% Smoking

Smoking already increases risk of blood clots (aswell as other issues).
For trans women, it's worse because oral estrogen increases risk of
blood clots. Nicotine (from cigarattes, e-cigs, vaping, patches, etc)
interferes with how oral estrogen is metabolised, to the point where you
might aswell not use it orally. [Our self-medication guide also
describes this](hrt-internet.md).

How to quit smoking
-------------------

Whether trans woman, trans man, non-binary, cis or other, smoking is bad
for both your mental and physical health. It causes cancer, stroke,
heart attack, heart disease, impotence, and lots of other things. It
also messes with dopamine and serotonin and can cause some depression
symptoms.

If you won't quit using nicotine, we recommend using e-cigs (vaping).
The risks aren't well-known, but generally it's believed to be safer
than smoking.

Smoking also complicates surgery, again due to clotting risk. Vaping
(e-cigarettes) is considered safe.

Using patches long-term probably isn't good for most smokers. It
doesn't really give you that same fix as a cigarette or e-cig really,
so it's no wonder why smokers switch to e-cigs these days.

Quitting all nicotine usage (quitting smoking/vaping/etc)
---------------------------------------------------------

Quitting nicotine cold-turkey is the most logical thing to do.

[This cold-turkey quitting site is very good for those who want to know
how to quit successfully](http://whyquit.com/).

You'll notice physical and mental improvements after quitting nicotine
usage, especially if it's cigarettes that you're quitting.

