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constricts blood vessels, reducing blood flow to the skin and extremities Metabolic : Stimulates glucose release from the liver and increases insulin resistance, which can contribute to type 2 diabetes over time Appetite/weight : Suppresses appetite and raises metabolic rate, which is why patients often worry about weight gain when quitting Immune function : Impairs immune response, increasing risk of respiratory infections and delaying wound healing Signs of Nicotine Use Disorder Recognizing nicotine use disorder goes beyond asking "do you smoke?" Look for these clinical indicators: Strong, persistent cravings for nicotine Difficulty controlling use despite awareness of negative health consequences Continued use even when it worsens existing physical or psychological conditions Neglecting social, occupational, or recreational activities because of nicotine use Developing tolerance (needing more to achieve the same effect) Withdrawal symptoms appear when a patient tries to quit or cut back