Diabetes Forced Me to Quit Smoking After 30 Years. Here’s How Patches Got Me Through.

I’m Gary Buchanan, I’m 53 years old, and I live in Indianapolis, Indiana. I smoked for thirty years, from the time I was 23 until just over a year ago. What finally made me stop was being diagnosed with type 2 diabetes and hearing my endocrinologist explain, in very specific terms, what happens when diabetes and smoking occupy the same body. It’s not good. I used nicotine patches to get through the withdrawal, and I’ve been cigarette-free for thirteen months.

Thirty Years of Winstons

I grew up on the east side of Indianapolis, went to Warren Central, worked at my uncle’s auto body shop through high school. After graduation, I got into HVAC work through a union apprenticeship and that’s been my career ever since. Heating, ventilation, air conditioning. I install systems, repair them, maintain them. It’s good work. Physical, honest, and it keeps the lights on.

I picked up smoking at 23 because everyone on the job smoked. HVAC work means you’re crawling through attics in the summer and working in unheated crawl spaces in the winter, and cigarette breaks were sacred. You’d finish a compressor swap or a duct run, climb down from wherever you’d been working, and light up. Winston Reds were the default brand on every crew I worked on. I don’t know why. It was just the culture. I started with Winstons and never switched.

A pack a day for thirty years. I did the math once and it came out to roughly 219,000 cigarettes. At an average price of maybe $6 a pack over thirty years (accounting for the fact that they were cheaper in the nineties and more expensive now), that’s around $65,000. I could have bought a house with that money. A small one, but still.

My wife Sharon tried to get me to quit for years. She’d cut out articles from magazines, leave pamphlets from the doctor’s office on the kitchen counter, point out my cough when I was hacking away in the mornings. I’d tell her I’d think about it. “Think about it” was my way of saying no without saying no. I knew she was right. I just wasn’t ready.

Two Tries That Didn’t Take

First try was in 2009. I went cold turkey because a buddy at work had done it and said it wasn’t that bad. Either he was lying or his withdrawal was different from mine, because mine was miserable. I was shaky, couldn’t concentrate, couldn’t sleep, and the anger was out of control. I’m normally an even-tempered guy. But three days into cold turkey, I nearly bit my coworker’s head off because he handed me the wrong fitting. That’s not me. I was back to smoking by day six because I didn’t recognize who I was becoming without cigarettes, and I didn’t like that person.

Second try was in 2016. I used Nicorette gum, the 4mg fruit chill flavor. It wasn’t terrible. The gum took enough edge off the cravings that I could function. But I made a classic mistake: I kept gum as a permanent crutch instead of a temporary bridge. I chewed Nicorette for five months without actually reducing my usage. My dentist told me the constant chewing was causing jaw problems and wearing down my molars. I stopped the gum and went straight back to Winstons because I’d never actually broken the nicotine dependence. I’d just shifted the delivery method.

After that second failure, I stopped trying. I told myself I was a lifer. Some people can quit and some people can’t, and I was in the second group. That story was comfortable enough to keep me smoking for another eight years.

The Diagnosis

In August 2024, I went to my doctor because I was peeing constantly, always thirsty, and feeling fatigued in a way that sleep didn’t fix. I figured it was something simple. Maybe a UTI. Maybe just getting older.

My fasting blood glucose came back at 247 mg/dL. Normal is under 100. My A1C was 9.1%. That’s solidly in the diabetic range. My doctor diagnosed me with type 2 diabetes and referred me to an endocrinologist named Dr. Hadley.

Dr. Hadley was thorough. She put me on metformin, adjusted my diet, and set up a follow-up schedule. Then she asked if I smoked. I said yes. She pulled up something on her computer and turned the screen toward me.

She showed me research on diabetic smokers. The combination of high blood sugar and smoking creates a perfect storm for vascular damage. Smoking constricts blood vessels. Diabetes damages them from the inside. Together, they accelerate peripheral artery disease, which can lead to circulation problems in the legs and feet. She said diabetic smokers have amputation rates significantly higher than diabetic non-smokers. She said the word “amputation” and let it sit in the room.

