Total nicotine withdrawal, also known as ‘cold turkey’, is a method of stopping the drug nicotine abruptly rather than slowly or with the help of medication. This can be voluntary, of one’s own volition, or the result of involuntary withdrawal (e.g. due to a serious illness or accident).

quit smoking cold turkey

The term ‘cold turkey’ is often used to describe withdrawal from hard drugs (such as heroin). In some addictions, cold turkey can even be life-threatening (benzodiazepines, alcohol, heroin only in exceptional cases). With nicotine it causes unpleasant but (usually) harmless withdrawal symptoms.

But relapse rates (see also relapse triggers), especially on the first attempt, are very high. Only very strong-willed people manage to remain non-smokers permanently without any help.

Making cold turkey easier

Those who want to ease possible or already noticeable withdrawal symptoms can use nicotine substitutes or other drugs to stop smoking. However, these usually have to be paid out of your own pocket.

Some people find it easier to quit smoking together with other ‘fellow sufferers’. Exchange information with other fresh non-smokers in a non-smoking forum or book a non-smoking group course.

Instead of going it alone again, it is also worth looking for professional help. You can ask your pharmacist about nicotine replacement or entrust an experienced therapist with the task of stopping smoking.

Be motivated by the personal experiences of other successful non-smokers. Or just let yourself be motivated by the benefits that occur when you stop smoking. (Also read: What happens after you quit smoking?)

It may also help to find out more about smoking, its risks, the damage to your health and the various methods of quitting smoking (non-smoking books & DVDs).
Restarting after a relapse

A relapse is no big deal. Especially when you realize that many non-smokers have relapsed. Do not give up, get up and become a non-smoker again.
Our tips on how to avoid a relapse are perhaps also helpful.

Cold Turkey brings the most success

Are you one of those people who have tried to quit smoking several times in vain? Then there is good news for you now. Scientists have discovered the best way to quit smoking for good. However, they may not like the answer, because experts say that stopping with cold turkey is the best chance. Of course, this kind of quitting also includes the dreaded cold turkey withdrawal with all its side effects.

If you are planning to quit smoking, you will have a much better chance if you stop smoking cold turkey from one day to the next. This was the conclusion reached by scientists from the University of Oxford when they conducted a study to determine which method would be most successful in overcoming tobacco addiction. The doctors published the results of their study in the journal “Annals of Internal Medicine”.

Scientists recommend abrupt cessation (cold turkey) of cigarettes

In recent years, the acceptance of smokers has declined more and more. In general, smoking is no longer as widespread as it was 20 years ago, for example. So it is not surprising that more and more smokers are trying to quit for good. But what is the best way to quit? Stopping abruptly or slowly reducing the dosage further and further? Scientists from the University of Oxford found the answer to this question in a study. The experts concluded that cold turkey is the best way to quit smoking.

Study observes nearly 800 smokers as they quit

For the study, which was conducted from June 2009 to December 2011, the researchers recruited 796 people who smoked at least 15 cigarettes per day. These subjects had to be willing to stop smoking after two weeks of participation in the study, the researchers explain. The smokers were randomly divided into two groups. One group was to stop smoking cold turkey. The other group should gradually stop smoking, the doctors explain. The second group was to reduce smoking by 50 percent during the first week, reduce their smoking again by 25 percent in the second week and then stop smoking altogether. Both groups were supported and doctors gave them advice to help them stop smoking. The participants also had access to long-acting nicotine patches and various short-acting nicotine replacement therapies, such as nicotine gum and nicotine mouth spray, say the experts.

Group with cold turkey non-smokers showed the better results

The participants were examined weekly for four weeks and then again later after six months, the doctors explain. At each assessment they were asked how successful their withdrawal was and whether they had experienced any symptoms of nicotine withdrawal. To enable an objective assessment of progress, the researchers also measured the amount of carbon monoxide exhaled by the subjects and the amount of cotinine in their saliva (cotinine is a marker of exposure to tobacco smoke). After four weeks, 39 percent of the participants who were supposed to slowly quit smoking were still not smoking. In the group of smokers who stopped smoking cold turkey, the figure was even 49 percent, the experts say. After six weeks, the value was 15.5 percent in the gradual cessation group, compared with 22 percent in the other group, the doctors add.

Get help to stop smoking

Most people prefer to quit smoking gradually, even though they were more likely to achieve their goal in the group of abruptly quitting smokers, says lead author Nicola Lindson-Hawley of the University of Oxford. Although the study found that cold turkey is the more effective method, the authors point out that gradual cessation of cigarettes can still be useful if more people get help and medication to support their attempt.

The Story of Jana

Waking up at night to smoke a cigarette, digging for old cigarettes in the ashtray, knowing that it doesn’t even taste good. Heavy smokers can hardly get rid of nicotine.

She didn’t care about cancer. Jana (name of the editorial office known) smoked. 40, sometimes 50 cigarettes a day Often the 26-year-old woke up at night and had to light up a cigarette.

