August 6, 2023

Can Smoking Cause Diabetes?

Cigarettes increase your risk of developing the condition and worsening its effects

ash tray with lit cigarette

It’s not exactly difficult to connect a negative health outcome to smoking. That’s why 11 different warning labels appear on cigarette packs to emphasize the health risks that come with lighting up.


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One of those warnings links smoking to the onset of Type 2 diabetes, a life-altering condition with long-term health implications.

Smoking also worsens the effects of diabetes if you have the illness. (Hardly a surprise, right?)

Let’s take a closer look at the relationship between smoking and diabetes with Shannon Knapp, MEd, BSN, RN, CDCES, who’s the manager of diabetes care and education at Cleveland Clinic.

How smoking is related to diabetes

Let’s start with some numbers.

People who smoke are 30% to 40% more likely to develop Type 2 diabetes compared to those who don’t puff away on cigarettes, according to the U.S. Centers for Disease Control and Prevention (CDC).

Smoke more and your risk level for diabetes increases, too. “It’s a pretty strong connection,” states Knapp.

Here’s why.

The effects of nicotine

Your pancreas is an endocrine gland that releases a substance called insulin, which helps your body’s cells absorb blood sugar. Maintaining balanced blood sugar levels is essential for your body to function.

Nicotine disrupts that process by changing the way your cells react to insulin, which elevates blood sugar to unhealthy levels.


Diabetes, as you probably know, is a disease of the pancreas. When a person has diabetes, their pancreas either doesn’t make insulin, doesn’t make enough insulin or the insulin doesn’t work properly.

Chemicals in cigarettes

Smoking a cigarette releases more than 7,000 chemicals, including some that qualify as toxic. A U.S. Food and Drug Administration (FDA) list of harmful and potentially harmful constituents (HPHCs) in cigarettes features 93 entries.

As you might imagine, your body doesn’t respond well to these chemicals. These toxins ravage cells in your body to the point where they may stop responding to insulin.

Compounding risk

Smoking is hardly the only thing that can increase your chances of developing Type 2 diabetes. There’s a long list of risk factors tied to genetics, medical history and lifestyle.

But if you have any of those added risk factors and smoke … well, your likelihood of getting diabetes escalates quickly given the stress smoking places on your body, says Knapp.

Risk factors for Type 2 diabetes include:

  • Family history of diabetes.
  • Being Black, Hispanic or Native American.
  • Having obesity.
  • Physical stress (including surgery or illness).
  • Use of certain medicines.
  • Injury to your pancreas (including infection, tumor, surgery or accident).
  • Hypertension (high blood pressure).
  • High blood cholesterol or triglyceride levels.
  • Age (as risk increases with age).
  • Heavy alcohol use.
  • Having gestational diabetes while pregnant or delivering a baby weighing 9 pounds or more.

Can smoking worsen diabetes?

Smoking can make managing diabetes much more difficult. As mentioned, nicotine naturally increases blood sugar levels. So, if you smoke and have diabetes, you’ll probably need larger doses of insulin to manage your blood sugar, explains Knapp.

In addition, smoking can worsen potential complications of diabetes such as:

And of course, smoking in and of itself is just bad for you — a fact that’s pretty much indisputable at this point. The habit can lead to various cancers, stroke, heart attack and more health issues.


Will quitting smoking make a difference?

Absolutely! In fact, the FDA reports that insulin can become more effective at reducing your blood sugar within eight weeks after snuffing out your final cigarette. Add that to the list of amazing things that happen to your body after you quit smoking.

Now some research does show an increased risk of Type 2 diabetes in the short term after smoking cessation. This is most likely connected to weight gain during that time, which increases your risk for diabetes.

“But that increase in weight isn’t enough to negate the cardiovascular benefits of not smoking,” reassures Knapp. (Taking a more holistic approach to smoking cessation by adding physical activity and eating healthier may help prevent weight gain, too.)

Will it be easy to kick your smoking habit? No. The nicotine in tobacco makes smoking highly addictive.

But quitting can be done with a plan, a strong support system and a desire to be healthier. Talk to a healthcare provider about a smoking cessation program. There are online services to quit smoking, too.

“Certain diabetes risk factors like age, family history and ethnicity cannot be changed, but quitting smoking can help reduce your risk,” encourages Knapp.

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