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Kicking the Smoking Habit

separator Smoking isn't good for anyone's health, but having diabetes is even one more reason why it's a good idea to kick the habit. Diabetes itself is a risk factor for heart disease, kidney problems, high blood pressure and other conditions. People who have diabetes and who also smoke are just adding a risk factor for health problems. And smoking is a risk factor you can control.

Now, there's even more incentive to quit smoking. As you may know, arteries contract and relax to regulate blood flow, but smoking makes arteries stiffer and less responsive. This is what people are referring to when they say that someone has hardening of the arteries. A recent study looked at men in their twenties and thirties who had smoked an average of 20 cigarettes a day for more than five years. Results showed that quitting smoking for six months improved artery function, which in turn decreases the risk of heart disease because blood flow to the heart is improved. Further research on older participants will demonstrate whether quitting smoking has the same benefits on an older population as well.

If quitting smoking has been in the back of your mind for a while, the new year is a great time to give it your best shot. If you've tried before and weren't successful, don't worry about that now. Most people who quit successfully had unsuccessful tries earlier. Quitting is hard, but trying again is the only way to keep yourself on the path to quitting for good.

First, prepare yourself

If you smoke, your body is addicted to nicotine. But you're also probably attached to the behaviors that go along with smoking—maybe having a cup of coffee, talking on the telephone, socializing with friends, having a drink, feeling relaxed. The physical addiction is incredibly difficult to get past, but the emotional attachment is hard to give up as well.

That's why quitting is a multi-pronged effort. Here is a good way to approach it:

  • When you decide you want to quit, set a date about two weeks ahead. During the two weeks before you actually quit, write down the reasons why you want to quit. Keep a diary of the times that you smoke and the reasons that you smoke. Use these two weeks to get a profound understanding of your smoking habit. This knowledge will give you and your doctor insight that will identify the best ways to quit and avoid relapse when your time comes to actually stop smoking. Many people find it helpful to get rid of all cigarettes, ash trays, lighters, etc. just before they quit .
  • Gather your reinforcements. In other words, set up lots of support. Tell your family, friends and co-workers about your plan to quit. Just as important, enlist the help of your doctor. Research shows that people who get help from their doctor to quit smoking have higher success rates. Your doctor can help you identify the best quitting method for you and give you helpful advice about hotlines and effective smoking cessation programs in your community.
  • Consider joining a support group. Visit the American Cancer Society ( for information. Or visit the American Lung Association for a free online smoking cessation program (
  • Identify and implement new ways to relax. Consider changing your old triggers for smoking, and replace them with different activities for a while. For example, if you used to love getting on the telephone while you had a cigarette, plan a long walk instead. Or a hot bath. Or a little quiet time with music and some stretching.
  • Be realistic about how you'll feel right after you stop smoking. You're likely to feel jumpy, have headaches, be irritable, feel hungry. You'll probably crave cigarettes intensely. These are typical withdrawal symptoms. They get better over time, but they're hard to handle in the beginning. That's why using nicotine replacements or medications that blunt the effects of withdrawal can help people get through this difficult time. Managing your symptoms can help give you the confidence you need to continue with the process.

Tools and methods available to you

Nicotine replacements

Nicotine replacement therapy helps you quit smoking by providing nicotine to your system without the harmful chemicals that are in tobacco. They ease the symptoms of withdrawal that you would have if you stopped smoking without adding any nicotine to your system at all. Nicotine replacements include gum, patches, sprays, inhalers or lozenges. Your doctor, a smoking cessation support group or other healthcare professional can help you determine which kind of nicotine replacement would be right for you.

It's usually withdrawal symptoms that cause people to relapse. Nicotine replacement helps to ease the withdrawal symptoms. Most relapses occur within the first three months of quitting. If you've tried to quit before without a nicotine replacement, you might want to try one this time. It's also important to have the support of people around you.

Non-nicotine Medications

There are two main non-nicotine medications available for smoking cessation. The newest one on the market is called Chantix. The Food and Drug Administration approved it in April 2006. It's available for people 18 and older. Studies have indicated that Chantix may be more effective than Zyban, another approved smoking cessation medication.

Chantix works in two ways: it makes the withdrawal symptoms from nicotine less severe, and it makes smoking less pleasurable. It does this by interfering with nicotine receptors in the brain. When you're on Chantix and you have a cigarette, you're much less likely to get a feeling of calm or relief.

The most common side effect of Chantix is nausea. Other side effects may include changes in your dreams, constipation, vomiting and gassy feelings.