She knew that smoking makes you ill, is expensive and reduces life expectancy by 20 years. She was not intoxicated. She didn’t even like it. Cigarettes are the stupidest drug in the world, she thought, and kept smoking. So did one in three Germans.

Jana wouldn’t stop because she was afraid she wouldn’t make it. She sensed that the addiction that had numbed her mind would also overwhelm her will.

That is how it actually ends for many smokers. In Germany, 121,000 people die every year from the consequences of smoking, according to a recent study by the German Cancer Research Center (DKFZ). 65 percent try to quit during their lifetime. Only half manage to do so. They manage to keep their hands off the cigarette completely, usually after several relapses.

Cigarette at a child’s bedroom window

But Jana didn’t want to think about that. She had taken long enough to get used to smoking. She smoked her first cigarette at the nursery window when she was 15. She coughed, she was dizzy, she felt poisoned and wondered what adults liked about it.

But she did not give up and tried again and again. Eventually she didn’t have to cough anymore. And at 18, Jana never went another day without a cigarette.

Nicotine is more toxic than arsenic or cyanide, warns the DKFZ. In order to die of it immediately, one would have to take 50 milligrams at once. When smoking a cigarette, between one and two milligrams are ingested. Jana smoked 40 to 100 milligrams throughout the day.

Fishy and bitter

Where the nicotine came from, Jana didn’t care in the end. Because the student could no longer afford filter cigarettes, she switched to tobacco. First she made a roll of brand-name tobacco, then she bought no-name products. When she had forgotten to buy tobacco, she rolled a new cigarette from cigarette butts. It tasted fishy and bitter, but the body got nicotine.

Smoking is a strong addiction. Within seconds, the nicotine goes from the lungs via the bloodstream to the brain, where it stimulates the reward center. There, norepinephrine and dopamine are released, which leads to feelings of happiness and lust and makes you want to perform.

However, this effect lasts only for a short time, soon after the cigarette the withdrawal begins in the body. And it is not only the body that craves for more. Smokers mentally get used to the cigarette, smoking breaks, small rewards in everyday life, with which they associate positive feelings. That alone makes the decision to go into withdrawal difficult.

Fear of the smoker’s leg

The thought of this was far away for Jana for eleven years. Until the one morning after a long night with many cigarettes, when her left leg felt strangely numb. The word “smoker’s leg” came to her mind. Suddenly she became terribly afraid and could think of nothing else. An amputated leg at the age of not even 30 was something else than the danger of lung cancer in the far future. She decided to stop.

Even though 80 percent of smokers try it this way, cold turkey is not very promising according to experts. Too quickly restlessness, palpitations and sleeping problems undermine the will. In the beginning, nicotine replacement products can therefore prevent a relapse, just like hypnosis or acupuncture.

Recently, many Germans are turning to e-cigarettes. However, according to the German Head Office for Addiction Issues (DHS), this is not a good idea, because it makes smokers stay smokers. Inhaling and steaming activates the addiction memory. A combination of non-smoking courses and nicotine substitutes promise the best results. Prescription drugs can help with severe addiction. Nevertheless, a cold turkey can bring the desired success for some groups of people.

For experts, the inner attitude is the most important thing. Smokers in rehab should think positively and not about what they are giving up. Apps that report how much the heart has already recovered or how much money has been saved can help here.

There is some doubt that fear of illness is a deterrent. It is controversial whether the images of diseases and mutilated bodies deter smokers or, on the contrary, lead to defiance. In Germany, only ten percent of the population perceive anti-smoking campaigns. Some researchers believe that addiction is stronger than fear.

Irritated and sleepless

With Jana, fear triumphed. But the first day without a cigarette in almost ten years seemed like a horror trip to her. She walked up and down alternately and sat lethargically on the sofa, was irritated and couldn’t sleep.

If she had known this was going to continue for the next few months, she wouldn’t have hung on for another day. And another. She stopped smoking, but she was suffering. She felt that the most beautiful thing in her life had been taken away from her. Jana avoided parties and smoking boyfriends, but home alone wasn’t any better. Her mind was always on cigarettes.

Riot in the body

Neither sweets nor nicotine gums replaced the feeling of lighting a cigarette and inhaling the smoke deeply. The only thing that helped her were non-smoking books. They made her realize that it was the addiction that was clouding her brain.

Nicotine withdrawal puts the whole body into turmoil. Scientists showed in a study funded by the German Research Foundation (DFG) that smoking changes the brain. The amygdala, the fear centre in the brain, only worked in smokers when they consumed nicotine. After twelve hours of the cold turkey, the activity was significantly reduced.

The worst cold turkey in Jana lasted four months. Only then did she slowly become calmer and the thoughts of cigarettes faded away. After a year she cautiously believed she was a non-smoker. Today, after 14 years, she feels the same way. She knows that there was no better moment to quit than when she first thought about it.