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Does Nicotine Affect Blood Glucose?

Christie Borders, MS, CNS

Published in Glucose

7 min read

June 3, 2022
a person smoking a cigarette
a person smoking a cigarette

Nicotine, the chemical in tobacco that makes it so addictive, doesn’t have the best reputation. It has ties to various health conditions, including cardiovascular, respiratory, and gastrointestinal disorders. 

And since one cigarette may have anywhere between 6.17 to 28.86 milligram of this nicotine, it’s likely no shock that cigarette smoking leads to a higher risk of conditions like kidney failure and heart disease.

But there’s a connection between nicotine, cardiovascular disease, and blood glucose levels. To understand how nicotine affects glucose levels, it’s also essential to know the links between your blood sugar levels and heart health.

Whether you smoke cigarettes or electronic cigarettes, use nicotine patches or nicotine replacement products, or you’re just eager to learn, this article is for you.

Read on to learn more about the research on nicotine and your health and how consistent nicotine consumption can impact blood sugar levels and insulin sensitivity.

The History of Nicotine Usage

Nicotine usage dates back to the 18 century when it was added to tobacco-containing products (like cigarettes) in the 1770s. It's both a stimulant and anxiolytic (or anxiety-reducing) chemical.

Soon after, cigarette producers added additional chemicals to make nicotine intake easier for the body. The easier the nicotine was to absorb, the more addictive cigarettes became.

It wasn’t until the late 1940s and early 1950s that scientists noticed a link between cigarette smoking and declining health.

According to the Centers for Disease Control and Prevention (CDC), a team of surgeon scientists first discovered excessive cigarette smoking caused lung cancer in 1956.

Later studies also found that nicotine negatively affects blood sugar levels, insulin, and heart health.

Nicotine, Insulin Resistance, and Blood Sugar Levels

Person checking their glucose levels with finger prick method

So, does nicotine increase your blood sugar levels and impact insulin resistance? Let’s break down what some of the research says.

One study showed that smoking could increase blood glucose levels regardless of how long those with and without diabetes smoked cigarettes.

How does nicotine increase blood glucose levels? Well, when you consume it, your body sets off a series of signals and responses.

  1. Cortisol, which is your stress hormone, is released by the adrenal gland when you smoke a nicotine-containing cigarette. Having consistently high cortisol levels can reduce insulin sensitivity (leading to insulin resistance), meaning your body doesn’t respond to insulin as it should.
  2. Because insulin helps your body use glucose effectively, you are left with high amounts of sugar in the blood which is unable to be processed effectively by the body.
  3. Somatotropic hormone, or STH, is also stimulated in response to nicotine consumption. This hormone plays a vital role in carbohydrate metabolism.
  4. One study done with Latino youth suggests that increased STH can lead to high blood glucose levels because of its link to glucose breakdown and usage.
  5. Lastly, nicotine consumption increases levels of a specific group of neurotransmitters called catecholamines. Catecholamines stop insulin from being released and playing its part in regulating glucose levels.

Your body releases catecholamines when it is in a stressed state. Because nicotine-containing products have so many chemicals, they trigger that stressed state (we cover whether it’s the nicotine in the cigarette itself or all the chemicals that drive the negative benefits on glucose later on in the article).

This state sends a signal to your body to increase glucose production, preventing your cells and tissues from using the glucose.

The result? You’re left with high blood glucose or hyperglycemia. Along with experiencing symptoms of hyperglycemia, smokers may also see high hemoglobin A1C levels, or HbA1C, on their lab results.

The Effect of Nicotine on People With Type 2 Diabetes

Research shows that this increase in blood sugar levels is more prominent in people who have diabetes than in those who don’t. These findings highlight just how much of an impact it has on metabolic health and how important smoking cessation may be, specifically for those with conditions like diabetes.

These findings were confirmed by a later study—the first to show strong evidence of nicotine causing high blood glucose levels in diabetic smokers.

