This content originally appeared on diaTribe. Republished with permission.
By Andrew Briskin
While smoking is bad for anyone’s health, its effects on glucose levels, blood pressure, and the heart can also exacerbate both the short and long-term effects of diabetes. Smoking and using e-cigarettes can accelerate the progression of diabetes and heart disease, so quit today – it might not be as hard as you think.
Many people typically think of lung cancer as the most significant health risk associated with smoking. However, the impacts of smoking extend far beyond this, especially for people with diabetes. Not only can smoking have a negative effect on glucose management and insulin resistance, but it also increases your risk for complications like heart disease.
The harmful effects of traditional cigarette smoking have been researched extensively, but research on the effects of e-cigarettes and vaping has only come to light in recent years. We are still learning what impact these habits have on people with diabetes and diabetes-related complications.
Trends in smoking and vaping
According to the American Lung Association, the percentage of American adults who smoke cigarettes regularly has declined steadily since the mid-20th century, from 42.4% of adults in 1965 to 13.7% in 2018. Smoking rates among teens and young adults have also gone down; in recent years, however, a new challenge has emerged with the explosion of e-cigarette use in this population.
Data from the American Lung Association shows that from 2011 to 2019, rates of e-cigarette use increased from 0.6% to 10.5% of middle school students and from 1.5% to 27.5% of high school students. In 2019, nearly 2.9 million children started using e-cigarettes, an average of 7,900 new users every day.
Can smoking or vaping cause diabetes?
The cause-and-effect relationship between smoking and diabetes is complicated, as research studies have produced varying outcomes. According to the CDC and some research studies, smoking is associated with causing type 2 diabetes – smokers are 30% to 40% more likely to develop type 2 diabetes than those who do not smoke.
That being said, other researchers suggest that a cause-and-effect link between smoking and diabetes cannot be confirmed, as many other factors such as diet, exercise, genetics, body fat distribution, and stress also contribute to the onset and progression of type 2 diabetes. This makes it more difficult to determine the precise root cause of diabetes.
“There is certainly some association; other poorer health behaviors of various kinds [such as lack of exercise] are not surprisingly associated with smoking,” said Philip Home, emeritus professor of diabetes medicine at Newcastle University in the United Kingdom. Home said that there is not enough evidence for a cause-and-effect link, adding that those who smoke may simply be more likely to have unhealthy lifestyle habits, possibly leading to poorer glucose management.
Smoking and vaping have also been linked to a higher risk for prediabetes. Research shows that there is a greater risk for developing prediabetes if you use both e-cigarettes and traditional cigarettes. Even more concerning, those who used vaping alone without having ever smoked a cigarette still had a significantly higher risk of developing prediabetes, when compared to those who never smoked or vaped.
Risks of smoking with diabetes
For those who already have diabetes, smoking can have negative effects on insulin resistance, glucose management, and diabetes-related complications. Home said that nicotine, the highly addictive chemical in cigarettes and e-cigarettes, activates the part of the nervous system responsible for the “fight or flight” response. This releases adrenaline and other hormones that cause glucose and blood pressure levels to rise.
Cigarette smoking can also make your body more resistant to insulin, which can have significant effects on your heart and blood vessels. Cigarettes can raise your risk for plaque buildup in the blood vessels, leading to a heart attack or stroke. This can also lead to a condition called peripheral arterial disease (PAD), which reduces blood flow to the legs and arms, increasing the risk for amputation.
In terms of the risk for microvascular complications, which include kidney disease, nerve damage, and eye disease, Home said that further research is needed to understand the impact of smoking. He also indicated that even if smoking may not have an effect in the early stages, it might accelerate the progression of these complications after a certain point.
Is vaping better for you than smoking?
The previously mentioned study linking vaping to prediabetes is the result of initial research on the long-term health effects of vaping. Because e-cigarettes have existed for less than two decades, more research is required to properly assess the long-term impact of vaping on individual and population health.
Vaping may be of some use, particularly for former smokers. “Vaping is still a pointless habit, but there is some evidence for use in weaning people off cigarettes,” said Home. “That is particularly useful because of the cancer-inducing effects of smoke products, likely absent with standard vaping.”
Still, vaping has been known to cause other health issues such as vaping-associated lung injuries, and most e-cigarettes still contain highly addictive levels of nicotine and other unknown substances. Additionally, the sharp increase in e-cigarette use is primarily among youth, who are often introduced to vaping without any prior habit of cigarette smoking.
The bottom line is that both smoking and vaping are unhealthy habits that can have negative effects for people with diabetes. The following techniques and products can help you quit once and for all and improve your diabetes management.
How to Quit Smoking
Because smoking is such an addictive habit, many people find it difficult to quit, especially without the assistance of a smoking cessation product. There are currently two FDA-approved prescription medications intended to help people quit: Chantix and Zyban. Both these medications are taken orally, do not contain nicotine, and work by reducing the physical urge to smoke. According to the FDA, using one of these medications can double your chances of successfully quitting. Talk to your healthcare provider to see if either of these medications may help you.
Along with Chantix and Zyban, there are several nicotine-replacement products available over the counter, such as:
- Nicotine patches: a patch you place on the surface of your skin that slowly releases a steady amount of nicotine into your body
- Chewing gum: also referred to as nicotine gum, which can release a small dose of nicotine as you chew
- Nicotine lozenges: dissolvable tablets taken orally
Stopping on your own can be tough. Having support from friends or family can help make it easier to quit. Reach out to a trusted ally, or if any friends or family members also smoke, consider quitting together and leaning on one another for support throughout the process.
Interestingly, several studies found that the risk for type 2 diabetes actually increased temporarily in the immediate years after quitting. After this period, however, risk for type 2 decreased substantially. It is common for people to gain weight immediately after they stop smoking. Because of this, focus on getting plenty of exercise and managing your weight as you work to wean yourself off of cigarettes and vapes.
Before using any of these tools, talk with your healthcare provider about the methods that are best for you, weighing the benefits and risks of each one. Additionally, discuss any changes in your diabetes management because like any significant lifestyle change, quitting smoking can lead to changes in glucose levels.
Read more about Centers for Disease Control and Prevention (CDC), exercise, insulin, Intensive management, neuropathy, smoking, smoking with diabetes, U.S. Food & Drug Administration (FDA), vaping.