INS and chronic kidney disease: Smoking cessation is almost inevitably associated with weight gain due to a reduction in basal metabolic rate, increased appetite and craving for high-calorie food to mitigate nicotine withdrawal symptoms.45, 47 Nicotine and other toxic chemicals in cigarettes destroy the structure and function of insulin-secreting pancreatic beta-cells of Islets of Langerhans and damage glomerular vascular endothelium, predisposing to CKD.48, 50 Therefore, smoking cessation is recommended despite postcessation weight gain.51