- What are some of the withdrawal symptoms associated with quitting dip?
Quitting smokeless tobacco may cause short-term problems, especially for those who have dipped heavily for many years. These temporary changes can result in nicotine withdrawal symptoms.
Common withdrawal symptoms associated with quitting include the following:
- Anger, frustration, and irritability.
- Weight gain.
Studies have shown that about half of smokeless tobacco users report experiencing at least four withdrawal symptoms (such as anger, anxiety, or depression) when they quit. People have reported other symptoms, including dizziness, increased dreaming, and headaches.
The good news is that there is much you can do to reduce cravings and manage common withdrawal symptoms. Even without medication, withdrawal symptoms and other problems subside over time. It may also help to know that withdrawal symptoms are usually worst during the first week after quitting. From that point on, the intensity usually drops over the first month. However, everyone is different, and some people have withdrawal symptoms for several months after quitting.
- What are some of the triggers for smokeless tobacco cravings?
In addition to nicotine cravings, reminders in your daily life of occasions when you normally chew may trigger an urge to dip. Triggers are the moods, feelings, places, or things you do in your daily life that turn on your desire to use smokeless tobacco. Triggers may include any of the following:
- Being around others who dip.
- Starting the day.
- Feeling stressed.
- Drinking coffee, tea, or soda.
- Drinking an alcoholic beverage.
Knowing your triggers helps you stay in control because you can choose to avoid them or keep your mind distracted and busy when you cannot avoid them.
- What can I do about nicotine cravings?
As a smokeless tobacco user, you get used to having a certain level of nicotine in your body. You control that level by how much you chew, how long you chew, and the kind of tobacco you use. When you quit, cravings develop when your body wants nicotine. It takes time to break free from nicotine addiction. Also, when you see people chewing or are around other triggers, you may get nicotine cravings. Cravings are real. They are not just in your imagination. At the same time, your mood may change, and your heart rate and blood pressure may go up.
The urge to chew will come and go. Cravings usually last only a very brief period of time. Cravings usually begin within an hour or two after you have your last dip, peak for several days, and may last several weeks. As the days pass, the cravings will get farther apart. Occasional mild cravings may last for 6 months. Here are some tips for managing cravings:
What can I do about anger, frustration, and irritability?
After you quit dip , you may feel edgy and short-tempered, and you may want to give up on tasks more quickly than usual. You may be less tolerant of others and get into more arguments.
Studies have found that the most common negative feelings associated with quitting are feelings of anger, frustration, and irritability. These negative feelings peak within 1 week of quitting and may last 2 to 4 weeks. Here are some tips for managing these negative feelings:What can I do about anxiety?
Within 24 hours of quitting dip, you may feel tense and agitated. You may feel a tightness in your muscles—especially around the neck and shoulders. Studies have found that anxiety is one of the most common negative feelings associated with quitting. If anxiety occurs, it builds over the first 3 days after quitting and may last 2 weeks. Here are some tips for managing anxiety:
What can I do about depression?
- Remind yourself that anxiety will pass with time.
- Set aside some quiet time every morning and evening—a time when you can be alone in a quiet environment.
- Engage in physical activity, such as taking a walk.
- Reduce caffeine by limiting or avoiding coffee, soda, and tea.
- Try meditation or other relaxation techniques, such as getting a massage, soaking in a hot bath, or breathing deeply through your nose and out through your mouth for 10 breaths.
- Ask your doctor about nicotine replacement products or other medications.
It is normal to feel sad for a period of time after you first quit smokeless tobacco. If mild depression occurs, it will usually begin within the first day, continue for the first couple of weeks, and go away within a month.
Having a history of depression is associated with more severe withdrawal symptoms—including more severe depression. Some studies have found that many people with a history of major depression will have a new major depressive episode after quitting. However, in those with no history of depression, major depression after quitting is rare.
Many people have a strong urge to chew when they feel depressed. Here are some tips for managing depression:
Identify your specific feelings at the time that you seem depressed. Are you actually feeling tired, lonely, bored, or hungry? Focus on and address these specific needs.