Then she talked about diabetic retinopathy, the eye damage caused by diabetes. Smoking accelerates it. She said I was at elevated risk for vision loss if I continued smoking with uncontrolled blood sugar.

Then she talked about diabetic neuropathy, the nerve damage that starts in the feet and hands. Smoking makes it worse. Tingling, numbness, pain. She said she had patients who couldn’t feel their feet, and the ones who smoked got there faster.

I sat in that office and felt the same thing I imagine people feel when they realize the house they’ve been living in has termites all through the foundation. The damage was already happening. Every cigarette I’d smoked in the last thirty years had been contributing to a body that was now breaking down in multiple systems at once.

Dr. Hadley asked me directly: “Are you willing to quit smoking?” And I said yes, and for the first time in my life, I meant it without reservation.

The Patches, Done Right This Time

Dr. Hadley prescribed NicoDerm CQ, the step-down program. But unlike my previous attempts, she also connected me with a diabetes educator who helped me understand how nicotine and blood sugar interact. Nicotine increases insulin resistance, which means smoking was literally making my diabetes harder to manage. Quitting wouldn’t just help my lungs and blood vessels. It would help me control the disease that was threatening my eyesight and my feet.

She also set me up with the Indiana Tobacco Quitline, a free phone counseling service. I had a quit coach named Marcus who called me once a week. He was a former smoker himself, ten years clean, and he didn’t talk down to me. He’d ask how the week went, what triggers I’d faced, what strategies I’d used. Having someone check in kept me accountable in a way that quitting privately never had.

My quit date was September 16, 2024. I smoked my last Winston the night before, on the back steps of our house. Sharon came out and sat next to me while I finished it. She didn’t say anything. Just sat there. When I put it out, she picked up the ashtray and took it inside, and the next morning it was gone. She’d thrown out every ashtray, every lighter, every stale pack she could find. That woman had been waiting thirty years for that night.

The Withdrawal

The 21mg patch went on my upper arm the first morning. It took the worst edge off the cravings, but the behavioral withdrawal was still intense. Every break at work, my hands reached for the pack that wasn’t in my shirt pocket. Every time I got in the truck, I’d instinctively look at the cupholder where I kept my lighter. Every time I finished installing a unit and climbed down the ladder, my body expected a Winston.

I replaced the physical motion with water. I bought a 32-ounce Nalgene bottle and made it my constant companion. Every time I wanted a cigarette, I drank water. My coworker Dave said I was going to the bathroom more than a pregnant woman. He wasn’t wrong, but it worked. The act of reaching for something, putting it to my lips, doing something with my hands, the water bottle covered all of it.

The first two weeks, I was irritable. Not as bad as my cold turkey attempt in 2009, but noticeable. I warned Sharon and I warned my crew. They gave me space when I needed it. Dave, who smokes, started stepping further away from me during breaks, which I appreciated more than I could say.

The constipation hit around day four. Nobody talks about this but it’s a real withdrawal symptom. Nicotine stimulates gut motility, and when you take it away, everything slows down. I added more fiber to my diet and started walking after dinner, both of which helped. Not glamorous, but it’s the truth.

Sleep was disrupted for the first week. The patch can cause vivid dreams if you wear it overnight, so I took it off before bed. That meant my nicotine levels were low in the morning, and I’d wake up early with a gnawing craving. I’d put the patch on immediately and wait fifteen or twenty minutes for it to kick in. Those morning minutes were some of the hardest of the whole process.

The Hardest Moment

Week four. A Friday afternoon in October. I was on a job in Carmel, replacing a furnace in a crawl space that was tight and dusty and miserable. The old unit was corroded and the disconnection was a nightmare. I skinned my knuckles, hit my head on a joist, and spent three hours in a space barely big enough to turn around in.

When I finally crawled out, filthy and frustrated, Dave was standing by the truck smoking a Winston. My brand. My exact cigarette. The red and white pack sitting on the tailgate. The smell. The sight of the smoke curling up in the fall air.

