Smoking and vaping are widely known to harm your health, but when diabetes is part of the picture, the risks become even more serious. From glucose instability to cardiovascular complications, both cigarettes and e-cigarettes can interfere with diabetes.

🚭 The Rise of Smoking and Vaping

Traditional cigarette smoking has declined significantly in the United States over the past several decades. However, this progress has been challenged by the rapid rise of e-cigarette use, particularly among teens and young adults.

Between 2011 and 2019, e-cigarette use increased dramatically in middle and high school students. In 2019 alone, nearly 2.9 million youth reported using e-cigarettes, introducing a new generation to nicotine addiction under the misconception that vaping is safer than smoking.

 🚭 How Does Vaping and Smoking Increase Risks?

Research suggests a strong association between smoking and an increased risk of type 2 diabetes. According to the CDC, people who smoke are 30–40% more likely to develop type 2 diabetes than nonsmokers.

More recent studies have also linked vaping to prediabetes, a condition that raises the likelihood of developing diabetes later in life. Compared to nonsmokers:

  • Traditional cigarette users were 15% more likely to have prediabetes
  • E-cigarette users were 7% more likely
  • Dual users were 28% more likely

While researchers caution that lifestyle factors like diet, exercise, and stress also play a role, the association between nicotine use and impaired glucose regulation is becoming harder to ignore.

For people already living with diabetes, smoking and vaping can worsen both daily glucose control and long-term outcomes. Nicotine activates the body’s fight-or-flight response, releasing stress hormones that raise both blood glucose and blood pressure.

Smoking also increases insulin resistance and damages blood vessels, raising the risk of serious complications such as:

  • Heart attack and stroke
  • Peripheral arterial disease (PAD)
  • Reduced circulation and higher amputation risk

While more research is needed on smoking’s impact on microvascular complications, like kidney, nerve, and eye disease, evidence suggests it may accelerate their progression over time.

🚭 How to Quit and Protect Your Health

Quitting nicotine can significantly improve glucose control and reduce the risk of diabetes complications. While stopping can be challenging, several tools may help:

  • Prescription medications like Chantix® or Zyban®
  • Nicotine replacement options (patches, gum, lozenges)
  • Support from friends, family, or quit-together plans

Some people experience temporary weight gain or a short-term increase in diabetes risk after quitting, but this risk drops substantially over time. Staying active and monitoring glucose closely can help ease the transition.

Before quitting, talk with your healthcare provider about the best approach for you, especially since quitting may require adjustments to your diabetes management plan.

 

Summary

Both smoking and vaping pose serious risks for people with diabetes. Nicotine can worsen insulin resistance, disrupt glucose control, and increase the likelihood of heart disease and other complications. While vaping is often marketed as a safer alternative, growing evidence suggests it still carries significant health risks. Quitting nicotine altogether remains one of the most impactful steps you can take to protect your health and support long-term diabetes management.