How to quit smoking and shisha: a quit plan and what nicotine withdrawal feels like

How to quit smoking: the short answer

If you are wondering how to quit smoking or shisha, the approach with the strongest evidence is this: set a quit day, prepare a plan for handling cravings, get behavioral support, and ask a doctor about a medicine that suits you, such as nicotine replacement therapy. The World Health Organization (WHO) says in its tobacco fact sheet (2026) that counseling and medication can more than double the chance of quitting successfully.

The first weeks are the hardest, but what you feel in them is expected and temporary. Many people need more than one attempt before they succeed, so don't count an earlier attempt as a failure. Treat it as practice that taught you what sets off your cravings and what helps.

Why is nicotine so hard to give up? A real addiction, not just a habit

The US National Institute on Drug Abuse (NIDA) explains that nicotine is addictive and is the main reason most people who smoke keep smoking. Within seconds of inhaling, it raises dopamine in the brain's reward circuits, then the effect fades quickly and the body asks for another dose. With repetition the brain adapts to having nicotine around, so withdrawal appears when it is gone.

On top of that there is a strong psychological side: the ritual of lighting a cigarette, the "hagar" (a bowl) of shisha with friends at the café, the glass of tea after a meal. These moments become cues that set off cravings automatically. That is why simply "deciding" is not enough: you need a plan that deals with your body and your habits together.

The same applies to other forms of tobacco common in the region, such as toombak and shammah (known in Sudan, Yemen and Saudi Arabia). They contain nicotine too, and the quit plan in this article works for them as well. Our article on khat, toombak and shammah explains their harms and how to quit them in more detail.

Shisha health risks: is it milder than cigarettes, and does the water filter the smoke?

This is one of the most widespread myths. The US Centers for Disease Control and Prevention (CDC) states that the water in a shisha (hookah or water pipe) does not filter the smoke, that the smoke still carries high levels of toxic substances after passing through the water, and that shisha carries many of the same risks as cigarettes.

• Much more smoke: a shisha session can last an hour or more, and the CDC estimates that someone who smokes for an hour inhales 100 to 200 times the smoke of a single cigarette.
• Enough nicotine to cause addiction: shisha tobacco and mu'assel contain the same nicotine found in cigarettes, and the CDC notes that a single session can expose you to more nicotine than one cigarette.
• The charcoal: burning it produces carbon monoxide, metals and cancer-causing chemicals.
• Linked diseases: the CDC links shisha to lung, bladder and mouth cancers, and to clogged arteries and heart disease.
• The shared mouthpiece: passing the hose (the "lay") around a group of friends can spread infections, as the American Academy of Pediatrics warns.
• Flavors: a sweet taste and a pleasant smell do not mean safety; sweeteners and flavourings may even increase your exposure to toxins.

So switching from cigarettes to shisha is not a step toward quitting, only a change in the way you smoke. The smoke also harms the people sitting around you: the WHO (2026) estimates that second-hand smoke kills more than 1.6 million non-smokers every year, and stresses that there is no safe level of exposure to it.

Nicotine withdrawal timeline: what to expect week by week

The US National Cancer Institute (NCI) describes withdrawal symptoms as common and temporary. How strong they are varies from person to person, but this is the general pattern:

• The first hours: cravings can start within an hour or two of your last cigarette or shisha session.
• The first week: the hardest stretch, with symptoms usually peaking in the first three days: strong cravings, irritability and frustration, tension, trouble concentrating, poor sleep and extra hunger.
• Weeks two to four: irritability and anxiety begin to settle, although some of it can last two to four weeks, and cravings come less often.
• After the first month: most people feel clearly better, though some have symptoms for several months, and a mild craving can come back now and then months or even years later, especially in situations linked to smoking.

Less common symptoms can also appear, such as headaches, tiredness, dizziness, coughing, mouth ulcers and constipation. Knowing that all of this is expected and will pass helps you not to read it as "my body can't live without cigarettes".

Irritability, mood and weight after quitting: how to cope

Irritability after quitting smoking

Irritability and frustration are among the best-known symptoms of the first weeks. Remind yourself that they are temporary, and tell your family and colleagues in advance so they understand. The NCI's tips include walking or any physical activity, cutting down on tea and coffee, and slow breathing and relaxation exercises.