I stood there covered in dust and sweat, and the craving hit me like a freight train. Not a subtle urge. A full-body demand. I could feel it in my jaw, in my fingertips, in the back of my throat. Every instinct I had was telling me to reach for that pack.

I turned around, walked to the other side of the house, sat on the homeowner’s back steps, and drank half my water bottle. I thought about Dr. Hadley showing me the research on amputation rates. I thought about my feet, which had started tingling at night, a sign of early neuropathy that had gotten better since I’d quit. I thought about Sharon sitting next to me on the back steps the night of my last cigarette.

I sat there for five minutes. The craving peaked, held, and slowly receded. When I walked back to the truck, Dave had finished his cigarette and put the pack away. He looked at me and said, “You good?” I said, “Yeah. I’m good.”

Stepping Down and Stepping Free

I moved to the 14mg patch at week six and felt a slight uptick in cravings that settled within a few days. At week eight, I went to 7mg. At week ten, I took off the last patch.

The first week without any nicotine was uncomfortable but not unbearable. Mild headaches, some restlessness, occasional flashes of craving. My quit coach Marcus was especially helpful during this phase. He reminded me that I’d already done the hard part, that the behavioral patterns were broken, and all I had to do was ride out the last of the physical withdrawal.

He was right. By the end of that week, I felt clean. Not just smoke-free but nicotine-free. For the first time in thirty years, my body was running entirely on its own chemistry.

Thirteen Months Later

My A1C dropped from 9.1% to 6.8% in thirteen months. The diabetes educator said quitting smoking was a significant factor alongside the metformin and diet changes. My blood sugar is more stable, my medication is working more effectively, and Dr. Hadley said at my last appointment that she was “genuinely pleased” with my progress. From her, that’s practically a standing ovation.

The tingling in my feet has improved. It’s not completely gone, but it’s less frequent and less intense. My circulation is better. I used to get cold hands and feet constantly, even in warm weather. That’s improved noticeably.

I’ve saved approximately $5,500 in cigarette costs. I put most of it toward a used fishing boat that Sharon said I deserved. We take it out on Geist Reservoir on weekends. Sitting on that boat, casting a line, breathing clean air, I think about all the years I spent standing outside in the cold, smoking Winstons and telling myself this was just who I was.

My morning cough is gone. My lung capacity has improved enough that crawling through attics and crawl spaces doesn’t leave me gasping anymore. I’m doing my job better at 53 than I was at 50, and the only thing that changed was removing cigarettes from the equation.

Sharon said to me recently that I seem lighter. Not my weight, though that’s improved too. She said I seem like I’m carrying less. I think she’s right. Thirty years of addiction is a heavy load, and you don’t realize how heavy until you finally set it down.

To Someone Still Smoking, Especially If You Have a Chronic Condition

If you’ve been diagnosed with diabetes or heart disease or high blood pressure or anything that smoking makes worse, I know the temptation to think it’s too late. That the damage is done. That quitting now won’t matter because you’re already dealing with the consequences.

That’s a lie the addiction tells you to keep you smoking. Quitting matters at every stage. My A1C improved. My circulation improved. My neuropathy improved. My diabetes became more manageable the moment I took cigarettes out of the picture. Your condition, whatever it is, will respond to the absence of cigarette smoke. Your body wants to heal. You just have to stop poisoning it.

Patches worked for me when I combined them with a real plan: a quit coach, family support, trigger management, and a medical team that understood how smoking connected to my other health issues. The patches alone aren’t enough, and willpower alone isn’t enough. But together, with a structure around them, they can get you through.

You are not alone. Plenty of us have stood where you’re standing, holding a cigarette in one hand and a medication bottle in the other, wondering if it’s even worth trying. It is. I promise you it is.

Make the appointment. Tell your doctor you’re ready. And then do the work. It’s the hardest thing I’ve ever done, and it’s the best thing I’ve ever done, and those two facts don’t contradict each other at all.