Call a friend and plan to have lunch or go to a movie, concert, or other pleasurable event.
- Increase physical activity. This will help to improve your mood and lift your depression.
- Breathe deeply.
- Make a list of things that are upsetting to you and write down solutions for them.
- If depression continues for more than 1 month, see your doctor. Ask your doctor about prescription medications that may help you with depression. Studies show that bupropion and nortriptyline can help people with a past history of depression who try to quit smokeless tobacco. Nicotine replacement products also help.
Learn about the signs of depression, and where to go for help, at the National Institute of Mental Health Web site (http://www.nimh.nih.gov
Gaining weight is common after quitting. Studies have shown that, on average, people who have never dipped weigh a few pounds more than dippers, and, when dippers quit, they attain the weight they would have had if they had never dipped.
Although most smokeless tobacco users gain fewer than 10 pounds after they quit, the weight gain can be troublesome for some people. However, the health benefits of quitting far outweigh the health risks of a small amount of extra weight. Here are some tips for managing weight gain:
- Ask your doctor about the medication bupropion. Studies show that it helps counter weight gain.
- Studies also show that nicotine replacement products can help counter weight gain. Because some people who quit smokeless tobacco increase their food intake, regular physical activity and healthy food choices can help you maintain a healthy weight.
- If weight gain is a problem, you may want to consult a nutritionist or diet counselor.
How can I resist the urge to dip when I’m around smokeless tobacco users?
You may want to analyze situations in which watching others dip triggers the urge in you. Figure out what it is about those situations that makes you want to chew. Is it because you associate feeling happy with being around other dippers? Is there something special about the situations, such as being around the people you usually dip with? Or, is it the social or recreational activity?
Here are some tips:
- Limit your contact with other dippers, especially in the early weeks of quitting.
- Do not buy, carry, or hold dip cans for others.
- Do not let people dip in your home. Post a small “No Tobacco” sign by your front door.
- Ask others to help you stay quit. Give them specific examples of things that are helpful (such as not dipping around you) and things that are not helpful (like asking you to buy chew for them).
- Focus on what you’ve gained by quitting. For example, think of how healthy you will be when all smokeless tobacco effects are gone from your body and you can call yourself nicotine-free. Also, add up how much money you have saved already by not purchasing dip and imagine (in detail) how you will spend your savings in 6 months.
How can I start the day without smokeless tobacco?
Many smokeless tobacco users get started right after they wake up. After 6 to 8 hours of sleep, a user's nicotine level drops and the dipper needs a boost of nicotine to start the day. After you quit, you must be ready to overcome the physical need and routine of waking up and dipping. Instead of reaching for your dip in the morning, here are some tips:
- The morning can set the tone for the rest of the day. Plan a different wake-up routine, and divert your attention from dip.
- Be sure no tobacco is available.
- Before you go to sleep, make a list of things you need to avoid in the morning that will make you want to dip. Place this list where you used to place your dip.
- Begin each day with a planned activity that will keep you busy for an hour or more. It will keep your mind and body busy so you don’t think about dipping .
- Begin each day with deep breathing and by drinking one or more glasses of water.
How can I resist the urge to dip when I’m feeling stressed?
Most dippers report that one reason they dip is to handle stress. This happens because dipping actually relieves some of your stress by releasing powerful chemicals in your brain. Temporary changes in brain chemistry cause you to experience decreased anxiety, enhanced pleasure, and alert relaxation. Once you stop dipping, you may become more aware of stress.
Everyday worries, responsibilities, and hassles can all contribute to stress. As you go longer without dipping, you will get better at handling stress, especially if you learn stress reduction and relaxation techniques.
Here are some tips:
- Know the causes of stress in your life (your job, traffic, your children, money) and identify the stress signals (headaches, nervousness, or trouble sleeping). Once you pinpoint high-risk trigger situations, you can start to develop new ways to handle them.
- Create peaceful times in your everyday schedule. For example, set aside an hour where you can get away from other people and your usual environment.
