Smoking And Diabetes
03 January 2007
The How and Why of Quitting
Tobacco has many bad health effects, particularly for people with diabetes. No matter how long you've smoked, your health will improve when you quit.
Nicotine, the drug in tobacco, is one of the most addictive substances known. Besides the physical addiction, many smokers also become psychologically hooked on cigarettes. So kicking the habit is hard -- but worth the work. There are many methods you can try that can help you quit and stay quit.
10 Ways Smoking Hurts Your Health
The best-known effect of smoking is that it causes cancer. Smoking can also aggravate many of the problems that people with diabetes already face, such as heart and blood vessel disease.
* Smoking cuts the amount of oxygen reaching tissues. The decrease in oxygen can lead to a heart attack, stroke, miscarriage, or stillbirth.
* Smoking increases your cholesterol levels and the levels of some other fats in your blood, raising your risk of a heart attack.
* Smoking damages and constricts the blood vessels. This damage can worsen foot ulcers and lead to blood vessel disease and leg and foot infections. Of people with diabetes who need amputations, 95 percent are smokers.
* Smokers with diabetes are more likely to get neuropathy (nerve damage) and kidney disease.
* Smokers get colds and respiratory infections easier.
* Smoking doubles your risk of getting limited joint mobility.
* Smoking can cause cancer of the mouth, throat, lung, and bladder.
* People with diabetes who smoke are three times as likely to die of cardiovascular disease as are other people with diabetes.
* Smoking increases your blood pressure.
* Smoking raises your blood glucose level, making it harder to control your diabetes.
Why Quitting Is So Hard
People keep smoking for two reasons. First, nicotine is highly addictive. Often, a person who quits smoking goes through withdrawal. Symptoms of withdrawal include being irritable; sweating; having headaches, diarrhea, or constipation; and feeling restless, tired, or dizzy. Withdrawal is usually worst the second day after quitting and usually lasts less than a week.
Second, many people also become psychologically tied to smoking. It is part of the ritual of their day. It helps them wake up in the morning, comforts them when they are upset, and rewards them for a job well done. Smoking also has pleasurable physical effects. It relaxes people and perks them up.
These factors make it easy to smoke and hard to quit. The pleasures of smoking start within seconds of lighting up; the bad effects can take years to make themselves known. On the other hand, when you try to quit, your first experience is the bad feeling of withdrawal. Only later do you begin to enjoy the benefits of quitting, such as more pep.
Preparing to Quit
The first step in getting ready to quit is to study your own smoking habits. For a few days, write down every time you have a cigarette. What events or activities make you light up? How often do you smoke?
Once you have an idea of when and why you smoke, you can look for replacements for smoking. For example, smoking may relax you. If so, before quitting, learn and practice another way to relax, such as deep breathing and relaxation exercises.
If you think smoking gives you energy, try standing and stretching or taking a walk when you start to feel the urge to smoke. Exercise can make you more alert.
Perhaps you enjoy the feeling and rituals of holding the cigarette, lighting it, gesturing with it, and tapping off the ashes. To keep your hands busy without a cigarette, try a strand of beads, a polished stone, or a pen.
Before you quit, it's also a good idea to plan rewards for sticking to your goal. For example, you might go to a movie to reward yourself for each week you don't smoke. Or you might put your cigarette money into a jar and use it to buy books or CDs or clothes -- or save it for a trip.
Also, set up a cheerleading squad -- family or friends who will give you support. Former smokers understand what you're going through and may be especially supportive. The more people you tell that you are quitting, the more your pride will help you resist lighting up.
Finally, set a quitting date. Choose a time when you expect your life to be fairly calm. That way, stress won't tempt you to smoke. And if you do have withdrawal symptoms, they won't interfere with your life as much. If you work Monday through Friday, quitting on Friday is a good idea because then you will be past the worst of withdrawal by the start of the work week.
Be a Quitter
There are many ways to quit -- cold turkey or gradually, with a group or by yourself. Talk to your doctor about your decision to quit. He or she can help you choose the best way for you.
Remember, what works for one person may not work for another. Don't be discouraged if the first method you try fails. Some other method may be the one you need to kick the habit for good.
If smoking is merely a habit for you, something that you can take or leave, cold turkey may work best for you. But if you are very dependent on cigarettes, gradually weaning yourself from cigarettes may work best.
One method that helps you quit gradually is nicotine replacement. In this method, your doctor prescribes a nicotine patch or chewing gum. When you wear the patch or chew the gum, some nicotine enters your blood. The patch and gum let you taper off from the physical addiction slowly. They blunt your craving for cigarettes and reduce withdrawal symptoms.
You do not wear the patch forever. Instead, you use a series of patches with decreasing nicotine doses. After a few weeks, you've been weaned totally from nicotine.
Nicotine replacement is especially good for people who are physically addicted to nicotine. These are people who smoke more than 20 cigarettes a day, who have their first cigarette within 30 minutes of waking up, and who have had strong withdrawal symptoms when they tried to quit before.
Research shows that a smoker who uses a patch is twice as likely to quit successfully as someone who doesn't use a patch.
Patches aren't perfect. They raise glucose levels in some people with diabetes. And you must not smoke while wearing the patch.
If you think that you would find it easier to quit with a group of people, think about joining a class. Your company, health plan, or a local hospital may sponsor such courses.
Hypnosis helps some people stop smoking. It is most useful for helping you avoid the things that trigger you to smoke. If you are interested in hypnosis, choose a hypnotist with a clinical degree (for example, a physician or psychologist).
Another method is acupuncture. In acupuncture, fine needles are placed in various parts of your body. For some people, acupuncture stops the craving to smoke. If it's going to work for you, it probably will do so in seven treatments or fewer.
However you decide to quit, there are several ways to help yourself keep at it. Throw away your cigarettes, lighters, and ashtrays at work and at home to make it hard to give into the urge to smoke. Avoid situations in which you enjoy smoking.
Give yourself the rewards you planned. When you are tempted to smoke, make a list of things you like about not smoking. For example, your breath and hair smell fresher, you are saving lots of money, you aren't coughing like you used to, or food tastes better.
Once You've Quit
Once you've quit, the next step is not to start smoking again. The first three months or so after quitting are the hardest time. Most people who return to smoking do so then. During those first three months, they've broken the physical addiction but not yet shaken their psychological dependence on cigarettes.
It only takes one cigarette to put you back on the smoking treadmill. So have some ideas up your sleeve to fight temptation. For example, plan to take a bath, chew sugarless gum, sip some water, find something to do with your hands, or step outside for some fresh air when the urge to smoke hits you.
If you know you are going to be around smokers, be prepared. Practice an answer for when you're offered a cigarette. Seek out non-smokers in the group. Don't apologize for not smoking.
If you do smoke a cigarette, then you need to renew your decision to quit. Focus on learning from your slip, not on berating yourself for it. Figure out why you slipped up and how you might avoid doing so again.
Once your body's metabolism returns to normal, you may put on a little weight. The average is only 7 pounds. If you are worried about gaining weight, talk to your dietician about changing your meal and exercise plans.
You also need to stay in touch with your doctor after you quit. Your diabetes control will probably improve. If so, your doctor may want to change your insulin dose or diabetes pill schedule. Similarly, if you are being treated for high blood pressure or high cholesterol levels, your condition may improve so much that your doctor may want to change your treatment.