Diabetes and Smoking: Risks and How to Quit
Smoking is harmful for everyone, but it is especially dangerous for people with diabetes. Smoking raises the risk of developing type 2 diabetes, makes diabetes harder to manage, and greatly increases the risk of serious complications such as heart disease, stroke, kidney disease, and amputation. Quitting is one of the best things you can do for your health, no matter how long you've smoked. This guide explains how smoking affects diabetes, the benefits of quitting, and proven ways to quit.
How smoking affects diabetes risk
People who smoke are more likely to develop type 2 diabetes than people who don't smoke. Nicotine and other chemicals in tobacco smoke can increase insulin resistance, meaning the body's cells respond less well to insulin. Smoking also causes inflammation and oxidative stress, which may damage cells and affect how the body uses glucose. See insulin resistance.
How smoking affects people who have diabetes
Harder blood glucose management
Because smoking increases insulin resistance, people with diabetes who smoke may need more insulin or medicine and may have more difficulty reaching their glucose targets. See A1C and blood sugar targets.
Heart disease and stroke
Diabetes and smoking both damage blood vessels. Together, they greatly increase the risk of heart attack and stroke. Smoking raises blood pressure, lowers HDL ("good") cholesterol, makes blood more likely to clot, and speeds up the buildup of plaque in arteries. See heart health.
Poor circulation and amputation
Smoking narrows blood vessels and reduces blood flow to the legs and feet. Combined with diabetic nerve damage, this increases the risk of foot ulcers, infections that don't heal, and amputation. See diabetic foot care.
Kidney disease
Smoking can speed the progression of diabetic kidney disease. See kidney health.
Eye disease
Smoking is linked with a higher risk of diabetic retinopathy progression, cataracts, and macular degeneration. See eye health.
Nerve damage
Smoking may worsen diabetic neuropathy. See diabetic neuropathy.
Gum disease
Smoking greatly increases the risk of gum disease, which is already more common in people with diabetes. See diabetes and dental health.
Other effects
Smoking also raises the risk of many cancers, lung diseases such as COPD, infections, and erectile dysfunction.
The ABCs include "S"
The American Diabetes Association and other health organizations emphasize the "ABCs" of diabetes: A1C, blood pressure, and cholesterol, and often add "S" for stop smoking. The ADA's Standards of Care recommend that all people with diabetes be advised not to use cigarettes and other tobacco products or e-cigarettes, and that tobacco cessation counseling and other treatment be included in diabetes care.
What about e-cigarettes and vaping?
E-cigarettes typically contain nicotine, which is addictive and can affect blood vessels and insulin sensitivity. The ADA advises people with diabetes not to use e-cigarettes, and they are not recommended as a substitute for proven quit-smoking treatments. Other tobacco products, such as cigars, pipes, hookah, and smokeless tobacco, are also harmful.
Benefits of quitting
Quitting has benefits that start quickly and grow over time:
- Within days to weeks, carbon monoxide levels in the blood drop, and circulation begins to improve.
- Over months, lung function improves and coughing and shortness of breath decrease.
- Over years, the risk of heart disease, stroke, and many cancers falls substantially.
For people with diabetes, quitting can also make blood glucose easier to manage over time and lower the risk of complications.
Weight gain after quitting
Some people gain weight after quitting, and some notice temporary changes in blood glucose. The health benefits of quitting far outweigh the risks of modest weight gain. Planning ahead can help:
- Keep healthy snacks on hand. See best snacks for diabetes.
- Increase physical activity. See exercise and diabetes.
- Check your glucose more often in the first weeks after quitting, and tell your care team about changes; medicine doses may need adjusting.
- Ask about quit-smoking medicines that may help limit weight gain.
Proven ways to quit
Most people try several times before quitting for good. Each attempt is a step forward. Using a combination of counseling and medicine is the most effective approach.
Get free help
- Call 1-800-QUIT-NOW (1-800-784-8669) to reach free state quitlines with trained coaches.
- Visit Smokefree.gov, a resource from the National Cancer Institute, for quit plans, text-messaging programs, and apps.
- Text programs: Smokefree.gov offers free text support.
MedlinePlus also has information about quitting smoking.
Medicines
FDA-approved medicines can significantly increase your chance of quitting compared with trying alone. Options include:
- Nicotine replacement therapy (NRT): patches, gum, lozenges, inhalers, and nasal spray. Combining a patch with a short-acting form is often more effective than one alone.
- Prescription medicines: such as varenicline and bupropion.
Talk with your provider about which option is right for you, especially if you have heart disease or other conditions.
Make a plan
- Set a quit date within the next few weeks.
- Identify triggers, such as stress, alcohol, coffee, or certain routines, and plan alternatives.
- Remove cigarettes, lighters, and ashtrays from your home, car, and workplace.
- Tell friends and family and ask for support.
- Plan for cravings: they usually pass within minutes. Try deep breathing, drinking water, chewing sugar-free gum, or going for a walk.
- Manage stress in healthy ways. See stress and blood sugar.
If you slip
A slip doesn't mean failure. Figure out what led to it, adjust your plan, and keep going.
Secondhand smoke
Secondhand smoke is also harmful. Keep your home and car smoke-free to protect yourself and your family.
Frequently asked questions
Will quitting make my blood sugar go up?
Some people notice temporary changes in glucose or weight after quitting. Check your glucose more often and tell your care team. Over time, quitting helps diabetes management.
Is it too late to quit if I've smoked for decades?
No. Quitting at any age brings health benefits.
Is nicotine replacement safe if I have diabetes?
NRT is generally considered much safer than smoking. Talk with your provider about the best option for you.
Is vaping a good way to quit?
Vaping is not recommended by the ADA for people with diabetes. Proven treatments like counseling and FDA-approved medicines are preferred.
Does smoking affect my A1C?
Smoking increases insulin resistance, which can make it harder to keep glucose in your target range. Many people find their glucose easier to manage over time after quitting, though changes in the first weeks are common, so check more often and keep your care team informed.
Is smokeless tobacco safer?
No. Smokeless tobacco, such as chewing tobacco and snuff, contains nicotine and other harmful substances and is linked with oral cancer and gum disease. It is not a safe alternative to cigarettes.
How can my family help me quit?
Family and friends can help by keeping the home smoke-free, avoiding smoking around you, offering encouragement instead of criticism, and helping you find distractions when cravings hit.
Where can I find more reliable information?
Trusted sources include the CDC, NIDDK, MedlinePlus, and the American Diabetes Association. Be cautious with social media posts or products that promise quick fixes, and check new information with your care team before making changes.
Key takeaways
- Smoking increases the risk of type 2 diabetes and makes diabetes harder to manage.
- Smoking with diabetes greatly raises the risk of heart disease, stroke, kidney disease, eye disease, and amputation.
- Quitting brings benefits at any age.
- Combining counseling with medicines gives the best chance of success; call 1-800-QUIT-NOW or visit Smokefree.gov.
Sources
Links to the sources cited above appear in the text. We rely on the Centers for Disease Control and Prevention (CDC), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the American Diabetes Association (ADA).
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