Nicotine and Diabetes

Written by Cara Schrager, MPH, RD, CDCES

It is well known that smoking cigarettes causes a multitude of health problems including but not limited to cancer, heart disease, stroke, COPD and diabetes. Studies have shown that cigarette smokers are 30-40% more likely to develop type 2 diabetes than non-cigarette smokers (1). Those who have diabetes and smoke have an elevated risk of heart disease and stroke. Because smoking is a factor in increasing risk for diabetes complications, it is among one of the diabetes ABCs (A1C, Blood Pressure, Cholesterol, Stop Smoking) to prevent diabetes complications.

Nicotine is the chemical in tobacco that is highly addictive and leads to increased heart rate, blood pressure, narrowing of blood vessels, and hardening of arterial walls. Nicotine may impact blood sugar control by elevating blood glucose levels. Research found that nicotine may raise hemoglobin A1C (a 3 month average of blood glucose) up to 34% (2).

E-cigarettes and “vaping” have become very popular over the last decade, targeting young adults and youth. A 2022 study found that those who use cigarettes are  22% more likely to develop prediabetes based on self-report (3). Those who smoke regular cigarettes have a 40% chance of developing prediabetes.

E-cigarettes are often regarded as a healthier choice to regular cigarettes, however they still contain nicotine. Because nicotine raises blood glucose levels, it makes diabetes more difficult to manage. People with diabetes who smoke often need higher doses of insulin to manage their blood glucose levels to target range (3). A study in rats found that a specific diabetes associated gene plays a role in pathways for responsiveness to nicotine and insulin production, leading to higher blood glucose levels by way of the pancreas and increased consumption of nicotine (4). 

Whether or not you have diabetes, vaping can increase your risk of developing the disease or make managing the disease more challenging. If you are looking for support to quit smoking check out these resources from the CDC and talk with your doctor about a plan that’s best for you.

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