- Try relaxation techniques, such as progressive relaxation or yoga, and stick with the one that works best for you.
- Rehearse and visualize your relaxation plan. Put your plan into action. Change your plan as needed.
- You may find it helpful to read a book about how to handle stress.
How can I resist the urge to dip when I'm driving or riding in a car?
You may have become used to dipping while driving—to relax in a traffic jam or to stay alert on a long drive. Like many dippers, you may like pack a lip when driving to and from work to relieve stress, stay alert, relax, or just pass the time. There is some evidence that dipping actually does make you feel more awake and alert.
Tips for short trips:
- Get rid of your spit can or any other receptical in the car.
- Keep nonfattening snacks in your car (such as licorice, sugarless gum, and hard candy).
- Turn on your favorite music and sing along.
- Take an alternate route to work or try carpooling.
- Tell yourself:
- “This urge will go away in a few minutes.”
- “So, I’m not enjoying this car ride. Big deal! It won’t last forever!”
- “I’m a better driver now that I’m not dipping while driving.”
When you are driving or riding with other people:
- Ask passengers not to dip in your car.
- If you’re not driving, find something to do with your hands.
Your desire to dip may be stronger and more frequent on longer trips. Tips for long trips:
How can I resist the urge to dip when I’m having coffee, tea, or soda?
- Take a stretch break.
- Take fresh fruit along.
- Plan rest stops.
- Plan stops for water or fruit juice.
Its important to understand the chemistry associated with nicotine addiction. Withdrawal from nicotine can make you cranky. Any stimulant (like caffeine) is likely to increase that anxiety and the urge to dip. Consider switching to decaffeinated beverages while you are getting through the critical first six weeks of your quit.
How can I resist the urge to dip when I’m having a beer?
You may be used to dipping when drinking beer, wine, liquor, or mixed drinks, and you may associate good feelings with drinking alcoholic beverages. When you quit dipping, you may feel a strong urge to dip when you drink alcohol. Know this up front if you are going to drink. If you do drink, keep in mind that your control over your behavior may be impaired under the influence of alcohol. When you try to quit dipping, alcohol may make it even tougher to cope.
Here are some tips for the first few weeks after quitting:
- Many people find it helpful to reduce or avoid drinking alcohol.
- Switch to nonalcoholic drinks.
- If you do drink, don’t choose the alcoholic beverages you usually have when dipping.
- Don’t drink at home or by yourself.
- Stay away from the places you usually drink alcohol, or drink only with nondipping friends.
How can I resist the urge to dip when I’m feeling bored?
When you quit dipping, you may miss the increased excitement and good feeling that nicotine gave you. This may be particularly true when you are feeling bored.
Here are some tips:
- Plan more activities than you have time for.
- Make a list of things to do when confronted with free time.
- Move! Do not stay in the same place too long.
- If you feel very bored when waiting for something or someone (a bus, your friend, your kids), distract yourself with a book, magazine, or crossword puzzle.
- Look at and listen to what is going on around you.
- Keep gum or beef jerky in your mouth.
- Listen to a favorite song.
- Go outdoors, if you can, but not to places you associate with dipping.
Do nicotine replacement products relieve nicotine cravings and withdrawal symptoms?
Yes. Nicotine replacement products deliver measured doses of nicotine into the body, which helps to relieve the cravings and withdrawal symptoms often felt by people trying to quit smoking. Nicotine replacement products are effective treatments that can increase the likelihood that someone will quit successfully.
Five forms of nicotine replacement products have been approved by the U.S. Food and Drug Administration (FDA):
- The nicotine patch is available over the counter (without a prescription). A new patch is worn on the skin each day, supplying a small but steady amount of nicotine to the body. The nicotine patch is sold in varying strengths, usually as an 8- to 10-week quit-smoking treatment. Typically, the nicotine doses are gradually lowered as treatment progresses. The nicotine patch may not be a good choice for people with skin problems or allergies to adhesive tape. Also, some people experience the side effect of having vivid dreams when they wear the patch at night. These people may decide to wear the patch only during the daytime.
