Why Quitting Nicotine is Essential for Health
Quitting nicotine is critically important because it significantly reduces mortality risk, with smokers living approximately 10 years less than non-smokers, and causes widespread damage to nearly every organ system in the body. 1
Cardiovascular Health Impacts
Nicotine directly harms the cardiovascular system through multiple mechanisms:
- Increases blood pressure and heart rate
- Increases blood flow to the heart while simultaneously narrowing arteries
- Contributes to arterial wall hardening (atherosclerosis)
- May lead to heart attacks through these combined effects 1
- Causes endothelial dysfunction by reducing nitrogen monoxide production 2
- Creates pro-thrombotic conditions and activates inflammatory pathways 2
These effects significantly increase the risk of:
- Coronary heart disease
- Hypertension
- Atrial fibrillation
- Heart failure 2
- Stroke
Respiratory System Damage
Tobacco use, particularly smoking, severely damages the respiratory system:
- Is the leading cause of preventable mortality and morbidity worldwide 1
- Significantly increases risk of respiratory diseases
- Worsens outcomes in respiratory infections (e.g., increased severity and death in COVID-19 patients) 1
Neurological Effects
Nicotine has profound effects on the brain:
- Is highly addictive, binding to nicotinic cholinergic receptors 3
- Facilitates neurotransmitter release (especially dopamine, glutamate, and GABA) 3
- Damages developing brains in adolescents 1
- May inhibit estrogen signaling in women's brains, increasing susceptibility to ischemia 1
Special Population Concerns
Diabetes
Patients with diabetes who use nicotine face compounded risks:
- Higher risk of cardiovascular disease
- Premature death
- Worsened microvascular complications
- Poorer glycemic control compared to non-smokers 1
- Smoking may contribute to the development of type 2 diabetes 1
Pregnancy
Nicotine poses serious dangers during pregnancy:
- Crosses the placenta
- Associated with multiple adverse consequences including sudden infant death syndrome 1
- Has genotoxic effects on fetal cells 1
Peripheral Artery Disease
For patients with PAD, continued smoking:
- Increases risk of limb-related events and death
- Accelerates disease progression
- Increases risk of bypass graft failure and amputation 1
Benefits of Quitting
The benefits of quitting nicotine are substantial and begin almost immediately:
- Reduced risk of cardiovascular mortality 2
- Lower incidence of hypertension, type 2 diabetes, and heart failure 2
- For PAD patients, smoking cessation is associated with lower rates of major adverse limb events 1
- For diabetic patients, quitting is associated with improved metabolic parameters, reduced blood pressure, and reduced albuminuria 1
Effective Cessation Approaches
Successful nicotine cessation typically involves:
Pharmacotherapy combined with counseling:
- Varenicline
- Bupropion
- Nicotine replacement therapies 1
Healthcare provider involvement:
Common Pitfalls to Avoid
Electronic Cigarettes
Despite marketing claims:
- E-cigarettes contain and emit numerous potentially toxic substances 1
- Long-term health effects remain uncertain 1
- No persons should be advised to use e-cigarettes as a way to stop smoking tobacco 1
Secondhand Smoke
Avoid exposure to secondhand smoke which:
- Contains nicotine, fine particulates, and toxic chemicals
- Is associated with increased risk of all-cause death, stroke, and cardiovascular disease 1
- Has been associated with the development of PAD 1
Relapse Risk
Be aware that:
- The risk of PAD remains elevated for 10-20 years after quitting 1
- Weight gain may occur shortly after quitting but does not diminish the substantial cardiovascular benefits 1
Quitting nicotine is one of the most important health decisions a person can make, with immediate and long-term benefits for nearly every aspect of health, particularly cardiovascular and respiratory systems.