Quitting brings new risks
(My daughter calls Anthony Bourdain, right, the smoking chef. He quit smoking a few years ago. This one's for you, Tony.)
The conventional picture is always the same. People are smoking like mad. It helps with the nerves from not drinking, but doctors know you're just swapping addictions, and cigarettes will do the same thing to your lungs that alcoholism did to your liver.
OK, so you quit smoking. We all have friends who have quit smoking. What happens first?
You gain weight. Food suddenly tastes good again, you need something to do with your mouth and hands. Loyal friends keep quiet because, heck, it beats smoking.
Yes, it does. But according to the Annals of Internal Medicine, it nearly doubles your risk for diabetes over the next few years.
Johns Hopkins scientists looked at the Atherosclerosis Risk in Communities (ARIC) study. It involved about 11,000 people who did not have diabetes starting in 1987 to 1989. Interviews both at at the start and during the study identified the smokers, and blood tests identified those who developed Type 2 diabetes.
Over the 9 years of the study, that represented 1,254 people, about 10% of the sample. The Hopkins researchers found smoking itself increased the risk of Type 2 diabetes by 42%.
The study's authors then followed up with the records of 380 patients who quit smoking. After fully adjusting for age, weight and other factors, it was found these people were 91% more likely to get diabetes within three years of quitting.
But here's the key takeaway. That increased risk gradually dropped. After 12 years without cigarettes, the risk of diabetes onset was no different than for people who had always been smoke free.
Here's the conclusion:
Cigarette smoking predicts incident type 2 diabetes, but smoking cessation leads to higher short-term risk. For smokers at risk for diabetes, smoking cessation should be coupled with strategies for diabetes prevention and early detection.
Everyone agrees that drinking, smoking and overeating are lifestyle choices, and they are. But they are also choices that can lead to sickness and a horrible death. Cirrhosis, lung cancer and diabetes are all very nasty.
The question is, how do we develop a lifestyle approach for quitting all excess that doesn't make the doctor look like a hectoring tyrant, and doesn't turn patients like Bourdain into boring health nuts?