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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Comments
  1. I enjoyed Why Stop Smoking esp. because I have been trying to quit for years. I am 66 yrs old, have T-1 diabetes, use an insulin pump and am in good physical shape. I think I have tried everything on the market, e-cigs, chantix, welbutrin etc. and most recently hypnotherapy for the 2nd time. The longest I have gone without a cig is 1 month. But I have always come back to them.
    Most recently I noticed that my bg levels were lower and easier to control with less insulin. This is the first time I’ve seen any positive result from quitting, all other times i never noticed a difference other than obsessing over having a smoke.
    Got any suggestions or ideas?
    thank You, Dave

    Posted by Dave in SC |
  2. In your chocolate cupcake recipe,you use 3/4c.+2Tb. sugar!!!!!& this is ok for diabetics????

    Posted by AVY |
  3. Tough column.

    me mom died of cancer of lung and was horrible way out the door.

    Luckily my dad stopped when it was felt he had tb. At least he lived to 87. mom passed away in 1970.

    I was extremely lucky as kid tried it, didn’t like it and never pursued it.

    My mom was unable to stop even as cancer raging out of control.

    it seems we all - many of us pick up bad habits of the fork/knife; glass or the cigarette.

    Cheers David.

    Posted by jim snell |
  4. Quitting smoking is the hardest thing I ever did. As a Type 1 since 1965, after many tries and failures, the only thing that worked was to quit everything else that related to smoking. I quit drinking alcohol, coffee, and began running. Yes, it was drastic but worth it.

    Posted by Moe |
  5. For those who are having trouble quitting smoking, this info may ease your guilt and stir up your anger enough so that quitting is just a bit easier.

    For YEARS, the tobacco companies have been breeding the plant to have a higher concentration of nicotine, making them incredibly more addictive and harder to quit. And, tobacco company memos have described cigarettes as nicotine delivery systems.

    Now you can stop beating yourself up for having a hard time — perhaps again and again — quitting. But you should be so incensed (no pun intended) that it might give you the extra strength to hold off when the craving is clawing at you.

    Best wishes on your success.

    Posted by marciejoy |
  6. Hi David: I was lucky to get into SFGeneral’s stop smoking clinic with Suzanne, a nurse, artist and former smoker. Maybe if I keep typing, I will remember her … got it … Harris. The meeting was held on Tuesdays, but that was twelve years ago, so any interested wannabees, call the hospital and ask for Suzanne. She hosts a yearly party in addition to the weekly (bi-weekly) sessions, so quitters are able to develop a kinship to others like us. We are a stubborn bunch. It was easier for me to quit the hard drugs, which aren’t advertised in magazines or road signs, and cost a lost more in money and debilitating one’s lifestyle. Despite my active participation in the 60’s I am happy to say that I can cycle a few times a week (for 40 minutes) do some stretches, and know that those endorphins, no joke, these things are for real, really do help me manage pain. A great motivator, pain led me to want to quit smoking; Suzanne’s expertise helped me make it happen. Please don’t ever think of smoking as an outlet for something that will give back to you. I’ve got the usual disabilities one often acquires after seventy, and I don’t have the umphh to go to the Y anymore. I’m stuck with me. But I’m smoke free. Thanks for an interesting forum, David. I miss talking to you. Best wishes, Mary N.

    Posted by Mary Nordseth |
  7. We, my wife and I, have just recently found out that she has diabetes. Fortunately, she has never been a smoker so that is at least one concern that we do not have. I, however, was a smoker. I believe that anyone who smokes needs to quit. I hope I can help.
    Cliff

    Posted by Cliff |
  8. I recently dioscovered a way to finally quit smoking afyter 45 years. It’s a new combination of time proven techniques used in the past for changing human behavior and applying them to smokers today. By changing the way you think about tobacco, understanding the reasons you smoke, realizing the addictions involved and the habits formed, finding ways to retrain your mind through positive thinking, you will be able to stop smoking, just as I did, without drugs and medications.
    The concept of signing a Contract is used in dietary control, religious sects, success and motivational studies, marriage counseling and other human relation efforts to commit to a goal of improvement. To focus on the “what” you want to change or improve in your life. In a relationship for example, people formally write down a personal contract with that other person and promise to fulfill certain obligations with regards to that relationship. What this does is commit you to your goals. Donald Trump says: “ when you commit to something in writing all of a sudden it becomes real”. I took this “Promissory Contract” idea, added the fact I wanted to live a longer, healthier life and applied it to my method for quitting smoking.
    Many religious people rely on Meditation to elevate their consciousness. To follow a system of creating new thought patters in their mind to change and improve their relationship with other human beings and/or the creator. I took this time proven method of self-hypnotic, subconscious suggestion and applied it to smoking cessation.
    Positive Thinking and Affirmation. Success oriented, self- improvement techniques are abundant and I used them in constructing a list of affirmations to be repeated throughout the day. This way my smoking habits were replaced with healthy habits.
    One thing I did this time that was never done before when I tried quitting, was to be committed to it while finding the methods to do so permanently. Once I acquired the necessary education, adapted the contract concept, created the meditation time and repeated the affirmations, it really made it possible for me to quit smoking. If you want to read my book, it’s available on Amazon.com “Quit Smoking using Education, Meditation and Affirmations.”
    Good Luck

    Posted by Steven Talbott |

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