Nicotine hijacks the survival instinct of the brain

Have you ever gone without smoking and developed an overwhelming craving that felt like, "I'M GOING TO DIE OR GO CRAZY IF I DONT' HAVE A CIGARETTE!"?
If so, nicotine has hijacked the survival part of your brain. From the very first puff of a cigarette, nicotine produced a powerful effect on the primate part of our brain that controls our survival instincts. Often people will say that smoking is just a "bad habit". Picking your nose is a bad habit, something that you have control over and you can change easily. But we don't have control over our survival instinct and quitting smoking is not easy. Willpower is not stronger than the survival instinct. This is why it's so difficult to quit smoking. Medications can help take the edge off, which allows the thinking part of our brain or our willpower, to make the decision to not give into the craving. Meds move the craving from an "I'M GOING TO DIE OR GO CRAZY"  to "I'm having a desire to smoke right now but I can do something else to take my mind off the cigarette."
A smoker does not need to take cessation medications to quit smoking, just like a dieter does not need medications to lose weight. It be successful at either, it takes a plan of how to resist temptation and overcome that strong survival instinct.

Smoking causes surgical complications

The doctor was running late for my pre-operative appointment and I had time to talk with Jeanni, the patient coordinator at UCLA. In September I had a bilateral mastectomy (mandatory) with immediate (elective) DIEP-flap (tummy tuck) reconstruction. In two weeks I will have the second stage of the reconstruction. This surgery is on the cutting edge of breast reconstruction and offers the best possible cosmetic result. The surgery is very long (I was under anesthetic for 10 hours) and complicated (fat is harvested from the tummy and transplanted to create a new breast). But I told Jeanni that my recovery has really been a breeze. She said from our first conversation, she knew I would have an easy time because patients that are healthy to start with and have a good attitude, often don't experience problems. Patients that are smokers, have diabetes or hypertension are often the ones with complications. All three affect the blood vessels and smoking affects the lungs which can interfere with the recovery from the anesthetic.
I had been told that anyone who smokes, must quit 6 weeks prior to this elective surgery. Jeanni said that some patients had lied about quitting, and the surgeon cancelled the surgery. The risk of complications is too high. I know of one smoker that had quit 6 weeks to the day, prior of her surgery and she has experienced some complications (she needed an immediate second surgery since her "flap" died due to lack of blood supply) and two months after surgery, continues to have pain. Could it be that after smoking for over 40 years, that the damage to her blood vessels and lungs has already been done?
No one wants to think that any surgery lies in their future but it is another good reason to quit now. If I had been a smoker, I would not have been a candidate for this type of surgery. My options would have been limited, the cosmetic result would have been much worse and I might have had serious complications.
So on this Thanksgiving day, I have so much to be thankful for, including being a good candidate for a leading edge surgical option that has left no emotional scars and minimal physical scars. Cigarettes would have killed my opportunity for this surgery and who knows what emotional and physical scars I would have had after a double mastectomy.