Smoking and Diabetes

If you smoke, giving up is one of the best things you can do for your health. Smoking is the biggest cause of preventable deaths and one in two smokers will die from a smoking-related disease.

It’s well known that smoking causes diseases such as cancer, heart disease and respiratory conditions such as COPD or asthma, but what effect does it have on diabetes or your risk of developing diabetes?

Does smoking put me at a higher risk of developing diabetes?

It has been established that there is a clear link between smoking and the risk of developing type 2 diabetes. Nicotine is one of the many chemicals that are found in cigarettes and is what makes smoking so addictive. When you smoke, nicotine changes the chemical processes in the cells inside your body so they do not respond to insulin. This is known as insulin resistance.

Insulin is the hormone that allows your body to use sugar from the food we eat for energy and stops your blood glucose level from getting too high. If your body starts to become resistant to insulin, then your blood glucose levels will rise and put you at an increased risk of developing type 2 diabetes.

What if I already have diabetes?

As smoking makes your body more resistant to insulin, you will need to take more insulin to control your blood glucose levels. Prolonged periods of high blood glucose levels can cause serious damage to your eyes, heart, feet and kidneys, commonly known as diabetes complications.

How does smoking affect my body?

Heart

Smoking is a risk factor for developing heart disease on its own, so when combined with diabetes it greatly increases your chance of having a heart-related condition such as a heart attack or stroke.

Both smoking and high blood glucose levels damage the walls of the arteries which can lead to fatty deposits building up. This build-up makes the blood vessels narrower which makes it harder for blood, which carries vital oxygen, to circulate around the body. If the blood vessels in your heart become blocked, or they can’t supply enough blood, then this increases your risk of a heart attack.

Similarly, if the blood vessels to your brain become blocked or not enough blood can get through, this increases your risk of having a stroke.

Eyes

The chemicals that are found in cigarettes can cause damage to the tissues and blood vessels in your eyes. Smoking has been linked to the development of both cataracts and age-related macular degeneration, which is one of the UK’s leading causes of sight loss.

Prolonged high blood glucose levels cause damage to the blood vessels and the retina, which is the area at the back of the eye responsible for detecting light and sending messages to the brain to form pictures.

Damaged blood vessels in the retina can leak and become blocked which is known as diabetic retinopathy and can eventually lead to loss of vision. Smoking is a significant risk factor for developing diabetic retinopathy as less oxygen is supplied to the eye due to damaged blood vessels. Smoking raises both your blood pressure and blood glucose levels which in turn makes it harder to control your diabetes.

Kidneys

Smoking increases your risk of developing kidney disease independently, but when you have diabetes, it doubles the speed of progression to kidney failure. Smoking raises your heart rate, blood pressure and causes fat to be deposited in your arteries, reducing the supply of blood and oxygen to your kidneys.

High blood glucose levels also damage the membranes around the small blood vessels of the kidneys which means they don’t work as well at filtering out the waste products in our blood. This is known as diabetic kidney disease or diabetic nephropathy.

Feet

As with the complications described previously, smoking promotes the build-up of fatty plaques inside the arteries which narrows or blocks them. As the arteries become stiffer and narrowed, blood has problems reaching your feet which can result in sores, ulcers, gangrene and amputation.

Smoking also increases the carbon monoxide content in your blood. Carbon monoxide attaches itself to your red blood cells, which normally carry oxygen around your body. Cells need this oxygen to stay alive and to support healing so without this, wounds and ulcers cannot heal.

Diabetes can cause damage to the nerves, leading to a loss of feeling which means you may not notice an injury or wound to your foot. Reduced sweating due to nerve damage can result in hard cracked skin and foot ulcers can occur. Nerve damage can also, in rare cases, lead to bone and muscle weakness which can change the shape of your foot.

Are there any benefits to smoking?

There are absolutely no benefits to smoking. People that smoke say that they find it relaxing, and it helps them deal with stress. In reality, it has the opposite effect. The nicotine in cigarettes is a stimulant and it is what people crave. You may feel some relief as you are temporarily satisfying the craving, but once you’ve finished your stress levels increase to more than what they were before having a cigarette.

Another common reason for smoking is that it keeps weight down, and people are worried about putting on weight if they stop. Smoking can suppress your appetite, but it doesn’t necessarily mean that if you quit you will put on weight. It’s important to know what could make you gain weight when you stop so that you are prepared and avoid this.

• Smoking speeds up your metabolism so your body burns calories at a faster rate. When you quit smoking you will need to consume fewer calories. To keep your metabolism high, exercise regularly.
• Smoking dulls your taste buds so when you stop, you taste foods better and may crave sugary foods. Keep some healthy snacks such as fruit, nuts or vegetable sticks to hand so that you’re not tempted by high sugar snacks.
• It’s possible that you may mistake nicotine cravings for hunger pangs and use food as a distraction. Make sure you take any smoking medicines that you have been prescribed to help you suppress any cravings.
• Some people miss the ‘hand to mouth’ action from smoking and replace this by eating more. Try and find an activity to distract your hands and replace the hand to mouth action.

