Diabetes and Smoking

What is Diabetes?

Diabetes is a disease where your body can't make or use a hormone called insulin. Insulin is made by your pancreas. It's what lets your cells turn glucose (sugar) from the food you eat into energy. There are two types of diabetes. Type 1 is where your body doesn't make insulin. Type 2 (often called “adult onset”) is where your body can't use the insulin it makes as well as it should.

People with diabetes have higher glucose levels because the glucose (sugar) in the food they eat can't be turned into energy. Over time, high blood glucose (blood sugar) levels can damage your organs such as kidney, heart, blood vessels and eyes. This damage can cause them to malfunction or fail.

In the U.S., 29 million people have diabetes, or 9.3% of the population. [1]

Does smoking make me more likely to develop diabetes?

Yes, smoking increases your risk for developing diabetes. Smoking can change how your body processes and regulates sugar from the food you eat. It can also make it harder to control your blood sugar levels if you already have diabetes. [2] If you smoke, you have a 30-40% higher chance of developing diabetes than someone who never smoked.

And the more you smoke, the higher your chance of developing diabetes. Once you quit, your risk of developing diabetes goes down. The longer you've been quit, the less likely it is you'll become diabetic.

How does smoking affect me if I already have diabetes?

If you have diabetes, smoking increases your chances of dying from any cause compared to non-smokers.[3] It also increases your risk for damage to your organs, as well as your chances for having a heart attack or stroke.

  • Smoking can double your risk of developing kidney damage compared to non-smokers, if you have diabetes. That risk goes down the longer you've been quit. [5] [6]
  • Smoking increases the risk of diabetic eye disease (called diabetic retinopathy). Smoking reduces blood circulation. When this happens to the retina, light sensing cells in the eye are damaged, and causes blindness. [7]
  • Both diabetes and smoking increase your chances of developing cancer of the pancreas. This cancer is fatal in 95% of cases. If you have diabetes and you smoke, your risk of pancreatic cancer is even higher than if you only smoked or were a non-smoking diabetic. [8]
  • Diabetes and cigarette smoking are major risk factors for heart attack and stroke. If you're diabetic and you smoke, your chances for having a heart attack or stroke are higher than if you were just a smoker, or a non-smoking diabetic. [4] Stopping smoking and controlling your diabetes are incredibly important to lowering your chances of heart attack or stroke.

I smoke to keep my weight down. Isn't that good for my diabetes?

Keeping your weight down is good, that's true. But the risks of smoking usually outweigh whatever benefit you might get from controlling your weight.

Yes, smokers tend to weigh less than nonsmokers. Some smokers need fewer calories to feel satisfied with food. Controlling your weight is an important part of managing your diabetes. And eating less can reduce your insulin requirements.

However, smoking makes it harder to control your blood sugar levels. This makes it more likely you'll develop complications associated with your diabetes.

The risk of organ damage from smoking and diabetes add to each other. So over the long term, you'll have a higher chance of developing heart disease, kidney disease and retinopathy than if you didn't smoke.

How will quitting smoking affect my diabetes?

When you stop smoking, your liver slows down the processes it uses to remove hormones (like insulin) and drugs used to treat diabetes from the body. If the amount of insulin or diabetes drugs go up, blood sugar will go down.

If you have diabetes and stop smoking, you may need to test your blood sugars more frequently for a while to avoid dangerously low levels. Once your blood sugar levels stabilize, you can go back to regular testing patterns.

If you have any questions or concerns, talk to your health care provider about the best way to quit smoking and manage your diabetes.

There are no concerns about using most quit-smoking medications if you have diabetes (nicotine replacement therapy, or bupropion). Because diabetes can lower kidney function, you should talk to your doctor if you want to use varenicline to quit smoking. Get more information about quit-smoking medications.

The bottom line

Smoking increases your risk for developing diabetes and increases your risk of organ damage from diabetes. Quitting will reduce these risks and improve your chances for a long and healthy life.

Others in the EX Community have quit smoking while managing their diabetes. Connect with them to get their perspective!


  1. Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.
  2. U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
  3. Ahlen E, Pivodic A, Wedel h, et al. Glycemic control, renal complications, and current smoking in relation to excess risk of mortality in persons with type 1 diabetes. J Diabetes Sci Technol 2016; June 2014 (epub)
  4. Lubin JH, Couper D, Lutsey PL, Yatsuya H. Synergistic and nonsynergistic associations for cigarette smoking and non-tobacco risk factors for cardiovascular disease incidence in ARIC study. Nicotine Tob Res 2016; September 2016 (epub)
  5. Yeom H, Lee JH, Kim HC, Suh I. The association of smoking tobacco after a diagnosis of diabetes in the prevalence of diabetic nephropathy in the Korean male population. J Prev Med Public Health. 2016 Mar;49(2):108-17.
  6. Ohkuma T, Nakamura U, Iwase M, et al. Effects of smoking and its cessation on creatinine and cystatin c-based estimated glomerular filtration rates and albuminuria in male patients with type 2 diabetes: the Fukuoka Diabetes Registry. Hypertension Res 2016; June 2 (epub)
  7. Omae T, Ngaoka T, Yoshida A. Effects of habitual cigarette smoking on the retinal circulation in patients with type 2 diabetes. Invest Ophthalmol Vis Sci 2016;57:1345-51.
  8. Antwi SO, Oberg AL, Shivappa N, et al. Pancreatic cancer: associations of inflammatory potential diet, cigarette smoking and long-standing diabetes. Carcinogenesis. 2016 May;37(5):481-90.

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