If a slave to inhaled nicotine, have you ever noticed how your lack of control over that next fix bears remarkable resemblance to loss of control over how much or often you eat?

Maybe not just yet, as nicotine is a nervous system stimulant and appetite suppressant. But once you muster the courage to stop smoking or quit vaping, what then?

While most who quit smoking initially gain a few pounds, one in five actually lose weight. But how?

Appetite

Let's focus on 3 factors while briefly reviewing appetite as it relates to full and abrupt nicotine cessation: ghrelin, leptin, and dopamine.

Produced primarily by the stomach wall, ghrelin is called the "hunger hormone" as it stimulates appetite. Ghrelin is released into the bloodstream and signals the brain via dopamine pathways when the stomach is empty. It's also released by our salivary glands and taste buds.[1]

On the other end of the appetite spectrum is leptin. Leptin is the body's satiety or "feeling-full" hormone. Produced primarily by fat cells (adipose tissue) in the small intestines, hunger and fat storage are inhibited when bloodstream leptin levels increase.[2]

Like nicotine, ghrelin and leptin impact brain dopamine levels.

Although still poorly understood, infusion of ghrelin into the brain's ventral tegmental area (VTA) stimulates dopamine release and dramatically increases food intake,[3] while an increase in leptin in the VTA somehow diminishes dopamine and appetite.[4]

How does this relate to quitting smoking or vaping? Although activating different receptor combinations, within 8-10 seconds of a puff, inhaled nicotine stimulates the release of dopamine within the VTA too.[5]

I submit that a primary reason why most smokers gain 5 to 8 pounds after quitting is that, after nicotine use ends and dopamine flow temporarily declines, there is a natural tendency to attempt to compensate by using extra food to release additional dopamine.

Research suggests that it can take up to 3 weeks for brain dopamine pathways to re-sensitize after quitting, as the number of receptors is gradually down-regulated to levels seen in never-smokers.[6] Unfortunately, horrible eating patterns/habits can be established within 3 weeks.

Additionally, nicotine is a nervous system stimulant capable of burning 100-300 calories a day via increased metabolism caused by repeated activation of the body's fight or flight response. But keep in mind that it takes roughly 3,500 unburned calories to generate 1 pound of weight gain.[7] In heavy nicotine users, that accounts for, at most, a pound or so of additional weight during the first couple of weeks.

Also, as we age, with each passing year, our metabolism declines a bit anyway.[8] If we want to keep our body weight the same, we have no choice but to either increase our level of daily activity or reduce our calorie intake.

Regarding our gradually declining metabolism, nicotine cessation is simply a golden opportunity to practice making a lifestyle adjustment now.

Oh, one more weight point. Water retention is normal during the first few days (a nicotine cessation rebound effect).[9] Not to fret. The extra water is usually shed within two weeks.

Ghrelin & Leptin Control

So, how can a super basic understanding of ghrelin, leptin, and quitting appetite aid in maintaining or reducing body weight during nicotine dependency recovery? Let's explore three avenues to eating contentment: decreasing ghrelin, increasing leptin, and minimizing the use of extra food as a nicotine/dopamine substitute.

As for ghrelin and increasing appetite, although this may come as a shocker, blood ghrelin levels are at least 6 times higher after drinking a carbonated beverage, including diet soda, than after drinking water.[10]

While diet soda itself is zero calories, what good is that if it forces you to eat? Consider non-carbonated zero calorie flavored water instead.

Insufficient sleep can also increase appetite. A 2004 study found that ghrelin levels were 28% higher, leptin levels 18% lower, and hunger ratings 24% greater after two nights of getting 4 hours sleep.[11]

Are you a regular caffeine drinker? If so, it's important to note that nicotine somehow doubles the rate by which the liver eliminates caffeine, and your blood caffeine level will double to 203% of your pre-quitting baseline once nicotine use ends.[12] Consider a caffeine reduction of up to 50% if experiencing difficulty sleeping, anxiety or irritability.

