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Your Guide to Treating Diabetes

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The Dangers of Smoking with Diabetes

Medically Reviewed By Kelly Wood, MD

While smoking isn’t good for anyone, it may be particularly harmful if you have diabetes. Smoking increases the risk of some complications and can make diabetes harder to manage. Quitting smoking can help lessen these risks and lead to better overall health. Learning more about the effect of smoking on diabetes may be just enough to inspire you to quit. Making a quitting plan, getting support from friends and family, and working with your doctor all boost your chances of quitting smoking for good. That way, you can focus on managing diabetes and staying as healthy as possible.

Read on to learn more about how smoking affects people with diabetes, quitting smoking, and other ways to manage diabetes.

How smoking affects diabetes

A closeup of a person's hand putting out a cigarette
Liderina/Getty Images

While diabetes itself increases your risk of serious complications, smoking can boost this risk even higher.

Diabetes occurs when your body doesn’t produce enough insulin or can’t use it properly. Insulin, a hormone, allows the cells throughout your body to absorb glucose, or sugar, for energy. If you have diabetes, cells can’t absorb glucose, which builds up in your bloodstream.

Eventually, the buildup damages your blood vessels and nerves, leading to cardiovascular and kidney diseases and other problems like infections.

Smoking also damages many tissues and organs, including the heart, blood vessels, and lungs. In addition, it makes diabetes much harder to manage.

High nicotine levels, the addictive chemical in cigarettes, may reduce Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source your cells’ ability to use insulin. This means that insulin is less effective — and if you already have diabetes, this may mean that your treatment, such as insulin shots, doesn’t work as well as it should.

The following are complications you may experience if you have diabetes and smoke.

Circulation issues

Some substances in cigarettes have been linked to inflammation. Persistent inflammation over time can lead to atherosclerosis, when fats and other substances build up inside blood vessels.

This buildup may make it more difficult for blood to flow through a vessel. Long-term poor blood flow, particularly in the legs and feet, can lead to hard-to-treat infections and ulcers. This, in turn, may increase the likelihood Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source of amputation.

Heart and kidney disease

According to researchers, the risk of cardiovascular events in people with diabetes is up to 4 times higher than in people without diabetes. In addition, smoking can increase your risk for cardiovascular disease.

Circulation problems may also cause additional damage to your kidneys, making them less effective at filtering waste products from your blood. Chronic kidney disease may also progress at a faster rate in people with diabetes who also smoke.


If blood vessels are damaged and can’t deliver blood effectively, nerves throughout your body may also become damaged. This is known as neuropathy. According to the National Institute of Diabetes and Digestive and Kidney Diseases, people with diabetes often develop diabetic neuropathy.

A 2019 research review noted that previous studies had mixed results when determining whether there was a link between smoking and the risk of neuropathy in people with diabetes. Some studies saw an increased risk, while others didn’t. Therefore, further research is necessary.


The National Eye Institute Trusted Source National Eye Institute Governmental authority Go to source states that more than 50% of people with diabetes will eventually develop diabetic retinopathy, which is blood vessel damage in the retina.

Like neuropathy, the results of previous studies have been mixed as to whether people with diabetes who smoke are at a greater risk for retinopathy. However, people with type 1 diabetes who smoke may have a higher risk for diabetic retinopathy than people with type 2 diabetes who smoke.

Quitting smoking

Quitting smoking is difficult, but doing so can significantly improve your health and lessen your risk for complications. To quit smoking successfully, try:

  • setting a quit date and writing down your reasons for quitting
  • telling friends and family about your intent to quit
  • throwing away cigarettes, lighters, and ashtrays
  • using a quitting strategy, such as going cold turkey or using nicotine patches, gums, or sprays
  • working with your doctor and taking prescribed medication to lessen cravings

Learn more about quitting smoking.

Managing diabetes

Treatment and management plans for diabetes usually include lifestyle changes and medications.

Lifestyle changes

To manage diabetes, your doctor may recommend:

  • eating a diet rich in foods Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source like vegetables, fruit, and lean protein
  • maintaining a moderate weight
  • exercising regularly


Medications to manage diabetes can include:

  • insulin
  • drugs to manage high blood pressure and cholesterol
  • medications that stimulate the release of insulin, such as sulfonylureas
  • medications that increase your cells’ insulin sensitivity, such as metformin (Fortamet)

Learn more about how managing diabetes improves your overall health.


Quitting smoking can improve your health, help you better manage your diabetes, and reduce your risk for severe complications. Talk with your doctors about ways to quit smoking and manage your diabetes.

Was this helpful?
  1. Artese, A., et al. (2017). Cigarette smoking: An accessory to the development of insulin resistance.
  2. Campagna, D., et al. (2019). Smoking and diabetes: Dangerous liaisons and confusing relationships.
  3. Diabetes meal planning. (2022).
  4. Diabetic retinopathy. (2022).
  5. Śliwińska-Mossoń, M., et al. (2017). The impact of smoking on the development of diabetes and its complications.
  6. Smoking and diabetes. (2022).
  7. What is diabetic neuropathy? (2018).

Medical Reviewer: Kelly Wood, MD
Last Review Date: 2023 Mar 14
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