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Diabetes and smoking cessation (#DiabetesChat Twitter party October 13th, 8-9p EST.)

Diabetes and smoking.

According to the Centers for Disease Control and Prevention (, smokers are “30 to 40% more likely to develop type 2 diabetes than nonsmokers”. Additionally, people with diabetes who are smokers are more likely (than nonsmokers) “to have trouble with controlling their disease”.

Currently, there are 29.1 million Americans with diabetes, and approximately 90% of them have type 2 diabetes. Additionally, there are approximately 86 million prediabetics. Type 2 diabetes/ prediabetes is heavily influenced by our lifestyle choices. Lifestyle changes, including a healthier diet, an increase in activity and a decrease in stress are all basic changes each of us can address. In addition to a healthier diet (calorie and carbohydrate controlled, lower in sodium, higher in whole grains, fruits and vegetables), smoking cessation is highly encouraged for a person with diabetes.

Smoking, in terms of the general public, raises your risk of stroke, heart disease, and lung and kidney disease. For a person with diabetes, there are additional risks associated with smoking. Tobacco causes temporary constriction of blood vessels, which can lead to impaired circulation, higher blood pressure readings, and less oxygenated blood flow to vital organs (heart, lungs, brain, kidneys). For the person with diabetes, already at risk for heart, stroke, and kidney disease, smoking can cause serious complications.

Damaged nerve and blood vessels due to diabetic complications are further compromised with the addition of tobacco products and their associated carcinogenic ( potentially cancer causing) chemicals. The risk of non-traumatic amputations increase greatly in this population due to further impaired circulation.

Tobacco cessation- “quitting smoking” -is a difficult lifestyle change, but there are numerous products available to assist the motivated individual to change this single behavior. By doing so, a person with diabetes will most likely experience a great improvement in their overall health, and get better control of their blood glucose levels as well. In addition to reports of improved health, many former smokers report a better financial situation due to the cost savings of no longer buying tobacco products.

The FDA (Food and Drug Administration) has approved seven medications as safe and effective in helping smokers quit. Some are available OTC ( over the counter- without a prescription) while others do require a prescription from your doctor. OTC nicotine replacement therapy includes a variety of patches, gum, lozenges, inhalers, and nasal spray. Prescription medications used to assist with smoking cessation include Bupropion and Varenicline.

Kirkland Signature Quit2® and Quit4® are two examples of nicotine replacement products available. They are available in both 2mg and 4 mg lozenges and gum products. Its active ingredient is nicotine; it is thought to be a safe nicotine replacement therapy as they do not contain the tar, and carbon monoxide traditionally found in a cigarette. The two doses available are targeted for specific smoker patterns: 4mg products are suitable for smokers who smoke within 30 minutes of waking. 2mg products are suitable for smokers who have their first cigarette of the day more than 30 minutes after waking up.

These products are for oromucosal use, meaning that the nicotine in the lozenge is released slowly into the mouth from where it is absorbed into the body. In all cases you should use nicotine lozenges by putting one lozenge in your mouth and from time to time move it from one side of your mouth to the other, until it is completely dissolved. This should take around 20-30 min. As the packet insert will explain, this product has an outlined smoking cessation program that can go up to 12 weeks. These instructions include information on number of lozenges/gum a day and recommendations on how to reduce their use as the weeks go by. For more information on the product, check out this weblink->,-380-Pieces.product.100155525.html

Smokers have also found that individual, and group therapy, support groups, online counseling, and telephonic coaching were all effective avenues that gave them much needed support. Perrigo designed a smoking cessation program for Costco. Read more about it -> Nationally, there is toll free number for people to find out more information on smoking cessation programs in their area. People interested in smoking cessation can call 1-800-QUIT-NOW (1-800-784-8669) or 1-855-DÉJELO-YA (1-855-335-3569 for Spanish speakers)to learn more about available resources.

The decision to stop smoking is to be applauded. Quitting smoking is very difficult, so it is best to prepare wisely in advance. Successful former smokers have given the following suggestions on how to prepare for your designated “quit day”. Write down all the reasons you want to quit smoking- think of all the health benefits, and cost savings. Ask your family and friends to help you. Rid your home and work place of matches, lighters, ashtrays and cigarettes, to avoid temptation or visual reminders. Simple changes in behavior and your (current) daily routine may need to be addressed. Do you always have a cigarette with your morning coffee, or after dinner? Do you only smoke when with others, or at certain times of the day? Be prepared to change aspects of your daily routine, which will support your cessation efforts. Small changes will definitely yield big results. Congratulations on your decision to improve your health.

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