Five years ago, I smoked the very last cigarette of my life. One year later I took stock of benefits and especially side effects. Very rarely it is possible to find reports about side effects of smoking cessation. Mostly it is talked about the health benefits which there are with no doubt many. Here, I want to talk about the side effects which I was facing when I had stopped smoking.

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moking cessation is without any doubt a very healthy decision. It requires a very strong will. Sometimes even the help of a doctor who can prescribe medication or the coaching from a group. Nonetheless, more than 95% of people who stopped smoking have a relapse within the first week of cessation. Fortunately, I am one of the 3-5% who are successful ex-smokers even after five years. One reason why I was successful was apart from a very strong will the very strong side effects which I experienced. Side effects which I would never wanted to experience again. Of course, there are a lot of health benefits, but you cannot feel them. What you feel are the side effects. They gave me a very hard time; a miserable time and I wasn’t even a heavy smoker. How much harder it must be for someone who smoked much more than I did? A study in “Addictive Behaviours” from 2015 showed that people who metabolized nicotine fast were less likely to quit smoking, more likely to relapse and needed medication compared to people who metabolized nicotine in a normal speed. They were more likely to stick to cessation and benefited from nicotine patches ¹. I guess the fight with the cigarette will never really be over. It seems that with cigarettes it is like with all addictions. One is addicted forever until the end of life. There are not only dry alcoholics or clean drug addicts but also clean smokers. Here, I will tell you about the side effects of stopping smoking. Something which is very seldom talked about.

 

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lready many years before I quitted smoking I wanted to stop but as every smoker knows it is not an easy thing. For me it was especially difficult because the cigarette was my very best friend in all situations of my life. It never disappointed me and was always there. And if it was not there, I walked miles to get it. I remembered evenings when I traveled with the underground to the next gas station only to buy cigarettes. Basically, this was paradox. I am an independent person who loves her freedom in all situations of life but on these stupid cigarettes I depended totally. They helped me through boredom and loneliness. A little thin stick to hold on to, no matter where and when. I started to understand that the cigarette was a very false friend and that I should better say farewell to the friend who wasn’t one.

Finally, I was ready. 

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o make it not too difficult I said slowly goodbye from the very best but false friend of my life. I started with not smoking at work, then I reduced the cigarettes in the evening from five to only two or maximal three, then only one. When a friend from work took a course together with her husband to help them quitting, she always told me a little bit about what they had learned there about addiction and dependence. This helped me to carry on. At this time, I smoked this one cigarette at the evening. It was enough, but I still needed it. Of doing the next step I was afraid and postponed it every evening. One evening my mood was so bad that I wanted to kill someone. So, for the health of my surrounding I skipped giving up this evening again until a few evenings later I was ready to go until the end, incited by the fact that my colleague had done it, so I didn’t want to fall behind too much. I was envious that she already had it behind her, the first complete day without smoking. The first evening was very very very hard. Also, the next day was very very very hard. My thoughts circled only about cigarettes. They broke into my brain and drilled through my thoughts. But I wouldn’t give; I would consciously brush them away. Starting all over again and having another first day again and again for thoughts which would vanish after a few minutes again wouldn’t make any sense. I had to go through it NOW.

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uitting smoking is I guess like quitting drugs. You are on Cold Turkey for a few days up to two weeks depending on how many cigarettes you had smoked and how your body reacts to the cessation. It is much more than only a bad mood. It is a VERY deep unrest, a very deep irritability and aggressiveness which needs to be hold of                           constantly which increases the stress.

 It is a feeling of bursting out every second. For about a week I wanted to kill someone or at least scream at someone or throw something very hard on the floor. Additionally, I had a bad headache which probably resulted from the stress of holding back the anger within, which I tried to beat with lots of water. And it was hard for me focus. I had dreaded these symptoms and kind of knew that this would probably happen. So, I stayed strong and hoped that it would go away, soon.

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very day I said to myself: “Be strong for this one day only.” Already after three days, my body had lost the desire to smoke but I walked after every person on the street who hold a cigarette in his hand to inhale the smoke deeply. This was kind of my nicotine patch. When I had woken up on the third morning I felt that s incredible had happened. I could breathe freely. For the first time in years I could go up the very small and very short hill our house to the bus stop without grasping for breath. I had never known that so much air could go into my body.

This is what happens during the first three days of smoking cessation. After about twelve hours the body starts to dismantle carbon monoxide in the body. That leads to more oxygen in the blood. Carbon monoxide and oxygen compete for the docking sites inside the haemoglobin in the red blood cells whereby carbon monoxide always wins. That means a smoker always has mild carbon monoxide poisoning. Similar holds true for a person who lives in a big dirty city. When less carbon monoxide is inside the blood, more oxygen can get transported throughout the body and to the lungs which leads to be able to breathe better. People asked me if I could also smell or taste better. But I never had problems with smelling or tasting, so nothing had changed here.