Also potentially affecting sleep, the blue LED light emitted from smartphones and from computer and television screens suppresses the body's release of melatonin, a hormone that makes us feel sleepy.[13] Again, if having trouble falling to sleep consider ending the use of electronic devices an hour or so before bedtime.

Ghrelin levels have been found to be substantially lower within 60 minutes of eating foods rich in fiber or whole grains as compared to eating refined carbohydrates.[14]

Why invite ghrelin to sabotage your quit attempt by adding demoralizing pounds generated by chips, cookies, pasta, white rice, or bread? The average cookie is 50 calories. You'd need to walk half a mile to burn those calories. The cookie isn't worth it.

Healthy eating can also aid in maintaining satiety for hours. For example, adding half an avocado (100-150 calories) to your lunch has been found to elevate blood leptin levels by 22% after 30 minutes of eating, and 52% after 3 hours.[15]

Additional leptin elevation and stabilization foods include rolled oats, eggs, broccoli, lean protein, green bananas, nuts, seeds, and oily fish such as salmon or halibut.

Have you ever noticed how you're soon hungry again after eating flour pancakes? Have you noticed how oatmeal sticks to your ribs for hours? Why not give healthy flourless oatmeal pancakes a try.

Minimizing Nicotine to Food Dopamine Replacement

Take a slow deep deep breath. As you slowly exhale, sense the subtle "aaah" sensation. That's dopamine. Take a sip of cool refreshing water. Again, feel the "aaah" sensation? Now, if available, go get a big big hug. Feel it? While eating generates an "aaah" too, breathing, water and hugs are 100 percent calorie-free.

A stimulant, nicotine disrupts normal healthy eating by pumping stored blood sugar and fats into our bloodstream within seconds of a puff. One of nicotine dependency recovery's greatest challenges is re-learning when it's time to feed ourselves and how much.

An inability to concentrate, confusion, nervousness, anxiety, headaches, most quitting symptoms are blood sugar related.[16] Normal people eat two to three times daily, not with every puff.

The body becomes 100 percent nicotine-free and withdrawal peaks in intensity within 3 days of ending nicotine use.[17] If your health and diet allow, sipping on acidic natural juice (the lowest pH, cranberry is excellent) during those 3 days will aid in both helping avoid blood sugar swing symptoms and in more rapidly eliminating the alkaloid nicotine from your bloodstream.[18]

The worst behind you, the balance of recovery will be in allowing yourself the time needed to reach Easy Street. You'll know you've arrived when you begin experiencing entire days without once thinking about wanting to inhale nicotine. After the first such day, they'll become more and more common until becoming your new sense of normal.

There was always only one rule to getting there. It's called the Law of Addiction.[19] In that one puff will always be too many and thousands not enough, to Never Take Another Puff!

And remember, there is a massive distinction between cravings for food and cravings for nicotine. Surrendering to one keeps us alive while the other keeps us enslaved. Without food, we die. Without nicotine, we gradually become super comfortable, arrive home and thrive.

References

1. ↩ Kaabi YA, Khalifa MA. Acute one-cigarette smoking decreases ghrelin hormone in saliva: a pilot study. Int J Endocrinol. 2014;2014:575671. doi: 10.1155/2014/575671. Epub 2014 Apr 7. PMID: 24808912; PMCID: PMC3997941.

2. ↩ Wikipedia, Leptin, accessed 05/25/22

3. ↩ Abizaid A. Ghrelin and dopamine: new insights on the peripheral regulation of appetite. J Neuroendocrinol. 2009 Sep;21(9):787-93. doi: 10.1111/j.1365-2826.2009.01896.x. Epub 2009 Jun 12. PMID: 19523165.

4. ↩ DiLeone RJ. The influence of leptin on the dopamine system and implications for ingestive behavior. Int J Obes (Lond). 2009 Jun;33 Suppl 2(Suppl 2):S25-9. doi: 10.1038/ijo.2009.68. PMID: 19528975; PMCID: PMC2812808.

