Nicotine from smoking vaping and pouches linked to higher risk of type 2 diabetes
TOI World Desk | TOI Global Desk | Sep 18, 2025, 22:02 IST
Highlight of the story: A recent study shows that smoking, vaping, and using nicotine pouches increase the risk of developing type 2 diabetes. Nicotine harms the body’s ability to manage insulin and blood sugar, affecting all diabetes types. Heavy users face the highest risk. Experts warn that nicotine is a major factor and quitting is key to preventing the disease.
A new study shows that smoking, vaping, and using nicotine pouches increase the risk of developing type 2 diabetes. The research, presented at the European Association for the Study of Diabetes, found that nicotine harms the body’s ability to control blood sugar and insulin. This risk affects all forms of type 2 diabetes, with heavy smokers facing the highest chance of getting the disease.
Researchers from Sweden and Norway studied over 3,300 people with type 2 diabetes and nearly 3,900 without the disease. They divided the diabetes patients into four groups based on the type of diabetes they had: mild age-related diabetes (MARD), mild obesity-related diabetes (MOD), severe insulin-deficient diabetes (SIDD), and severe insulin-resistant diabetes (SIRD).
The goal was to see if smoking increased the risk in all these groups or only in some. The study found that smoking raised the risk for all types of type 2 diabetes. Both current and former smokers were more likely to develop the disease compared to non-smokers.
Heavy smoking raises risk even more
The risk was much higher for heavy smokers who smoked about 20 cigarettes a day for 15 years. For this group, the chance of developing severe insulin-resistant diabetes (SIRD) was 2.35 times higher than for non-smokers. The risk for other types of diabetes also increased: 45% higher for MARD, 52% for SIDD, and 57% for MOD. This shows that smoking seriously damages how the body handles glucose and insulin.
The study also looked at smokeless tobacco, especially a product called snus, popular in Scandinavia. Snus users had a 19% higher chance of getting severe insulin-deficient diabetes and 13% higher risk of severe insulin-resistant diabetes. Since snus delivers nicotine but without the harmful chemicals from burning tobacco, this points to nicotine itself as a main cause.
Emmy Keysendal, the study’s lead author, said, “Snus raises the risk of type 2 diabetes just like smoking does. Nicotine may be the reason.” She added that nicotine pouches and e-cigarettes, often marketed as safer options, might be just as dangerous.
Nicotine appears to make the body less able to respond to insulin. This problem is called insulin resistance and is a key feature of severe insulin-resistant diabetes (SIRD), the subtype most affected by smoking. Nicotine may speed up the development of diabetes by worsening this resistance.
Keysendal noted that scientists still need to understand how nicotine interacts with genes and other risk factors. She said future studies will look at how lifestyle and genetics together affect different types of diabetes. This could help make better prevention strategies.
Some people wrongly believe smoking lowers diabetes risk by controlling weight. Dr. David Cutler, a family doctor, strongly disagrees. He says smoking does not protect against diabetes but actually raises the risk. He urges people to focus on proven factors like healthy diet and exercise to reduce their chances of getting diabetes.
About 11% of people worldwide have diabetes, and 90% of these cases are type 2 diabetes. As vaping and nicotine products become more common, these findings highlight the importance of avoiding all forms of nicotine. Unlike age or genetics, nicotine use is a risk factor people can change to protect their health.
Smoking and all types of diabetes
Researchers from Sweden and Norway studied over 3,300 people with type 2 diabetes and nearly 3,900 without the disease. They divided the diabetes patients into four groups based on the type of diabetes they had: mild age-related diabetes (MARD), mild obesity-related diabetes (MOD), severe insulin-deficient diabetes (SIDD), and severe insulin-resistant diabetes (SIRD).
The goal was to see if smoking increased the risk in all these groups or only in some. The study found that smoking raised the risk for all types of type 2 diabetes. Both current and former smokers were more likely to develop the disease compared to non-smokers.
Heavy smoking raises risk even more
The risk was much higher for heavy smokers who smoked about 20 cigarettes a day for 15 years. For this group, the chance of developing severe insulin-resistant diabetes (SIRD) was 2.35 times higher than for non-smokers. The risk for other types of diabetes also increased: 45% higher for MARD, 52% for SIDD, and 57% for MOD. This shows that smoking seriously damages how the body handles glucose and insulin.
Nicotine pouches and vaping also risky
The study also looked at smokeless tobacco, especially a product called snus, popular in Scandinavia. Snus users had a 19% higher chance of getting severe insulin-deficient diabetes and 13% higher risk of severe insulin-resistant diabetes. Since snus delivers nicotine but without the harmful chemicals from burning tobacco, this points to nicotine itself as a main cause.
Emmy Keysendal, the study’s lead author, said, “Snus raises the risk of type 2 diabetes just like smoking does. Nicotine may be the reason.” She added that nicotine pouches and e-cigarettes, often marketed as safer options, might be just as dangerous.
Why nicotine causes diabetes
Nicotine appears to make the body less able to respond to insulin. This problem is called insulin resistance and is a key feature of severe insulin-resistant diabetes (SIRD), the subtype most affected by smoking. Nicotine may speed up the development of diabetes by worsening this resistance.
Keysendal noted that scientists still need to understand how nicotine interacts with genes and other risk factors. She said future studies will look at how lifestyle and genetics together affect different types of diabetes. This could help make better prevention strategies.
Health experts warn against myths
Some people wrongly believe smoking lowers diabetes risk by controlling weight. Dr. David Cutler, a family doctor, strongly disagrees. He says smoking does not protect against diabetes but actually raises the risk. He urges people to focus on proven factors like healthy diet and exercise to reduce their chances of getting diabetes.
A growing health concern
About 11% of people worldwide have diabetes, and 90% of these cases are type 2 diabetes. As vaping and nicotine products become more common, these findings highlight the importance of avoiding all forms of nicotine. Unlike age or genetics, nicotine use is a risk factor people can change to protect their health.