorders, social phobias (often linked to those who seek help from doctors of tobacco-related illnesses), and panic attacks. (22) (23) (24) To this end, CBT works towards managing the emotional effects that result from giving up smoking. (26) CBT has also proven effective in managing bulimia and could therefore help to control the development of bulimia, a condition often associated with quitting smoking. (27)

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