No more cigarettes: quitting smoking always pays off

Professor dr. Andreas Stefan, why is smoking and diabetes a particularly bad combination?

People with diabetes already have a high risk of cardiovascular disease, and smoking increases that risk significantly. Elevated blood sugar levels damage blood vessels. Smoking also causes damage to the arteries. This can result in heart attacks and strokes, and problems with circulation in the legs, eyes and kidneys. Studies have shown that smokers are twice as likely to develop type 2 diabetes and that diabetes is also made worse by cigarette smoke. Tobacco smoke seems to slow the body’s production of its own insulin, which leads to higher blood sugar levels.

Professor Dr. Andreas Stefan is a lung specialist in Immenhausen and leads the Tobacco Cessation Task Force of the German Society of Pneumology and Respiratory Medicine

Professor Dr. Andreas Stefan is a lung specialist in Immenhausen and leads the Tobacco Cessation Task Force of the German Society of Pneumology and Respiratory Medicine

Many smokers worry that if they stop smoking they will gain weight. A dilemma for people with diabetes, right?

Of course, people with diabetes should keep their body weight as healthy as possible, because being overweight also increases the risk of cardiovascular disease and affects the further course of the diabetic disease. But it is absolutely wrong to think that gaining weight while giving up tobacco is worse than continuing to smoke. Quitting smoking is always profitable, even with a few extra pounds of weight. A large American study of 160,000 participants found that when you quit smoking, your body weight increased slightly – by an average of about three kilograms – but the mortality rate in those who quit smoking decreased. In other words, former smokers live longer. So compared to weight gain, smoking is a much more extreme health problem. You also need to know that smokers are leaner at times, but body fat is often especially harmful.

Why could fat burning be a bigger problem?

Smokers often appear thin. But they still have more fat from the internal organs on the belly. Fat which is especially problematic because it produces neurotransmitters that promote diabetes and cardiovascular disease.

Bars instead of cigarettes: people with diabetes are not allowed. So how do you avoid gaining weight after quitting smoking?

Of course, there is a risk that ex-smokers will find alternative satisfaction in something sweet and eat a chocolate chip cookie instead of a cigarette with their coffee, for example. Basically, I think people who want to quit smoking should concentrate fully on it first. It’s frustrating to have to quit smoking, then replace chocolate with carrots and exercise more. To keep your weight gain in check, devise a strategy and do something other than reaching for candy, especially when you have a strong craving for a cigarette. I know it’s hard. Therefore, I believe that getting support is absolutely advisable. Only about five percent of smokers manage to quit in the long run without any aids.

Do you recommend nicotine substitutes?

Patches, sprays, inhalers, chewing gum, and nicotine tablets help to quit smoking and may prevent you from reaching for a chocolate bar as a substitute. For example, using a nicotine mouth spray and patch roughly doubles your chances of successfully quitting smoking in the long term. In addition, nicotine replacement therapy reduces weight gain when stopping smoking. Nicotine replacement products are available over the counter at pharmacies, where you can also get comprehensive advice. The goal is to gradually reduce the amount of nicotine and reduce the symptoms of withdrawal and craving. At the same time, ex-smokers must change their behavior and consider alternatives to smoking. Behavioral withdrawal programs can support this.

Is throwing together in a group effective?

Yes, behavioral therapy-oriented group therapies with drugs are considered to be the most effective method of quitting smoking in the long run. Participants analyze situations in which they are addicted to a cigarette and jointly develop strategies for changing habits. Courses are offered, for example, by clinics. Most insurance companies cover a large proportion of the costs.

Drug support? Stop smoking pills?

Yes. Smokers may also be prescribed anti-smoking drugs on a private prescription. They contain active ingredients such as varenicline, bupropion or cytisine. The treatment should be performed under medical supervision and the treatment lasts for at least eight weeks. Medicines are not suitable for every smoker, can have serious side effects, and must not be used in some comorbidities.

But do you have to pay for drugs out of your own pocket?

Unfortunately at the moment. However, your health insurance will cover the costs in the future. Consultations are ongoing about what medications can be prescribed and what conditions must be met for this.

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