Smoking, Vaping and Nicotine Pouches: How They Affect T1D

If you live with Type 1 Diabetes (T1D), you already work hard to keep your blood glucose in range, count carbs, and manage your insulin. There’s something else that can quietly mess with all that effort- nicotine.

Whether it comes from smoking, vaping, or nicotine pouches, nicotine can affect your blood glucose, make insulin work less effectively, and increase your risk of future health problems. Even if these things seem “normal” or “ not that bad,” it’s worth knowing what’s really happening inside your body.

How Nicotine Affects Your Blood Sugar

Nicotine- no matter how you take it- makes your body release stress hormones like adrenaline and cortisol. These hormones cause:

• Higher blood sugar levels- your liver releases extra glucose into your blood

• Insulin resistance- your insulin doesn’t work as well, so you might need more of it

• Unpredictable swings- blood sugars may rise or drop quickly, especially if you mix nicotine use with things like caffeine, alcohol, or missed meals.

So even if you’re managing your T1D well, using nicotine can make your blood sugars harder to control day to day.

Smoking

Smoking cigarettes adds another layer of harm beyond nicotine- the tar and carbon monoxide in smoke damage blood vessels, reduce oxygen in your body and increase inflammation.

For people with T1D, this means:

• Higher risk of heart disease and stroke, even at a young age

• Faster damage to eyes, kidneys and nerves

• Slower healing and worse circulation

Even smoking “just socially” or “only on weekends” has these effects- it doesn’t take years of heavy smoking to start seeing damage.

Vaping

Vapes are often seen as a “safer” alternative, but they still deliver nicotine- and often in high doses. Many vape liquids also contain flavouring chemicals that can irritate the lungs and blood vessels.

For someone with T1D, vaping can:

• Raise your blood sugar and make insulin less effective (just like smoking)

• Increase inflammation, which can worsen long-term diabetes complications

• Make it easier to become addicted to nicotine, especially with constant use throughout the day

Even nicotine-free vapes aren’t totally risk free- the chemicals and fine particles can still affect your lungs and blood vessels.

Nicotine Pouches

Nicotine pouches (sometimes called Zyns or Velo) have become really popular, especially among teens, because they don’t produce smoke or vapour- you just put them under your lip.

But “smoke free” doesn’t mean “risk free.” These pouches still release nicotine directly into your bloodstream, which means:

• The same blood sugar spikes and insulin resistance issues

• Increased heart rate and blood pressure

• A higher risk of addiction, since the nicotine hits your body quickly and discreetly

Because they’re small, easy to hide and flavoured, it’s easy to underestimate how much nicotine your actually using- which can make dependence build up fast.

The Impact on Your Heart and Long Term Health

Having T1D already means your heart and blood vessels work harder to keep you healthy. Nicotine- from any source- makes that job tougher by:

• Narrowing your blood vessels

• Raising blood pressure and heart rate

• Reducing oxygen in your blood

Over time, that increases your risk of heart disease, strokes, circulation problems, and nerve damage. These aren’t just “older person” problems- they can start much earlier if nicotine becomes a habit.

Dealing with Peer Pressure

You might feel like everyone is vaping or using pouches, and it can be hard to say no. However, the truth is more people than you think are choosing not to and sticking to your health goals actually earns respect.

Here’s what can help:

• Have an easy response ready: “Nah, it messes with my blood sugars,” or “Can’t- my diabetes nurse would kill me.”

• Blame your T1D (it’s true!): Saying your glucose levels go wild when you use nicotine usually shuts down pressure fast.

• Hang out with people who get it. Real friends don’t push you to do things that could harm your health.

• Remind yourself why you’re saying no. You already do a lot to keep your body healthy- this is another way to stay in control.

If You’re Already Smoking, Vaping, or Using Pouches

If you’ve already started, don’t panic- and don’t beat yourself up. Nicotine is very addictive, and most people don’t realise how quickly it takes hold.

You can talk to your diabetes nurse, GP or pharmacist- they’ll never judge you. They can help you find ways to cut down or quit safely and help you adjust your insulin if your blood sugars change while doing so.

Free, confidential support is available from:

• NHS Smokefree

• Diabetes UK Helpline

The Bottom Line

Whether it’s smoking, vaping, or nicotine pouches, they all deliver nicotine- and all make managing Type 1 Diabetes harder.

They can:

• Raise your blood sugar

• Make insulin less effective

• Increase your risk of heart, eye, nerve, and kidney problems

Saying no to nicotine isn’t about being perfect- it’s about protecting your body so you can keep doing the things you love, feeling good, and living life on your own terms.

You already manage a lot every day with T1D- choosing to stay nicotine free is another powerful way to take control of your health and your future.