Are there any long-term psychological or emotional symptoms that I should expect long after I stop smoking?

While the experience of loss and having mild symptoms of the blues is common during the immediate period following stopping smoking even after the withdrawal symptoms have passed, regardless of whether one takes NRT (less so when one is treated with bupropion or nortriptyline, which are antidepressants), a few people slip into a depression. More serious symptoms of depression include sleep and appetite disturbance, and feelings of guilt, helplessness, and hopelessness. Most serious is the development of thoughts of suicide that may include developing a plan without carrying it out (which medically is termed suicidal ideation) or thoughts of self-injury. If you find that the depression continues for more than a couple of weeks, especially when accompanied by any of the listed symptoms, you should call your doctor.

But more often than not, the long-term emotional consequences are positive. This comes from the elated feeling of successfully conquering what can only be described as the Mount Everest of addictions.

What can I do to ease any residual psychological or emotional pain short of taking medication?

This is the primary reason individual and group therapy improves smoking cessation rates! You can take proactive measures to enhance your sense of well-being so the cravings are less severe. Regular aerobic exercise (such as swimming, dancing, running, walking, etc.) stimulates breathing faster, precipitates perspiration, increases the heart rate, and releases endorphins[1] ("feel good chemicals" secreted by the hypothalamus in the brain and pituitary gland following exercise). Plan regular exercise and follow the plan. Research shows that smokers who take up a regular exercise program have a much higher quit-smoking success rate. The greater the level of physical activity the higher the success rate at remaining tobacco-free. Many people use cigarettes to alleviate stress. Exercise is an excellent stress reliever and can replace your dependence on cigarettes for stress relief.

Eat a well-balanced diet. Drink lots of fluids. Any kind of fluids are good except coffee and alcohol, which often are triggers for a craving to smoke. Get more rest. Go to bed earlier than your usual bedtime to cope with the fatigue. Take a multivitamin for an energy boost.

More often than not, the long-term emotional consequences are positive.

Talk to yourself about the benefits of not smoking. Dispute all of the rationalizations that you used to remain a smoker. Reframe your thinking. Tell yourself, "I didn't give up smoking, I choose to become a nonsmoker, and this has been the greatest accomplishment of my life!" Visualize how much better you will look and feel. Meditate. Sit in a comfortable chair. Close your eyes. Make your mind a blank, allow all thoughts and feelings to fade into the background. Breathe slowly and deeply. After a couple of minutes, the craving to smoke will go away. Reward yourself with doing activities you like to do. Reach out to others; helping them will help you. Stay away from places where you smoked. Change your daily routine. Avoid smoke-filled rooms and friends who smoke. Explain to them your plan. Develop an action plan. Who do I want to be and what do I want to do, now that I am no longer a "smoker?" What are my goals? Table 14 may help you to think about and identify your personal strategies for success.

Table 14 Action Plan


strategies Needed to Achieve the Goals



Non-work related




Family (interpersonal)

Goals for the month

Goals for the year

Long-term goals


  • [1] (Also known as endogenous opiates.) A type of natural opiate manufactured by the body after strenuous exercise, laughing, or excitement to act on a variety of physiological changes, including pain perception, appetite suppression, and elevated mood.
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