due to the more rapid onset and higher levels of nicotine with cigarette smoking. Tobacco
withdrawal is common among daily tobacco users who stop or reduce but can also occur
among nondaily users. Typically, heart rate decreases by 5–12 beats per minute in the first
few days after stopping smoking, and weight increases an average of 4–7 lb (2–3 kg) over
the first year after stopping smoking. Tobacco withdrawal can produce clinically signifi-
cant mood changes and functional impairment. 
Associated Features Supporting Diagnosis
Craving for sweet or sugary foods and impaired performance on tasks requiring vigilance
are associated with tobacco withdrawal. Abstinence can increase constipation, coughing,
dizziness, dreaming/nightmare s, nausea, and sore throat. Smoking increases the metab-
olism of many medications used to treat mental disorders; thus, cessation of smoking can
increase the blood levels of these medications, and this can produce clinically significant
outcomes. This effect appears to be due not to nicotine but rather  to other compounds in
tobacco.