This client wanted to stop smoking, had tried “everything” to stop but was still smoking. He had been smoking since 12 years old, was now 45 and his health was compromised by the addiction, so it was critically important to stop permanently. He had tried the various pharmacological remedies with little success so he wanted something he could do indefinitely and that would improve his health — not just reduce the symptoms of addiction.
Nicotine
While nicotine is highly addictive, when a person finally decides to stop smoking, nicotine (and its main metabolite cotinine) effectively only lasts in the body for three or four days. The half-life of nicotine is only 2 hours and the half-life for tissue clearance is about 11 hours. The metabolite cotinine has a half-life of about 16 hours. As nicotine is a chemical with a reward/addiction pattern, the cravings (withdrawal symptoms) come from a variety of causes: the crutch for stressful situations (nicotine impacts on adrenal glands) or a behavioural pattern (when I have a drink on my hand I need a cigarette), but the main cause of the cravings is associated with blood sugar destabilisation.
Nicotine works through the stress response and insulin resistance increasing the reward mechanism of nicotine in the brain. Nicotine is a risk factor for the development of Type 2 diabetes as it increases insulin resistance with resulting hyperglycaemia. Therefore, when ceasing smoking, a reactive hypoglycaemia is a major factor in the cravings.
Stopping
To stop smoking on a permanent basis, blood sugar stabilisation is crucial. Many smokers massively increase their sugar intake (lollies are common) when they stop, often increasing their weight by up to 15kg. In this case we recommended he exercise regularly to help manage his hypoglycaemia, so he set up an exercise program whereby he ran up and down a nearby beach for an hour or two every day.
=Q=
This had a few advantages: he became fitter, his stress management improved and being out of the house for periods of time made his wife happier as she wasn’t the recipient of his extreme irritability (another common side-effect). He was also recommended a higher protein diet, snacking on nuts, seeds and eggs every few hours to stabilise his blood sugar.
A supplement containing fenugreek, gymnema, chromium and lipoic acid three times per day made a big difference in his ability to cope with the hypoglycaemia and significantly helped reduce the cravings, while improving his energy levels.
The extra activity, the higher protein diet and the supplements also meant he did not put on the excess weight that is so common when smokers quit. An overall program to improve his health was added with herbal and nutritional supplementation.
Nicotine withdrawal causes a heightened neural response to stress, so stress management and calming herbs such as passionflower were recommended. He found a cup of passionflower tea was helpful when the cravings became difficult to manage.
He was also prescribed a mixture of lobelia (contains a nonaddictive alkaloid similar to nicotine), oats for calming, Siberian ginseng and Withania (ashwagandha) to restore adrenal function and manage stress, and turmeric as an anti-inflammatory and to support cholesterol metabolism.
The endocannabinoid system plays a role in nicotine reward and dependence so two drops of CBD oil (cannabis oil) under the tongue at night was recommended. This made a big difference improving his sleep patterns and reducing his anxiety.
The supplement regime recommended was NAC (N-acetyl cysteine) twice a day as this reduces the addiction for nicotine and improves detoxification of the liver. NAC also reduces anxiety and regulates both the reward and withdrawal symptoms. Liposomal glutathione was recommended twice daily to improve liver detoxification.
For lung repair, he was advised to supplement cod liver oil (vitamins A, D and omega 3 fatty acids), with vitamin C and zinc. Vitamin C has a protective effect on airway responsiveness and lung function, and antioxidants benefit the function of the lung airways. Smoking causes vitamin A depletion in the lungs while omega 3 fatty acids are anti-inflammatory and have a protective effect against airway hyperactivity.
In the first couple of months of this regime, he experienced two quite severe lung infections where he was coughing up black tarry mucus. This is common in recent ex-smokers and is maybe a way for the lungs to rid themselves of the accumulated tars that have lodged there over the years. He was therefore prescribed expectorant herbs to be taken separately, with thyme, mullein, elecampane, hyssop and angelica. These cleared his lungs in a couple of weeks and he felt much better and could breathe more easily.
After six months on this regime, he was still motivated and happy with the results. Overall, he felt much healthier, fitter, had greater mental clarity, was not waking up coughing in the mornings and was acquiring new skills to manage his non-smoking self. It is said that it takes seven years for the lungs to fully recover from smoking but he has made an excellent start.