Zyban is an anti-depressant medication that's also known to reduce the effects of nicotine withdrawal.

Both Chantix and Zyban are prescription medications.


Hypnosis is a state of focused, relaxed concentration that allows you to be more open to suggestion than you may otherwise be. There have been mixed results for hypnosis as a smoking cessation method. But if it's something that interests you, there's no harm in pursuing it, either on its own or in combination with nicotine replacement or non-nicotine medications. Ask your doctor for a referral to a hypnotherapist, or ask the professionals at any of the smoking cessation programs you attend. If you do see a hypnotherapist, it's probably best to choose someone who makes no promises that you'll be able to quit after only one visit.


There's some evidence—although not a great depth of it—that acupuncture can help with smoking cessation. A study in the publication Preventive Medicine of 46 participants divided the group into an acupuncture group and a control group. The control group received fake acupuncture treatments, while the control group received treatment at acupuncture points that correspond with the lungs, airways and mouth. Participants had two treatments per week for three weeks. After five years, four of the acupuncture patients and two of the control group had been successful at quitting smoking.

For more general information about acupuncture, read the current Topic of the Month.


Exercise is one activity you can use to replace some of your smoking time. Lots of people who want to quit smoking say the fear of gaining weight holds them back. But exercise can help you keep your weight under control. It can also help you manage your stress.

If at first you don't succeed....

Really and truly—falling off the wagon is often just part of the process of eventual success in quitting. Don't get too discouraged if you need to try again. That's normal. The important thing is to keep going.

Sources: American Academy of Family Physicians; American Cancer Society; Food and Drug Administration; Journal of the American Medical Association; The Journal of Nuclear Medicine, December 2006;

Teasing Out the Truth in Internet Ads and Web Sites for Diabetes Medications and "Cures"

It can be so tempting. You see claims on a Web site about a new product that can make your blood sugar stable, improve the function of your pancreas or even make your diabetes disappear completely. There may be "testimonials" on the site too—stories from "actual" people who used these products and had great success. There may be a guarantee that you'll get your money back if you're not satisfied. So you think, "Why not?" and place your order.

Before you yield to the temptation of the claims on these Web sites, you should know that fraud is widespread on the Internet. According to the Federal Trade Commission (FTC), consumers spend millions of dollars every year on unproven health products and services. The FTC and the Food and Drug Administration (FDA) recently collaborated on a push to stop deceptive Internet advertisements and sales of products misrepresented as cures or treatments for diabetes.

This drive comes after a group called the International Consumer Protection and Enforcement Network conducted a search of the Web for hidden traps—sites that tried to entice people into buying unproven, and sometimes even dangerous, products. After that search, the FTC sent warning letters about deceptive ads to 84 domestic sites and 7 Canadian ones that targeted U.S. consumers. They referred 21 sites to foreign governments.

The Food and Drug Administration has issued warning letters to 24 firms that market dietary supplements that the firms claim can treat, cure or prevent diabetes. The letters warn that failure to correct the violations may result in enforcement action, such as seizure of products and injunctions against manufacturers and distributors.

To view the list of companies and the products they sell, click here:

How to tell an ad is probably a scam

The FTC and the FDA caution consumers to "Be smart, be skeptical" when you're looking at information about diabetes products. They also strongly advise that you talk with your doctor before you try any new product. And follow these guidelines to detect fraudulent claims:

  • Never believe any claims that a product can cure diabetes. There are no herbs, patches, teas, pills or any other known product that can cure diabetes. If there were, your doctor would know about it.
  • Be extremely skeptical of a product that claims it can perform many different functions.
  • Don't be fooled about claims of a "scientific breakthrough." If it really were a scientific breakthrough, you'd be more likely to be hearing about it on the national news or reading about it in the headlines of your newspaper.
  • Realize that a picture of a doctor on a Web page isn't necessarily a picture of an actual doctor. It could be a picture of a model posing as a doctor.
  • Success stories aren't necessarily true, even though they may sound extremely convincing.
  • Remember that a money-back guarantee is no guarantee at all. It's common practice for scammers to take your money and then disappear.

When you have a chronic disease, you may be more vulnerable to suggestion. You wish there were a miracle cure, a pill that makes diabetes go away, a special diet that can take care of all the problems.

Scammers know that you're vulnerable. The best way to protect yourself from them is to ask your doctor or other healthcare provider about products—before you make any purchases.

The Federal Trade Commission; The Food and Drug Administration
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