World Diabetes Day and Smoking Cessation – is there a connection?

November 8, 2016

World Diabetes Day is the primary global awareness campaign of the diabetes world and is held on November 14 each year. It was introduced in 1991 by the International Diabetes Federation and the World Health Organization in response to the alarming rise of diabetes around the world. This year the theme is Eyes on Diabetes and the focus is on promoting the importance of screening to ensure early diagnosis of type 2 diabetes and treatment to reduce the risk of serious complications.

According to the International Diabetes Federation (IDF) currently 415 million adults, across the globe, have diabetes. By 2040 they estimate that this will rise to 642 million.

Increasing prevalence of type 2 diabetes is associated with higher levels of urbanisation, ageing populations, more sedentary lifestyles, unhealthy diets with high sugar intake and smoking. Although there is not much you can do about the first two, you can make sure that you get enough exercise, reduce your sugar intake and stop smoking.

Much has been said about exercise and diet and its contribution to the growing burden of diabetes but not many know about the link between smoking and diabetes and the benefits of quitting smoking for diabetics. We now know that smoking causes type 2 diabetes. In fact, smokers are 30% to 40% more likely to develop type 2 diabetes than their non-smoking counterparts and the more you smoke the higher your risk for diabetes. Another interesting finding is that diabetics on insulin are more likely to have trouble controlling their blood sugar levels and so struggle to control the progression of their disease.

If you already have diabetes and you smoke, you are more likely to have serious health complications associated with diabetes. These include:

  • Heart disease including heart failure, stroke and heart attack
  • Life threatening kidney disease
  • Poor blood flow particularly in the legs and feet which can give rise to infections, ulcers and possible amputation
  • Retinopathy (an eye disease which can lead to blindness)
  • Peripheral neuropathy (damaged nerves in the extremities causing numbness, pain, weakness and poor co-ordination)
  • Erectile dysfunction (problems getting and maintaining an erection due to the effects of smoking on the blood vessels of the penis)
  • Gum disease leading to hot and cold sensitivity, bad breath and ultimately tooth loss
  • Problems with movement and flexibility in the joints

Young adult smokers with diabetes are 2 – 3 times more likely to be sick than non-smokers with diabetes.

How does smoking affect diabetes?

Over the past decade, several studies have demonstrated that smoking can severely reduce insulin sensitivity both in people with type 2 diabetes and in non-diabetics. The evidence shows that smokers, with and without diabetes, display the typical features of the metabolic syndrome. Metabolic syndrome is a group of symptoms which include insulin insensitivity, abdominal obesity, high blood pressure, high levels of blood fat, and impaired glucose tolerance. These are all precursors of type 2 diabetes and well-established risk factors for cardiovascular disease. It is believed that nicotine in cigarette smoke impairs both insulin sensitivity and insulin secretion. In short, nicotine causes less insulin to be released and reduces its effectiveness at getting sugar out of the blood stream into the muscle cells where it is needed. This leads to smokers having higher than normal blood sugar levels.

Nicotine, through its effect on adrenaline, also causes more fat to be broken down leading to raised levels of free fatty acids in the blood stream. It also impacts on the distribution of body fat and smokers tend to lay down fat around their abdomen.

A growing body of evidence indicates that nicotine negatively impacts a smoker’s glucose and fat metabolism through these mechanisms.

There is no doubt that diabetes and tobacco use is a harmful combination. It is extremely important for people to stop smoking, or better still, never to start using tobacco. Interestingly, it was also reported that after people stop smoking they experience improvements in insulin sensitivity and in all the other components of the metabolic syndrome. Diabetics on insulin often require lower doses of insulin and have better control over their blood sugar levels after stopping smoking.

Smokers, especially those with diabetes, need to stop smoking but smoking is a complex combination of behaviours driven by social and psychological factors as well as pharmacological addiction. Although surveys show that more than 75% of smokers would like to quit smoking less than 3% are successful. Effective smoking cessation programmes and products to help quit smoking are urgently needed to help smokers stop smoking in order both to prevent the development of diabetes and, in people with the condition, to reduce the progression of chronic diabetes complications.

Best way to stop smoking

Evidence shows that the most successful smoking cessation programmes are based on a combination of support, medication and behavioural modification therapy. The GoSmokeFree stop smoking service is based on this proven smoking cessation programme and is conveniently available across South Africa at your local pharmacy.

Triple your chance of successfully stopping smoking with the GoSmokeFree smoking cessation programme.

Support World Diabetes Day by stopping smoking and encouraging others to stop smoking.

Visit or email for more information.


This article contains opinions and facts and references to other information sources. You should always consult a registered healthcare professional for any personal advice.

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