- Nicotine gum is available over the counter in two strengths (2 and 4 milligrams). When a person chews nicotine gum and then places the chewed product between the cheek and gum tissue, nicotine is released into the bloodstream through the lining of the mouth. To keep a steady amount of nicotine in the body, a new piece of gum can be chewed every 1 or 2 hours. The 4-milligram dose appears to be more effective among highly dependent smokeless tobacco users (those who use more than a can a day). Nicotine gum might not be appropriate for people with temporomandibular joint disease or for those with dentures or other dental work, such as bridges. The gum releases nicotine more effectively when coffee, juice, or other acidic beverages are not consumed at the same time.
- The nicotine lozenge is also available over the counter in 2 and 4 milligram strengths. The lozenge is used similarly to nicotine gum; it is placed between the cheek and the gums and allowed to dissolve. Nicotine is released into the bloodstream through the lining of the mouth. The lozenge works best when used every 1 or 2 hours and when coffee, juice, or other acidic beverages are not consumed at the same time.
- Nicotine nasal spray is available by prescription only. The spray comes in a pump bottle containing nicotine that tobacco users can inhale when they have an urge to dip. Nicotine is absorbed more quickly via the spray than with other nicotine replacement products. Nicotine nasal spray is not recommended for people with nasal or sinus conditions, allergies, or asthma or for young tobacco users. Side effects from the spray include sneezing, coughing, and watering eyes, but these problems usually go away with continued use of the spray.
- A nicotine inhaler, also available by prescription only, delivers a vaporized form of nicotine to the mouth through a mouthpiece attached to a plastic cartridge. Even though it is called an inhaler, the device does not deliver nicotine to the lungs the way a cigarette does. Most of the nicotine travels only to the mouth and throat, where it is absorbed through the mucous membranes. Common side effects include throat and mouth irritation and coughing. Anyone with a breathing problem such as asthma should use the nicotine inhaler with caution.
It is very important to remember that nicotine is one of the most addictive drugs known to man. All nicotine replacement products replace one nicotine delivery system with another (sometimes more efficient) system. Studies have shown that nicotine use may contribute to high blood pressure and heart disease because it causes constriction of the arteries. Too much nicotine can also cause nausea, vomiting, dizziness, diarrhea, weakness, and rapid heartbeat.
Are nicotine replacement products safe?
It is less harmful to get nicotine from a nicotine replacement product than from smokeless tobacco because tobacco products contains many other toxic and cancer-causing substances.
Are there products to help people quit dipping that do not contain nicotine?
Yes, a doctor may prescribe one of several medicines that do not contain nicotine:
Are there alternative methods to help people quit smoking?
- Bupropion, a prescription antidepressant, was approved by the FDA in 1997 to treat nicotine addiction (under the trade name Zyban®). This drug can help to reduce nicotine withdrawal symptoms and the urge to dip and can be used safely with nicotine replacement products. Several side effects are associated with this product. Discuss with your doctor if this medicine is right for you.
- Varenicline, a prescription medicine marketed as Chantix®, was approved by the FDA in 2006 to help tobacco users quit. This drug may help those who wish to quit by easing their nicotine cravings and by blocking the pleasurable effects of nicotine if they do start chewing again. Several side effects are associated with this product. Discuss with your doctor if this medicine is right for you.
Some people claim that alternative approaches such as hypnosis, acupuncture, acupressure, and laser therapy (laser stimulation of acupuncture points on the body), or electrical stimulation may help reduce the symptoms associated with nicotine withdrawal. However, in clinical studies these alternative therapies have not been found to help people quit dipping. There is no evidence that these alternative approaches help dippers who are trying to quit.
The DIPSTOP Program was developed by former snuff dippers who understand your frustrations and struggles with trying to kick the habit. We are experts in smokeless tobacco addiction. We can help you understand the power of tobacco addiction and walk with you step-by-step as you successfully beat nicotine addiction through the DIPSTOP Program. It doesn’t matter how long or what quantity you have been chewing, DIPSTOP can safely help you quit for life!