Sadness and low mood

Some people feel a mild sadness that starts in the first days and usually lifts within a month. Spend time with people you love, and when a craving comes, ask yourself what you really need: are you tired, lonely, bored or hungry? If you have a history of depression, though, withdrawal can be harder, and the NCI notes that some studies have found many people with a history of major depression have a new episode after quitting. So it is important for a doctor to follow you before and during your quit attempt. If the sadness becomes intense or you have thoughts of harming yourself, don't wait to get help: if you feel you cannot keep yourself safe or you are in danger now, call an ambulance on 123 straight away or go to the nearest emergency department (outside Egypt, call your local emergency number), and do not stay alone. If there is no immediate danger, you can also get support from the Ministry of Health's 24/7 mental-health line on 16328 or Oxygen Center's 24/7 emergencies line on +20 100 006 6752; these lines are extra support and do not replace the ambulance when you are in danger.

A bigger appetite and weight gain

A bigger appetite is common, and you may put on a little weight. The NCI stresses that the health benefits of quitting far outweigh the risks of a small amount of extra weight. Keep healthy snacks ready, keep your mouth busy with sugar-free gum, and stay active every day.

Proven ways to quit smoking and shisha, including nicotine replacement therapy

• Behavioral support: one-to-one or group sessions that help you make a plan, spot what triggers your cravings and learn skills to handle them. The UK's National Health Service (NHS) says stop smoking services can improve your chances of quitting for good.
• Nicotine replacement therapy (NRT): such as patches, gum, lozenges and sprays. They give your body nicotine without the smoke of cigarettes and its toxins, easing withdrawal step by step. The CDC notes that combining a long-acting patch with a short-acting form may improve your chances. A doctor or pharmacist decides which type and which approach suit you.
• Prescription medicines: such as varenicline and bupropion. A doctor decides whether they are right for you after assessing your health and your other medicines, and whether they are available may differ from country to country.
• E-cigarettes (vapes): the NHS sees them as a tool that may help some people stop smoking, but how they are regulated and viewed differs between countries, so discuss it with your doctor.

The CDC sums it up: using counseling and medication together gives you the best chance of quitting for good. If you are being treated for a mental health condition, don't start any quit-smoking medicine or change your medicines on your own; talk it through with your doctor.

Why people with depression or in addiction recovery gain the most from quitting

Many people believe a cigarette "calms the nerves", but researchers suggest that the repeated withdrawal symptoms between one cigarette and the next, such as anxiety and irritability, may themselves be part of what drags mood down. A Cochrane review published in 2021, which brought together more than 100 studies, found that mental health does not get worse because of quitting. Instead, quitting was linked to a small to moderate improvement in anxiety, depression and stress, though the researchers noted that the certainty of this evidence ranged from very low to moderate.

For people recovering from alcohol or drug addiction, a fairly old analysis published in 2004, which pooled the results of 19 randomized trials, found that quit-smoking programs offered during addiction treatment were linked to a 25% higher likelihood of long-term abstinence from alcohol and drugs, although the researchers noted that staying off cigarettes was itself harder to sustain over the long term. In other words, quitting smoking does not threaten your recovery as some people fear; it may support it. Read more about relapse prevention and dual diagnosis.

A practical plan for how to quit smoking or shisha

1. Set a quit day soon, and choose a relatively calm day, away from exams or heavy pressure at work.
2. Write down your reasons: your health, your children, your breathing, your money. Put the list somewhere you will see it every day.
3. Know your triggers: when do you usually smoke? After meals, with tea, at the café, when you are stressed? Prepare an alternative for each situation.
4. Clear your surroundings: get rid of cigarettes, lighters and the shisha at home, and cut back on café sessions in the first weeks.
5. Ask for support: tell someone close to you, get help from a doctor or therapist, and ask about nicotine replacement or medicines.
6. Ride out the craving for a few minutes: a craving comes like a wave and then pulls back. Delay it by drinking water, walking or breathing slowly.
7. If you slip, don't give up: one cigarette is not the end of your attempt. Work out what happened and go straight back to your plan.

When should you get help?

• You have tried to quit on your own many times without success.
• You have depression, anxiety or another mental health condition, or you take psychiatric medicines.
• After quitting you have intense sadness, anxiety that won't settle, or poor sleep that disrupts your life.
• You are recovering from another addiction and worry that quitting might affect your recovery.
• You have heart or lung disease, or you are pregnant: medical follow-up matters.

What does Oxygen Center offer?

To be honest: Oxygen Center does not offer a dedicated treatment program for quitting smoking or shisha. But if your smoking goes hand in hand with anxiety, depression or constant stress, or you are recovering from an addiction and want to stop smoking too, an appointment with a psychiatrist can assess your situation and treat what comes with it, and psychotherapy sessions can teach you skills for handling stress and cravings. These services are open to men and women aged 15 and over (under 18 with a guardian's consent), and you can contact us to arrange an appointment.