Testosterone, smoking, vaping, and more!

[ftmblues]

I'm looking seriously at getting HRT soon. The door has finally opened, and though it's still months off, I'm trying my best to prepare.
Something which is daunting to me that I recently realized is that in order to safely take T, I have to stop smoking. This is a daunting idea to me. I suffer from PTSD and I use nicotine to cope for a variety of reasons, namely that it keeps me grounded and prevents me from dissociating, in addition to helping me manage the anxiety I suffer from because of my illness. I'm really scared of a life without cigarettes.
Is vaping a good alternative, or does it hold just as much risk? Is smoking once a month acceptable, or do I need to abstain altogether? Is there something safe I can replace nicotine with?
pls help

[Dani]

Smokers must consider three aspects of the chemicals involved in smoking.

The first is the unburnt chemicals called tar. This is a mix of many chemicals and are responsible for most of the cancers that are involved in inhaling tar. Filters will trap some, but not all of the tar from cigarettes. Vaping produces very little tar, so you are somewhat safer with vaping.

Nicotine is responsible for most of the cardiac diseases from smoking. The risk is the same with vaping and smoking. It all depends on the amount of nicotine your lungs absorb. Since both nicotine and testosterone are involved in cardiac diseases, using both just magnifies your risk.

Smoking to relieve stress and anxiety was common in WW 2 and Korea. This has been pretty much been replaced with more modern treatments due to the known health risks of tobacco products. Smoking may give you temporary relief from PTSD, but more permanent solutions are available. If your PTSD was from military service, the VA Hospital system can help you with that.

I served in Viet Nam and our C-rations were packed with four cigarettes in each meal. Today's MREs are not packed with cigarettes. This reflects a better understanding of the health risks of tobacco and todays available treatments for PTSD.

Of course any reduction in tobacco use is better than chain smoking. Since nicotine is so addictive, you must really ask yourself, "Can I really smoke only once a month and be OK with that?"

Many recovering and former smokers say that quitting was the hardest thing they ever did. Going back for just one smoke can be a disaster for your overall health, especially since your are taking testosterone.

[Lacy]

It can be a very hard thing to face. I had restarted smoking after quitting 8 years ago. After starting again I had been smoking for about 1.5 years. Not as frequent (8 years ago it was a pack a day) as it was about a pack and a few strays a week.
Once I decided to go on HRT, I stopped cold Turkey a month before. The need for me to start hormones was much greater than my enjoyment of tobacco. I have also had to give up cigars. This was tough has I have a cigar review channel on YouTube.

I still don't regret it. I feel much healthier and my friend out work is trying to quit! Help yourself and others.

The nicotine in vaping is no safer than cigarettes. It is still nicotine and has the same effects on your heart and blood as the tobacco form. They say it is safer for your lungs, but I don't know.

Either way, I would highly recommend getting away from nicotine completely. It isn't worth the risk.

As for alternatives, I don't know of any safe alternatives. Nicotine has it's own special enjoyment and addiction.

I'm sorry to hear about your PTSD. That is a tough cross to carry. Are you on any meds for it or seeing a therapist?

Hugs,
Lacy

[ftmblues]

Smokers must consider three aspects of the chemicals involved in smoking.

The first is the unburnt chemicals called tar. This is a mix of many chemicals and are responsible for most of the cancers that are involved in inhaling tar. Filters will trap some, but not all of the tar from cigarettes. Vaping produces very little tar, so you are somewhat safer with vaping.

Nicotine is responsible for most of the cardiac diseases from smoking. The risk is the same with vaping and smoking. It all depends on the amount of nicotine your lungs absorb. Since both nicotine and testosterone are involved in cardiac diseases, using both just magnifies your risk.

Smoking to relieve stress and anxiety was common in WW 2 and Korea. This has been pretty much been replaced with more modern treatments due to the known health risks of tobacco products. Smoking may give you temporary relief from PTSD, but more permanent solutions are available. If your PTSD was from military service, the VA Hospital system can help you with that.

I served in Viet Nam and our C-rations were packed with four cigarettes in each meal. Today's MREs are not packed with cigarettes. This reflects a better understanding of the health risks of tobacco and todays available treatments for PTSD.

Of course any reduction in tobacco use is better than chain smoking. Since nicotine is so addictive, you must really ask yourself, "Can I really smoke only once a month and be OK with that?"

Many recovering and former smokers say that quitting was the hardest thing they ever did. Going back for just one smoke can be a disaster for your overall health, especially since your are taking testosterone.

Ok. So if I go on HRT, I absolutely cannot smoke or vape or consume nicotine at all. This is going to be hard but I'll definitely figure it out.
Maybe I can replace smoking with a low-potency CBD pen. Half of the experience for me is the act of breathing in and then blowing out a cloud, and CBD has helped me out at times.

[ftmblues]

It can be a very hard thing to face. I had restarted smoking after quitting 8 years ago. After starting again I had been smoking for about 1.5 years. Not as frequent (8 years ago it was a pack a day) as it was about a pack and a few strays a week.
Once I decided to go on HRT, I stopped cold Turkey a month before. The need for me to start hormones was much greater than my enjoyment of tobacco. I have also had to give up cigars. This was tough has I have a cigar review channel on YouTube.

I still don't regret it. I feel much healthier and my friend out work is trying to quit! Help yourself and others.

The nicotine in vaping is no safer than cigarettes. It is still nicotine and has the same effects on your heart and blood as the tobacco form. They say it is safer for your lungs, but I don't know.

Either way, I would highly recommend getting away from nicotine completely. It isn't worth the risk.

As for alternatives, I don't know of any safe alternatives. Nicotine has it's own special enjoyment and addiction.

I'm sorry to hear about your PTSD. That is a tough cross to carry. Are you on any meds for it or seeing a therapist?