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bout three weeks later I started eating and when I had started I couldn’t stop. So, I ate before the meal, during the meal and after the meal I had to eat something. I tried to keep this low-calorie, sticking to vegetables like cucumbers or tomatoes but later I changed to chocolate. The inevitable began. I started to gain weight.

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 started to run because I didn’t want to become fat and I wanted to fight the depression. This was extremely hard for me, running is simply not my sport. So, I changed to going on walks, every evening, fast pace, for one hour. It helped a bit in the beginning when there was still hope that this running/walking would bring a change. But to be honest, it didn’t. I can say that it somehow even increased the depression. During the walks I was thinking and thinking and thinking, so that after the walk I had thought myself into a sad mood. I tried to listen to music to distract myself from all these thoughts. But they can read notes and simply find their way through the music. Maybe funny music would have worked better than the sad dark songs of separation and lost love. On top of it, I still gained weight which was very discouraging and frustrating. Later I found that there were studies showing that the weight gain after smoking cessation is not only due to increased food intake but also to dramatic changes in the gut flora. Scientists from Switzerland and Germany found that the gut bacteria of the species Firmicutes and Actinobacteria had increased after four weeks of smoking cessation while simultaneously the bacteria of the species Proteobacteria and Bacteroidetes had decreased, a gut flora composition similar to what can be found in the guts of obese people². Unfortunately, I couldn’t find any probiotics which contained Proteobacteria or Bacteroidetes.

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trangely, I began coughing. When I had smoked I never ever had a smoking cough but now it seemed as if I developed one. I thought that maybe my body started to clean itself and the lung would cough the dirt out. During this cleaning phase which holds on for about six months the body reacts more susceptible to ear-nose-throat and lung infections. The withdrawal of the anti-inflammatory substances which are in the cigarette smoke causes the mucous membranes to react more sensible to pollen, toxic substances, pathogens and so on.

Also, my skin got worse. Pimples and spots returned, not only in the face also on my back. This last for a few months and is related to the same effect. The body cleans itself and moves the toxins outside.

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bout three months later I became depressive. I felt so lonely and alone. I slept very badly, and I didn’t have energy to do something. I didn’t want to do anything, because something big was missing in my life and there was yet nothing which could replace it. Everything I did was staring into the television like a robot who was put in front of it. I asked myself whether this would go on like that for the rest of my life. I regretted very much that I had stopped smoking because I missed the cigarettes so much. Well, of course I went every day to work. My working friend suggested to me that I might be in pre-menopause because she remembered to have had a depression when she was in menopause. WHAT the hell? I was still much too young for menopause. And I had stopped smoking because I didn’t want to get into early menopause. But then there were the heat waves as in menopause. I was worried. Later I learned that heat waves can be a side effect of smoking cessation. It's due to hormonal changes. She added that there were three crises when quitting smoking. The first one would come after around three days, the second one after about three weeks and the third one after about three months. These crises one had to overcome to be a successful quitter of smoking. Obviously, I was in the third crisis. I calmed myself down.

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t this time point I didn’t know that this crisis would go on for a long time because it was not only the depression but also the beginning of severe digestion problems. Retrospectively, I can say with bald honesty that this was my worst nightmarish side effect and until today I still have to fight with the aftermath of the problem. Digestion problems especially constipation, flatulence and pain start because cigarettes work like a laxative. They increase the mobility of the intestine. Well, I always had problems with my digestion system, it runs in the family, but also because I had never drunken enough water. Let’s say it was never easy but with the cigarettes it was bearable. But now that I had withdrawn the body its laxative, the real problems began. My intestine was basically dead. It hardly moved at all anymore. No laxative which I bought in the pharmacy could help, even enemas couldn’t give relieve. In the end when I realized that I couldn’t continue like that until the end of my life, I went to a Chinese doctor where I was not only treated with acupuncture which relieved the body and the mind, I also learned what to eat to get it going and other useful advices. If I had ever read anywhere that by withdrawing nicotine one could possibly develop serious constipation maybe I would have started earlier to try to heal my digestion problems and I might have been spared from all the pain which I had to endure later for a long period of time.