Why should I quit?

There are so many reasons to quit, from the improvements to your health, those around you, and your bank balance! It’s also never too late to quit smoking, quitting has benefits at all ages.

Health

The health benefits from stopping smoking are huge and immediate:

• 20 minutes: your heart rate and blood pressure drop
• 12 hours: carbon dioxide levels in your blood return to normal
• 3 months: your circulation and lung function improve, and your risk of a heart attack decreases
• 9 months: you’ll be able to breathe easier and cough less
• 1 year: your risk of heart disease decreases by 50%
• 2 – 5 years: your risk of mouth, throat, oesophagus and bladder cancer decreases by 50%. Your risk of having a stroke is also reduced to that of a non-smoker
• 10 years: you are half as likely to dies from lung cancer and your risk of kidney or pancreatic cancer decreases.
• 15 years: your risk of developing coronary heart disease is the same as that of a non-smoker.

After quitting you will notice that you have more energy as your blood circulation improves. It will also make exercising much easier as you’re able to breathe more easily and cough less. Your lung capacity improves by 10% within 9 months of quitting.

Fertility

Men and women who smoke are also more likely to have fertility problems as the chemicals in cigarettes can damage eggs and sperm. The good news is that the effects of smoking on eggs and sperm are reversible, quitting will increase the chances of conceiving and creating a healthy baby.

Appearance

Smoking deprives your skin of oxygen and nutrients which leads to uneven skin tone, age spots and the destruction of collagen and elastin, which gives your skin strength and elasticity. Giving up smoking slows down the ageing of the skin and the appearance of wrinkles.

You’ll also notice a difference in the appearance of your teeth and gums. Smoking can stain your teeth and can cause gum disease which can lead to teeth falling out and bad breath.

Financial

Because of the serious implications smoking causes to your health and consequently the NHS, tobacco is heavily taxed by the Government to try and reduce consumption. At the moment the average cost of a packet of 20 cigarettes is £10.80, which if you smoke 10 a day works out at £37.80 per week. Add that up for a year and it’s just under £2000, and over 10 years nearly £20,000.

The costs are staggering and are only set to increase year on year as the tax on tobacco rises well up above the rate of inflation.

What support is available to help me quit?

The good news is that there is a lot of support available to help you stop smoking. The first stop for many is their GP or healthcare professional. They can signpost you to local programmes that are free to attend and are staffed by expert advisers that will help find the best method to quit.

Sometimes this might be a group support session or a one-to-one meeting with a smoking advisor. Overall you are 4 times more likely to stop smoking for good if you engage with an NHS Stop Smoking Service that can offer a combination of different treatments. To find what Stop Smoking Services are available in your area, put your postcode into the finder on the NHS Smokefree website.

We live now in a digital age and there are many digital tools that you can employ to help you quit. Have a look at the NHS Smokefree website which has lots of information and you can design your own personal plan. They also have their own Smokefree app which is available to download for free on both the App Store and Google Play.  

Tips to help you quit

Making the decision to quit is the first big step, we’ve put together some tips below to help you on your journey to being smoke-free:

• Set a date: Setting a date gives you time to prepare and increases your chance of successfully quitting. Try to choose a date that avoids situations where you would be tempted to smoke, such as at the pub or other places where people around you would be smoking. Setting a date in advance gives you time to get rid of any cigarettes, lighters or matches and to engage with Stop Smoking Services to support you when you quit.
• Remember why you are quitting: Reminding yourself why you want to quit helps you to stay motivated. Writing these reasons down and looking at them every time you feel like smoking can be a great tool to help you resist the craving.
• Stop Smoking Services: Engage with your local Stop Smoking Services so that they can help work out the best plan for you. If you’d prefer to do it yourself, then the Smokefree app is great to give you mobile support, expert advice and a 4-week tailored plan with daily support messages.
• Plan for cravings: Everyone has their own way of coping, whether that’s nicotine replacing therapy or distracting yourself by staying busy. It’s good to think about this before you stop so you have a strategy in place to deal with the cravings.

What about vaping?

An e-cigarette is a device that allows you to inhale nicotine in a vapour rather than smoke and it does not contain tobacco or produce tar or carbon monoxide. They work by heating a solution, commonly known as e-liquid, that contains nicotine, flavourings and propylene glycol and/or vegetable glycerine.

Many people in the UK have managed to quit smoking by using e-cigarettes. Using one can help you manage your nicotine cravings as you can choose the strength of liquid in your e-liquid and after time reduce this down. E-cigarettes are not currently available on prescription through the NHS, however, there are many specialists vape shops you can visit or you can buy them online.

How safe are e-cigarettes?

In the UK there are very strict safety and quality regulations for e-cigarettes. They are not completely risk-free and although the long-term effects are relatively unknown, leading organisations such as Public Health England, the British Medical Association and the Royal College of General Practitioners, have estimated that they are at least 95% less harmful. There’s also no evidence so far that smoking e-cigarettes are harmful to others, unlike smoking tobacco where second-hand smoking is very harmful to others health.