Hugs,
Lacy

I am currently seeing a therapist, yes. I don't take medications, mostly because I'm a stubborn guy who was raised with a lot of mental health medication horror stories. My condition has been improving over the last year (I'm not on high alert 24-7 anymore) but it's still a struggle.

Cigarettes right now are weird. They've been kind of a rite of passage symbol in my life. Im a punk, and the first cigarette I ever had was at a punk concert. That's how I got hooked. Whenever I go to a venue with my friends, there's always chainsmoking involved. I don't know what to do instead if I can't smoke in those settings.

[Lacy]

I am currently seeing a therapist, yes. I don't take medications, mostly because I'm a stubborn guy who was raised with a lot of mental health medication horror stories. My condition has been improving over the last year (I'm not on high alert 24-7 anymore) but it's still a struggle.

Cigarettes right now are weird. They've been kind of a rite of passage symbol in my life. Im a punk, and the first cigarette I ever had was at a punk concert. That's how I got hooked. Whenever I go to a venue with my friends, there's always chainsmoking involved. I don't know what to do instead if I can't smoke in those settings.

I knew as a kid watching westerns that I would smoke cigarettes and cigars like my favorite cowboys! I loved the blowing a cloud of smoke experience, and blowing smoke rings while smoking cigars or pipes. I actually have several humidors and a decent pipe collection that I will probably be selling soon. It has been tough to think about, as relaxing at night with a long stem pipe or heavy cigar was ritualistic to me. Creating a review website and talking to owners and blenders in the industry ways one of the main ways I coped when my Gender Dysphoria got super strong! Putting myself in that world and learning all I could about it kept me busy and netted me a lot of good relationships.

Smoking socially is how I went from a couple cigarettes a day to a pack a day. So much good conversations over a smoke. But there are other, healthier ways to engage in fellowship with other people! I can understand the hardship of going to things with friends where you would normally have smoked, and then be the odd one out!

I don't know what your plan is for a timeline on when to start HRT, but getting to a place where you don't smoke when you are outside the punk venues would be a good starting place. Cold turkey is hard, and not for everyone. Making a goal to smoke a few less cigarettes each day is a way one of my uncles used. He had a set number of cigareetes for each day, and reduced that number every week or few days.

I was terrified of taking meds as I grew up with the understanding that they were horrible! I won't go into the full story here, but if you click the link in my signature you can read some of my posts about my journey and see what finally pushed me to start meds. I just wish I would have started sooner.

Lacy

[SeptagonScars]

I've never heard before that it would be so dangerous to smoke while on hrt. I started smoking when I was 18, started taking hrt at age 21. I'm now 29, still smoking and just went off hrt for unrelated reasons. Meaning my reasons had nothing to do with my physical health. I'm just detransitioning. I'd say I'm a quite heavy smoker, and need cigarettes every day. I also smoke to keep my mental health in check, but also because I just really love to smoke.

I've never had any issues with it somehow interfering with my hormones, although of course I understand it's not a healthy habit in itself. If anything smoking was a bad combination with binding my chest (which I did for 5 years), cause that I'm pretty sure that reduced my lung capacity a lot (more than if I had either not been smoking or not binding) and messed with my breathing. I still get sporadic breathing issues and it's hard on my chest to just wear a regular bra now, even though it was over 4 years ago I stopped binding. So I'd say smoking while binding is probably much more harmful than smoking while on hrt, but of course, that might just be me and my cards in life.

I took testosterone for 6 years in total, and I smoked during all of those years, before and after. I only took a few months break for top surgery, but that's all. For the past 6 months or so my red blood cell count has been a little wonky which my endo thinks is due to the T and/or my diet but because I stopped taking it recently I'm pretty sure that will sort itself out just given more time off the hormone. It could have been caused by the smoking and T in combination, cause both smoking and sex hormones are known to mess with blood stuff. But that's all the issues I ever had with my hormones.

I'm not saying just because I'm fine then smoking+T is a totally fine combination, but this thread looks a little bit like fearmongering to me. Sure it has some increased risks and smoking in itself is factually dangerous, but it is possible to take hrt and stay a smoker and be reasonably healthy (meaning about as healthy as any smoker who's not on hrt), if you're willing to take that risk. It is an increased risk, yeah, but it's not that dangerous.

I'm not advocating for staying a smoker, or starting it, for that matter. I'm just saying it should be your choice and it's good the risks are being highlighted, but I kinda don't like this trying to scare you into quit smoking that's going on here, cause I just don't like that kind of tactic.

[Magnus]

The risk is blood thickening/clotting. I started smoking cigarettes at 13 (absolutely everybody in my family smoked; technically, I've never not really been a non-smoker. They all smoked indoors, in the car, etc). I was smoking little filtered cigars (far more nicotine than cigarettes) since about 2006 to about 2016 (I still do when I get a URI and can't vape. It's impossible). Vaping since, progressively reducing nicotine concentration.

I had some issues with high RBC and Hematocrit, but I don't believe it was due to smoking (my RBC and Hematocrit were normal and stable until 3 years into TRT when they substantially reduced my formerly very high dose a second time. Given my experience, I'd have to deduce the body doesn't appreciate abrupt and significant changes like that). It has since become a non-issue. I am still vaping (recently still smoking my cigars; takes me a bit to quit them again).

And note that the risks of blood clotting are GREATER for MTF than FTM. Estradiol is what actually increases this risk (some of your T becomes synthetic E, but far less than the other way which is why our risk is overall much less than theirs).

And, of course, your risk for blood clots is greater IF you have a family history (this would include heart attack and stroke).


It's best if you did quit or reduce your use of nicotine (whatever form), however I wouldn't call it absolutely necessary. My Endo didn't say I had to or even that I should, for this specific reason, just that it would be best for overall health.