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early, I forgot to mention the pancreas cancer. Yes, I was convinced after consulting with one or more of these diagnosis programs in google that I had pancreas cancer. Yes, I was melodramatic, but smoking can cause almost every type of cancer and I had been ready to kick the habit when I had begun to be worried about cancer. Since I had stopped smoking I wanted to eat sweet stuff ALL the time. After about eight months it started that I had to go to the toilet every twenty to thirty minutes, even when I hadn’t drunken water or coffee or tea or hadn’t eaten a juicy fruit or a soup. And it was not only a little bit, I had the feeling that every time I went to the toilet I lost at least one litre if not two. At least it felt like that. Also, during the night I had to go, sometimes twice. This is called polyuria. The sweet attacks paired with the polyuria suggests diabetes but why google suggested pancreas cancer? Probably because of the same reason. It sounds like diabetes which is related to the pancreas, so it could also be pancreas cancer which sounds much more dramatic and if someone really has pancreas cancer these diagnosis programs in the web wouldn’t have put it first, they could be sued because they suggested that there is only a polyuria related to stopping smoking. Although one of the symptoms of pancreas cancer is weight loss. Well, I gained weight because of all the chocolate I suddenly liked so much. Since cigarettes increase the glucose in the blood by causing the body to release glucose from glucogen - this is the form in which the body stores glucose in the muscles and in the liver for later use – one will eat less sweets when smoking, and stay slim, also because the metabolism is increased by nicotine.

So, eating lots of sugar and having stopped smoking could explain the polyuria but only if I had been insulin resistant. Insulin resistance or loss of insulin logically leads to increased glucose levels in the blood which cannot be taken up by the cells. Therefore, the body tries to get rid of the surplus glucose by releasing it with the urine.

That means, if I had been diabetic or pre-diabetic I had an explanation for the polyuria. But I was neither. It still didn’t make sense until I found an report claiming that 32% (which is a pretty high number) of women in my age who had stopped smoking developed polyuria³ https://www.ehealthme.com/cs/quit-smoking/polyuria/. Obviously, I was one of them and I didn’t need any further explanations. On the other hand, polyuria is when more than 3 L urine per day are produced. I had never actually measured my urine amounts that means I don’t even know for certain if I had really had it.



One year later I still hadn’t the feeling to be really smoke free and I still had the feeling that something was missing in my life and I still liked the idea of smoking. On the other hand, I despised the smell of cigarettes. When I smelled cigarettes or smelled a person who had smoked a few minutes ago, I felt sickened. In summer I had lit a cigarette for someone else and regretted it immediately because it was so utterly disgusting. Also, this taste in the mouth lasted for a long time. On the other hand, I was glad that I had done it because I understood with my heart that I wouldn’t want to go back. Today, after five years of not smoking I again like the smell of cigarettes but I wouldn’t lite another one again because I know that like an alcoholic you are addicted for the rest of your life and one cigarette will lead to the second and the third and then you buy the package. I wouldn’t want to go through all the pain of smoking cessation again. So, I will stay away from testing how it is to smoke a cigarette again. It is simply not worth it. It is sometimes still hard not to smoke and when friends were visiting me for a few days who are heavy smokers I was thinking that when they stay a little bit longer I will start smoking again. It worries me a bit that I like the smell of cigarettes again and that I had these thoughts of wanting to smoke a cigarette again, but I really hope that maybe one day it will vanish completely, and I will feel like someone who never ever had the desire to smoke.

After about a year the body has regenerated and adopted to the new situation of not getting nicotine anymore. Everything that had been troubled was getting back to normal again. Yesterday, I saw a woman with an electronic cigarette and I thought to myself how glad I am that all this is behind me. Out of “endure only this one day” and “every day is a success” became weeks and months and years and it probably will never be fully over. It is like cold war with the hardest battle won. It was worth it. Life is much better now.
If you want to learn more about side effects of smoking cessation go to this page:
https://healdove.com/mental-health/What-happens-to-your-body-when-you-quit-smoking-with-cold-turkey--Chantix-or-Zyban

Besides that, I couldn’t find anything which supports the idea that quitting smoking could cause menopause. Although doubts remained. Probably, I stopped smoking too late.

1.        Kaufmann, A. et al. Rate of Nicotine Metabolism and Smoking Cessation Outcomes in a Community-based Sample of Treatment-Seeking Smokers. Addict. Behav. 51, 93–99 (2015).

2.        Biedermann, L. et al. Smoking Cessation Induces Profound Changes in the Composition of the Intestinal Microbiota in Humans. PLoS One 8, e59260 (2013).

3.        Alcalai, R., Spectre, G., Bursztyn, M. & Israel, J. Smoking, cough, and polyuria. Arch. Intern. Med. (2002). doi:10.1001/archinte.162.2.223

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