For people with diabetes, smoking is a serious risk factor for numerous health issues. It can increase the risk of complications and may even trigger type 2 diabetes.

Smoking can lead to a wide range of complications, many of which are also complications of diabetes. It is also the leading cause of preventable death in the United States, where more than 16 million people have a smoking-related condition.

Smoking affects not only those who do it, but also people who share their space. The Centers for Disease Control and Prevention (CDC) suggest that secondhand smoke is responsible for 34,000 deaths in the U.S. every year.

Learn more about the links between smoking and diabetes, as well as how to minimize the effects, here.

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People who smoke may have higher risk of diabetes than those who do not.

Lifestyle choices are a major risk factor for type 2 diabetes and its complications. Smoking may be one of these choices.

According to the CDC, people who smoke are 30–40 percent more likely than people who do not to develop diabetes.

Smoking can also make it harder to manage diabetes for those who already have it.

The risks of smoking include:

  • sustaining damage to cells and tissues, increasing the risk of inflammation
  • introducing free radicals, leading to oxidative stress and cell damage
  • experiencing immune system problems
  • experiencing changes in lipid profiles
  • having a higher risk of respiratory and other infections
  • having a higher risk of cardiovascular disease, heart attack, and stroke

All of these risks can worsen the symptoms and complications of diabetes. People who have diabetes are more susceptible to infections, and infections can quickly become serious. In addition, both smoking and diabetes can lead to poor circulation.

They also increase the risk of foot ulceration, oral health problems, respiratory infections, and other infections that can have severe and possibly life-threatening consequences.

Research from 2008 suggests that smoking heavily may raise the risk of glucose intolerance and the accumulation of abdominal fat, both of which are risk factors for diabetes.

A 2016 study concluded that there may not be a direct link between smoking and insulin resistance. The researchers suggested that other factors may play a role, and they called for further studies.

Nevertheless, both smoking and diabetes can worsen a person’s health. Quitting or avoiding smoking is better for everyone, whether they have diabetes or not.

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Smoking with diabetes can increase the risk of poor circulation and heart disease.

Both diabetes and smoking can damage the cells and organs of the body, and smoking can worsen many of the health effects of diabetes.

For example, both smoking and diabetes can increase the risk of cardiovascular disease.

People with diabetes who also smoke are more likely to:

  • experience kidney and heart disease
  • have poor circulation leading to infections, ulcers, blood clots, or amputations
  • develop eye diseases, such as retinopathy, that can lead to vision loss
  • experience nerve damage that leads to pain, tingling, and mobility impairments

Many of the combined health effects of smoking and diabetes make it more difficult to make healthful lifestyle choices.

For example, cardiovascular issues, nerve damage, and reduced lung capacity can make it harder to exercise. This, in turn, may lead to a sedentary lifestyle.

These setbacks can make the symptoms of both smoking and diabetes even worse.

There is no safe way to smoke, particularly with diabetes. The best way to lower the risk from smoking is to quit or cut down dramatically.

The following strategies may lower the risks associated with smoking and diabetes:

Lead an active lifestyle: Exercise may lower the risk of lung cancer in people who smoke. It also supports glucose metabolism and can reduce the chance of obesity, which is another risk factor for diabetes.

Eat healthfully: Eating a diet rich in fresh fruits, vegetables, and whole grains and low in fat, salts, sugar, and other processed or simple carbohydrates can lower the risk of cardiovascular disease. Fiber is especially important for people with diabetes, as it helps lower blood sugar.

Follow the treatment plan: People with hard-to-control diabetes are more likely to experience complications. Smoking compounds these risks. Taking appropriate medications and following a doctor’s instructions can reduce these risks.

Cut back or quit smoking: There is no safe number of cigarettes to smoke, and all smoking and exposure to smoke is a health hazard. However, people who smoke heavily are more likely to experience extensive health problems.

A doctor can help a person start a plan to quit smoking. People with diabetes who smoke should consult a doctor before making any significant lifestyle changes.

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For people who smoke and have diabetes, doctors recommend quitting smoking or dramatically cutting down.

Smoking is an addictive behavior. Quitting is difficult, but doing so can significantly reduce the risk of short- and long-term complications that relate to smoking, diabetes, and the two combined.

Before quitting, people who smoke and have diabetes should ask their doctor about the best course of action. A healthcare professional may have advice for overcoming the following challenges:

Risk of overeating: People who smoke and have diabetes may need to adjust their diets. Smoking suppresses the appetite, and quitting can trigger the urge to overeat. This can lead to weight gain, another risk factor for diabetes and its complications.

Blood sugar levels: A 2015 study found that people with diabetes who quit smoking might struggle to manage their blood sugar levels for the first 3 years after quitting.

Some strategies that can help people quit smoking include:

1. Try to quit in one go

Some people plan to quit smoking gradually, but this can prolong the stress of quitting, because each reduction may trigger new withdrawal symptoms.

According to research from 2016, those who quit “cold turkey” were more successful than those who quit gradually.

2. Don’t give up

Many people attempt to quit several times before they are successful. Each attempt helps people learn what works for them. An unsuccessful attempt is not a failure, just one step on the way to quitting successfully.

3. Recognize the addiction

People who experience withdrawal may worry that the cravings and discomfort will never go away. Some people may feel that they have lost their only source of pleasure. However, these negative feelings stem from the addiction, which can distort a person’s way of thinking.

4. Finding a new, more healthful habit

Smoking is a behavioral and chemical addiction. Breaking the association between smoking and certain activities can be helpful. For example, if a person always starts their day with a cigarette, they could instead start with a short walk around the block.

5. Ask about nicotine replacement therapy (NRT)

NRT does not work for all people who smoke, and those with diabetes should consult a doctor before trying it.

6. Counseling

Counseling and psychotherapy can help people understand why they smoke and why they think smoking helps them cope. They also provide support for the emotional challenges of quitting.

7. Medication

Quit assistance medication can help some people who want to break the habit, such as varenicline (Chantix). These drugs can reduce cravings, and some also help with the emotional side effects of quitting. People who smoke should talk to a doctor about whether these drugs are safe to use alongside their diabetes medications.

8. Vaping

The long-term health impacts of using electronic cigarettes are unclear, and doctors advise that people who do not smoke do not start using them.

Evidence suggests, however, that “vaping” may be less harmful than smoking tobacco directly, and some doctors recommend it as a way to reduce the risks of smoking for those who find it hard to quit.

9. Convince others to join you

If another household member smokes, talk to them about quitting together. This way, people can encourage each other.

If the other person continues to smoke, the one who is quitting still faces exposure to smoke. Secondhand smoke can make it harder to stay tobacco-free, and it will continue to pose a health risk.

People who do not smoke but share accommodation with people who do should talk to them about quitting, for the health of both people in the household.

Smoking can damage a person’s health and well-being in many ways, and it can increase the risk of complications with diabetes.

People who smoke and have diabetes should speak to their doctor about the best way to quit or to cut down.

When quitting, many people will experience cravings and withdrawal, but these will become more manageable with time and eventually disappear altogether.

Quitting smoking can increase the life expectancy of any individual, and especially a person with diabetes.