A 2019 study found an interesting link between nicotine consumption and diabetes risk. The researchers found a specific gene, Tcf7I2, that plays a role in diabetes risk in rats. This diabetes-associated gene reduces nicotine addiction making you less likely to keep smoking.

However, it may play a key role in increasing blood glucose levels (and keeping them high), which can increase your risk of diabetes. So, even though this gene may make you less likely to develop an addiction to nicotine, it can make you more likely to develop diabetes and experience diabetes complications.

While research is still ongoing, there’s some evidence that nicotine intake may lead to an increased risk of diabetes and worse health outcomes, especially in those with diabetes.

The Effect of Nicotine on Healthy Individuals

a person smoking cigarette

While nicotine has a bigger impact on individuals with diabetes or those with diabetes-associated genes, it can still lead to high blood glucose in nonsmokers and metabolically healthy people.

Along with increasing blood glucose levels, nicotine also increases the risk of cardiovascular, gastrointestinal, and respiratory disorders. And while there is some debate on whether nicotine causes cancer, studies support the idea that this chemical does contribute to overall increased cancer risk.

The mechanism behind many cancers is not fully understood. Still, scientists suggest that factors like oxidative stress and DNA mutation can trigger the development of certain cancers, like cancer of the pancreas. These factors can cause your body’s cells to multiply rapidly, a characteristic of cancer.

Oxidative stress and increased cell death can damage the tissues in the gastrointestinal tract and the respiratory system, among other areas of your body. This may be one way through which nicotine increases the risk of the disorders listed above.

These effects can take years to manifest. Since genes play a role here, a family history of certain diseases such as a cardiovascular disorder or cancer can also increase your risk of these effects.

Nicotine, Blood Glucose, and Cardiovascular Health

Now, let’s tie it all together. Hyperglycaemia, or high blood glucose, is a pro-inflammatory condition. By creating an environment in the body where glucose is consistently high, nicotine leads to a pro-inflammatory state that lasts for an extended period.

Chronic inflammation damages vascular tissue such as blood vessels, and it can also damage the nerves that control your heart.

The damage from high blood glucose levels leads to high blood pressure and an increased risk of cardiovascular disease (such as congestive heart failure and heart attacks).

According to the National Institute of Diabetes and Digestive and Kidney Diseases, diabetes also reduces kidney health by damaging blood vessels.

When your blood vessels are damaged, you may see an increase in blood pressure. This increased blood pressure can lead to health issues like kidney disease.

What About Non-Cigarette Nicotine Products?

a person with nicotine patch

You may wonder, “is it nicotine itself that’s the culprit? Non-cigarette nicotine products are a safer option, right?”

The answer here may surprise you.

  • First, the study investigating the effects of nicotine and blood sugar levels found that nicotine-free cigarettes do not lead to high blood glucose levels. Interestingly, people who smoked nicotine cigarettes but did not inhale the smoke also did not show signs of hyperglycemia.
  • Second, the study identifying the diabetes gene in rats has an important implication for vaping despite being an animal study. The researchers suggest that the effects of this gene still apply to nicotine-containing vaping products like e-cigarettes.
  • Finally, research shows that other nicotine-containing products like nicotine gum increase insulin resistance, especially when consistently consumed over a long period.

Although research is ongoing, there’s evidence that nicotine use can affect your health (especially when consumed long-term as opposed to short-term). The addictive chemical is the main reason why cigarette smoking or tobacco use is associated with high blood glucose, insulin resistance, and an increased risk of cardiovascular disease.

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Katie Kissane, MS, RD

Reviewed by: Katie Kissane, MS, RD

Katie is a dietitian at Nutrisense. With over 11 years of experience as a dietitian in many areas of nutrition, Katie has worked as a clinical dietitian within a hospital, as well as in the fields of diabetes, sports and performance nutrition, recovery from addiction, and general wellness. She’s also an athlete and has run 8 marathons, including the Boston Marathon.

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