5. ↩ Liu L, Zhao-Shea R, McIntosh JM, Gardner PD, Tapper AR. Nicotine persistently activates ventral tegmental area dopaminergic neurons via nicotinic acetylcholine receptors containing α4 and α6 subunits. Mol Pharmacol. 2012 Apr;81(4):541-8. doi: 10.1124/mol.111.076661. Epub 2012 Jan 5. PMID: 22222765; PMCID: PMC3310415.

6. ↩ Mamede M, Ishizu K, Ueda M, Mukai T, Iida Y, Kawashima H, Fukuyama H, Togashi K, Saji H. Temporal change in human nicotinic acetylcholine receptor after smoking cessation: 5IA SPECT study. J Nucl Med. 2007 Nov;48(11):1829-35. doi: 10.2967/jnumed.107.043471. Epub 2007 Oct 17. PMID: 17942810.

7. ↩ Lin BH, Smith TA, Lee JY, Hall KD. Measuring weight outcomes for obesity intervention strategies: the case of a sugar-sweetened beverage tax. Econ Hum Biol. 2011 Dec;9(4):329-41. doi: 10.1016/j.ehb.2011.08.007. Epub 2011 Sep 6. PMID: 21940223.

8. ↩ Polito JR. "I'd gain weight and that's just as dangerous " Freedom from Nicotine - The Journey Home, Chapter 4, Sept. 14, 2020

9. ↩ Polito JR. Recovery weight gain" Freedom from Nicotine - The Journey Home, Chapter 4, Sept. 23, 2020

10. ↩ Eweis DS, Abed F, Stiban J. Carbon dioxide in carbonated beverages induces ghrelin release and increased food consumption in male rats: Implications on the onset of obesity. Obes Res Clin Pract. 2017 Sep-Oct;11(5):534-543. doi: 10.1016/j.orcp.2017.02.001. Epub 2017 Feb 20. PMID: 28228348.

11. ↩ Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med. 2004 Dec 7;141(11):846-50. doi: 10.7326/0003-4819-141-11-200412070-00008. PMID: 15583226.

12. ↩ Swanson JA, Lee JW, Hopp JW, Berk LS. The impact of caffeine use on tobacco cessation and withdrawal. Addict Behav. 1997 Jan-Feb;22(1):55-68. doi: 10.1016/s0306-4603(96)00023-8. PMID: 9022872.

13. ↩ Lockley SW, Brainard GC, Czeisler CA. High sensitivity of the human circadian melatonin rhythm to resetting by short wavelength light. J Clin Endocrinol Metab. 2003 Sep;88(9):4502-5. doi: 10.1210/jc.2003-030570. PMID: 12970330.

14. ↩ Costabile G, Griffo E, Cipriano P, Vetrani C, Vitale M, Mamone G, Rivellese AA, Riccardi G, Giacco R. Subjective satiety and plasma PYY concentration after wholemeal pasta. Appetite. 2018 Jun 1;125:172-181. doi: 10.1016/j.appet.2018.02.004. Epub 2018 Feb 7. PMID: 29427691.

15. ↩ Sabaté J, Wien M, Haddad E. Post-ingestive effects of avocados in meals on satiety and gastric hormone blood levels Actus, Proceedings 2015.

16. ↩ Spitzer J. Minimizing the most common side effects to quitting smoking Joel's Library, 2001.

17. ↩ Polito JR. Stop smoking recovery timetable WhyQuit 2002.

18. ↩ Polito JR. Avoiding blood sugar swing symptoms Freedom from Nicotine - The Journey Home, Chapter 6, Common hazards & pitfalls, September 15, 2020

19. ↩ Polito JR. The Law of Addiction Freedom from Nicotine - The Journey Home, Chapter 2, June 24, 2015

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