Anyone for cold turkey?

As anyone watching Nadia weep her way hysterically through an accidentally self-inflicted 24-hour cold turkey on Big Brother will know, people suffering from chronic nicotine withdrawal are not people to be trifled with. Watching the Portuguese transsexual wrestle with her cravings within the confines of the house, a casual observer would have been forgiven for thinking she was attempting to overcome an addiction far more illicit than a 20-a-day tobacco hit. Such was her distress, she threatened to leave the house: "Without my ceeeegarettes," she wailed, "I can have no fun."

Seeing such crazed behaviour can only be a deterrent to anyone seriously considering giving up smoking any time soon. To see a reasonably high-functioning, albeit hormonally eccentric, adult reduced to a sobbing mass of raw emotion through lack of nicotine is a grim reminder of the pain and irascibility everyone has to endure when a smoker is giving up.

But is it really as bad as all that? Do all smokers mutate into fire-breathing tyrants the minute they stub out?

I may be guilty of having selectively remembered the details, but when I gave up, six months ago, I don't recall being quite so possessed by the demon nicotine. Nor do I remember weeping uncontrollably at the slightest provocation, or fantasising about cigarettes 24/7. Sure, I missed them - sorely - but having prepared for the worst, I was genuinely surprised at how quickly I moved on. Does that mean that for the 10 years I smoked - between 10-30 cigarettes a day - I was somehow less of an addict? That, despite my unstinting service to the tobacco industry, I was never a real smoker?

Gay Sutherland, an addictions counsellor who runs a smokers' clinic in London, says no two people are alike when it comes to giving up. And despite my claims not to have been at all cranky during the first days of "turkey", Sutherland dismisses my apparent imperviousness to withdrawal as pure baloney. "Irritability, frustration, restlessness, not being able to sleep, depression, misery, tearfulness, getting into arguments and, paradoxically, feeling tired and washed out because nicotine can act as a stimulant and as a sedative, an absence of concentration, and an absence of mind are absolutely well-established in the scientific literature as being related to the loss of nicotine," says Sutherland. "It's not just a psychological side-effect because you miss the crutch of a cigarette ."

I subject my non-smoking history to a revisionist's scrutiny. Perhaps the occasion on which I nearly took my husband's eye out because I didn't fancy chicken for dinner was a little unnecessary. As was trying to pick a fight with my 84-year-old grandmother because she told me I was looking well.

But could it have been worse? Is it possible that withdrawal can dissolve into psychosis. "I think cases of complete psychosis from nicotine withdrawal may have been reported, but I wouldn't want to be quoted as saying that it's a proven fact," says Sutherland. Nadia's extreme withdrawal symptoms were exacerbated because she was "in a stressful, unnatural environment in which she was undoubtedly being wound up by those around her. Those environmental variables would have magnified her symptoms."

But for how long would an ex-addict expect to feel so miserable? "Without any nicotine, the average withdrawal lasts two to three weeks," say Sutherland. "But that's an average. Some smokers have a longer and more protracted withdrawal. Lighter smokers might lose their symptoms after a week. Within 24 hours, there are insignificant amounts of nicotine in the blood. But addiction, and dependence, are about more than just the presence of the drug. Heavy, chronic smokers' brains are structurally different from the brains of people who don't smoke. There are changes that persist in the body and brain for many weeks after the drug has left the system. It's complicated by personality, and how addictive you are. Just because you didn't find it too hard, doesn't mean other people don't become more dependent," she says.

Cigarettes are as addictive a substance as heroin or cocaine, and Sutherland's advice to those who really do want to kick the habit is to adopt a slowly, slowly approach. "I absolutely, definitely would not recommend cold turkey as a strategy," she stresses. "Many, many trials have shown that the most effective way to give up smoking is to use one of the nicotine replacement products, or Zyban (a prescribed drug), plus some kind of structured psychological support, counselling or group support so that people keep their quit attempt serious." Even then the success rates are pathetically tiny, at around 25 per cent. About six per cent of smokers succeed with nicotine replacement, and only a meagre two per cent give up by going cold turkey.

However, if you do find yourself in Nadia's predicament and without hope of a cigarette for an uncertain amount of time, the usual rules apply. "Keep busy and distracted," Sutherland advises. "Do things that are incompatible with smoking. Change your routine. And get support."

And her advice for those poor people who have to tolerate being in the company of a nicotine-depraved hysteric? "Best avoid them," she says. Which is all very well, unless you're stuck in the Big Brother house.