Smoking and Type 2 Diabetes: New Global Recommendations Explain Why Quitting Needs Medical Support
Last updated on 05 Oct 2026
People with type 2 diabetes already have a higher risk of cardiovascular disease and other long-term health problems. Smoking adds to that risk, making tobacco use an important concern in diabetes care. Yet quitting is not always as straightforward as being told to stop, particularly for people who have developed nicotine dependence.
This issue has now been addressed in a new international expert consensus on smoking cessation in people with type 2 diabetes. Developed by 35 experts from 13 countries, the consensus looks at how tobacco cessation can be incorporated into diabetes care and why people may need more structured support when trying to quit.
Key Takeaways
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Why Smoking Cessation Matters in Type 2 Diabetes
Type 2 diabetes is associated with a higher risk of cardiovascular disease and other long-term complications. Smoking adds to this risk, making tobacco use an important concern for people living with diabetes.
The evidence cited in the new consensus found that smoking was associated with a 55% higher risk of death from any cause among people with diabetes. This association comes from the evidence reviewed by the expert group, not a prediction of what will happen to every person with diabetes who smokes.
These findings provide the context for a new international consensus on smoking cessation in type 2 diabetes. Quitting tobacco is not always a single event. Some people may need repeated attempts and continued support before they are able to remain tobacco-free.
Why Isn’t “Just Quit Smoking” Enough?
For some people, deciding to stop smoking is only the beginning. Nicotine dependence can make cravings and relapse difficult to manage, which is why the consensus supports a structured approach rather than relying on brief advice alone.
Smoking cessation counselling can help people recognise situations that trigger tobacco use, prepare for cravings and work through setbacks.
The approach is not about replacing personal motivation with medication. Instead, the recommendations recognise that tobacco dependence may need the same kind of continued support given for other long-term health concerns.
Which Medicines Can Help People With Type 2 Diabetes Quit Smoking?
The consensus supports using smoking cessation medicines alongside behavioural support when appropriate. The recommended options include:
Varenicline: Receives a strong recommendation in the consensus for smoking cessation.
Nicotine replacement therapy (NRT): Provides nicotine without tobacco and is recommended as another pharmacological option.
Bupropion: Also recommended as an option for people who are trying to quit smoking.
Treatment choice should reflect the person's medical history and individual circumstances. People with type 2 diabetes who are considering medication to quit tobacco should discuss the appropriate option with their healthcare professional.
What Happens After Someone With Diabetes Quits Smoking?
Quitting smoking can change more than a person's tobacco use. For someone with type 2 diabetes, the period after cessation may also bring changes in glycemic control that need to be considered as part of their ongoing diabetes treatment.
After quitting, people may experience:
Changes in blood glucose: Blood glucose levels may change after smoking cessation, so they may need closer monitoring during this period.
Changes in body weight: Some people gain weight after quitting smoking. This can be monitored as part of weight management without taking away from the benefits of stopping tobacco use.
Changes affecting diabetes medicines: Smoking cessation can alter how some medicines work. People taking diabetes medicines to control blood glucose may therefore need their healthcare professional to review their treatment.
Follow-up at around 2 and 4 weeks can help assess whether someone has remained tobacco-free and whether additional support is needed. It also provides an opportunity to monitor blood glucose and weight and review any changes that could affect diabetes treatment.
People should not change their diabetes medicines on their own after quitting smoking. Any adjustment should be based on their clinical situation and discussed with their healthcare professional.
What Does the Consensus Mean for Tobacco Users in India?
The new consensus has particular relevance in India, where tobacco use takes different forms, including both smoking and smokeless tobacco. People who use smokeless tobacco may also need support to stop.
The Indian context is also reflected in the expert group itself. Dr Anoop Misra, an Indian diabetes specialist, was among the experts who helped develop the consensus.
For people with type 2 diabetes, the broader message is that healthcare professionals need to ask about tobacco use in its different forms and offer appropriate cessation support. Stopping tobacco use should be considered alongside other aspects of diabetes care rather than addressed only when a person develops a complication.
Could GLP-1 Medicines Help People Quit Smoking?
GLP-1 medicines are being studied for effects beyond their established role in diabetes and weight management, including their possible relationship with smoking-related behaviours. This is an emerging area of research.
However, these findings should not be confused with an established smoking-cessation treatment. GLP-1 medicines are not currently recommended as treatment for quitting smoking.
When Should Someone With Type 2 Diabetes Seek Help to Quit Tobacco?
People with type 2 diabetes do not need to wait until a complication develops before seeking help to stop using tobacco.
A healthcare professional can discuss previous attempts to quit, identify factors that may make cessation difficult and decide whether behavioural support, medication or both may be appropriate.
For someone with type 2 diabetes, quitting tobacco may involve support before and during the quit attempt, appropriate medication and follow-up afterwards. Addressing tobacco use as part of ongoing diabetes care can give people the support they need to work towards becoming tobacco-free.
FAQs
Q1. Can quitting smoking help with type 2 diabetes?
Yes. Quitting smoking can reduce the additional health risks linked to tobacco use in people with type 2 diabetes. Blood glucose and body weight may change after quitting, so diabetes management may need closer monitoring during the early weeks.
Q2. What do the latest smoking cessation recommendations say for people with diabetes?
The latest international expert consensus supports structured smoking cessation care for people with type 2 diabetes. It recommends combining behavioural support with pharmacological treatment when appropriate and includes follow-up after quitting. Varenicline receives a strong recommendation, while nicotine replacement therapy and bupropion are also recommended options.
Q3. How can smoking affect your blood sugar levels?
Smoking can affect blood glucose management in people with diabetes. After quitting, blood glucose levels may also change, so people with type 2 diabetes may need to monitor their levels more closely and discuss any significant changes with their healthcare professional.
Q4. What are the best stop-smoking medicines for people with diabetes?
The international expert consensus supports smoking cessation medications such as varenicline, nicotine replacement therapy (NRT) and bupropion when pharmacological treatment is appropriate. The choice depends on the person's medical history and individual circumstances.
Q5. Can quitting smoking cause weight gain with diabetes?
Some people gain weight after quitting smoking. For people with type 2 diabetes, weight can be monitored as part of ongoing diabetes care. The possibility of weight gain should not discourage someone from quitting tobacco.
Q6. What is the link between smokeless tobacco and diabetes?
People with diabetes who use smokeless tobacco may also need support to stop. In India, where tobacco use includes both smoked and smokeless forms, healthcare professionals should ask about the type of tobacco being used when discussing cessation.
Q7. How can someone get medical help to quit smoking with diabetes?
A healthcare professional can discuss tobacco use, previous attempts to quit and factors that may make cessation difficult. They can then help decide whether smoking cessation counselling, medication or a combination of both is appropriate.
Q8. Does smoking affect glycemic control in people with diabetes?
Smoking can affect diabetes management and is associated with poorer health outcomes in people with diabetes. People who smoke and have type 2 diabetes should discuss tobacco cessation with their healthcare professional as part of their overall diabetes care.
Q9. Are GLP-1 medicines recommended for smoking cessation?
No. GLP-1 medicines are being studied for their possible effects on smoking-related behaviours, but they are not currently recommended as smoking-cessation treatment.
Q10. What are the common withdrawal symptoms of quitting smoking?
Common nicotine withdrawal symptoms include cravings for tobacco, irritability, restlessness, difficulty concentrating, anxiety, low mood and changes in sleep or appetite. These symptoms are usually strongest during the first few days or weeks after quitting and tend to ease over time. Smoking cessation counselling and appropriate medicines can help people manage withdrawal symptoms and stay tobacco-free.
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