Diabetes Self-Management Blog

I started to write a stop smoking column. But after researching nicotine, I’m thinking of taking the habit up myself. Yes, it kills more people than all the other bad habits I can think of put together. It makes diabetes far worse. But what a drug!

Nicotine affects your brain much like cocaine does, but they don’t arrest you for having it. Nicotine hits your brain within 10–20 seconds after a puff and immediately starts raising dopamine levels.

Dopamine is our “reward chemical”; it tells you “you’re doing the right thing, so feel good.” A family of enzymes called MAOs (monoamine oxidase) breaks down dopamine and serotonin, another feel-good chemical. Nicotine is an MAO inhibitor; it blocks MAOs, so you have more dopamine and serotonin, so you feel better right away. And you don’t need a prescription!

Nicotine also promotes release of epinephrine (adrenaline) and endorphins, so you feel more energetic and more relaxed at the same time. (According to Wikipedia, small puffs/doses are more energizing, while higher doses/deeper puffs are more relaxing.) Nicotine makes you more alert and improves concentration. It relieves pain and anxiety. As a drug, it’s even better than sugar, but unlike sugar, it suppresses appetite and raises metabolism, making it great for weight loss. So why would anyone want to stop smoking?

So Why Stop?
According to the Web site Diabetes UK, “smoking can double the likelihood of [diabetes-related] heart disease, stroke, kidney problems, and erectile dysfunction.” About.com says that, “Both [smoking and diabetes] can damage your heart and your circulation. Both can raise your blood pressure and your cholesterol levels. Smokers also have a harder time controlling their blood glucose levels, because insulin resistance is increased by smoking.”

So smoking with diabetes is not just a double whammy. It’s the whammy squared. I calculate smoking with diabetes is about equivalent to an A1C of 12, because smoking causes blood vessels to constrict and clamp down, while diabetes can gum them from the inside. There’s not much room left for blood to flow.

And that’s not even mentioning the cancer and lung disease. Cigarettes are literally poisonous. According to About.com, cigarettes send “thousands of poisons, toxic metals and carcinogens coursing through our bloodstream with every puff we take.”

“Thousands?” Could that really be true? Yes it is. Cigarette smoke can contain benzene, ammonia, formaldehyde, pesticides, arsenic, cadmium, carbon monoxide, and cyanide, among many other poisons and carcinogens. When you read analyses of cigarette contents, you wonder how anyone can survive a pack at all! No wonder cigarettes are leading causes of cancer.

Why It’s Hard to Stop
But still, maybe it’s worth it for the dopamine, serotonin, and endorphins. At least, it might feel that way if your natural levels of these chemicals are low — like if you’re depressed, stressed, oppressed, lonely, or out of shape. According to Wikipedia, the elimination half-life of nicotine in the body is around two hours. That means you will need to puff on and off all day to keep your levels up.

Nicotine in and of itself might not be addictive, but combined with other chemicals in tobacco, it definitely is. If you stop smoking, your dopamine and serotonin levels will drop. Because the brain gets used to the higher levels of feel-good chemicals, it feels extremely deprived when the levels go down. Stopping smoking will lead to withdrawal symptoms.

According to Quit Smoking Support, “Withdrawal from nicotine…is characterized by symptoms that include headache, anxiety, nausea and a craving for more tobacco…Most withdrawal symptoms peak 48 hours after you quit and are completely gone in six months.”

But withdrawal symptoms aren’t what keep most people smoking. Many smokers come through withdrawal repeatedly, only to resume smoking when times get tough. The number of times the average smoker quits before being able to stay off for good is five to seven. I asked my neighbor William how many times he had quit, and he said, “Thousands.” Smoking just really helps many people get through the day.

So How Do You Quit?
Actually, we’ll need another entry to cover quitting, and I’d like your help. I haven’t experienced smoking or quitting. Perhaps you have. I know one thing — quitting will be a lot easier if you have other ways to raise your serotonin and dopamine levels. Meaning, things that make you happy, people to give you support, things that relax you, make you feel safe, and reduce your stress.

Let us know what has worked and hasn’t worked for you! When I read the responses, we’ll do part 2.

**
Read the new post on my blog Reasons to Live. It’s based on a piece that ran here last year about finding motivation, but I’ve spiced it up. Hope you like it!

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