Most Nigerians know smoking is bad for the lungs and heart but new evidence shows tobacco also significantly raises the risk of type-2 diabetes, not just in general, but across all its subtypes, including the most severe ones that cause complications faster.
A recent Scandinavian study presented at the 2025 European Association for the Study of Diabetes (EASD) congress confirmed that smoking makes people more likely to develop type-2 diabetes, particularly the aggressive forms marked by severe insulin resistance or insulin deficiency.
Four Faces of Type-2 Diabetes
Doctors now recognize that type-2 diabetes is not a single condition but a group of related subtypes:
1. Severe Insulin-Resistant Diabetes (SIRD): The body produces insulin, but tissues don’t respond well to it.
2. Severe Insulin-Deficient Diabetes (SIDD): The pancreas produces too little insulin.
3. Mild Obesity-Related Diabetes (MOD): Closely linked to excess weight, often in younger people.
4. Mild Age-Related Diabetes (MARD): More gradual onset, typically in older adults.
The new study showed smoking whether current or past increased the risk of all four.
The strongest effect was seen in SIRD, where smokers were more than twice as likely as non-smokers to develop it.
Nigeria’s Diabetes Burden
Nigeria is facing a diabetes crisis. A 2025 review of studies across the country puts prevalence at 6.3%, though the International Diabetes Federation’s 2024 data suggests a lower national figure of around 3%.
The wide gap reflects differences in regional studies, under-reporting, and limited diagnostic coverage.
In some zones, the figures are higher: research shows the southeast recording diabetes prevalence rates of up to 13.1%, while the southwest hovers near 5.4%.
Even at the lower estimates, millions of Nigerians are already living with diabetes, many without knowing it.
Smoking in Nigeria
Compared with other countries, Nigeria’s smoking rate is relatively modest, but still significant.
In 2022, about 2.9% of Nigerian adults were current smokers. 5.4% of men and 0.4% of women.
This may sound small, but in a population of over 220 million, it translates to millions exposed to heightened risk.
The danger is compounded by the growing popularity of shisha and smokeless tobacco among young people, often wrongly perceived as safer alternatives.
How Smoking Fuels Diabetes
Scientists say tobacco worsens diabetes risk through several
• Insulin resistance: Toxic chemicals in smoke reduce tissue response to insulin.
• Beta-cell damage: Smoking harms pancreatic cells that produce insulin.
• Inflammation: Ongoing stress and damage from smoking speed up complications.
• Visceral fat: Smokers often carry more belly fat, a key driver of insulin resistance.
The Scandinavian study also found that smokers with genetic vulnerability such as family history of diabetes faced magnified risk.
In some cases, heavy smokers were up to 3.5 times more likely to develop severe insulin-resistant diabetes compared to non-smokers.
The Nigerian Reality
In hospitals across the country, diabetes complications are a daily sight:
foot ulcers leading to amputations, kidney failure requiring dialysis, and sudden strokes.
Treatment is expensive, and for many families, unaffordable.
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Smoking adds fuel to this fire, making diabetes arrive earlier, progress faster, and devastate households already struggling with limited access to healthcare.
What Can Be Done
1. Quit Smoking Early: Risk declines significantly after quitting. Government and NGOs should expand cessation clinics and helplines.
2. Screen Smokers for Diabetes: Primary health centres should regularly test smokers and ex-smokers for blood sugar.
3. Educate Communities: Campaigns must stress that smoking is not just about cancer or lungs, it is also a diabetes trigger.
4. Tobacco Control Enforcement: Nigeria’s tobacco laws need stricter enforcement like higher taxes, tighter sales restrictions, and smoke-free public spaces.
5. Healthy Living: Balanced diets, physical activity, and weight management remain critical preventive measures.
A Call to Action
Nigeria cannot afford to ignore the link between smoking and diabetes.
While global studies highlight the dangers, the warning is clear for Nigerians too:
every cigarette, every puff of shisha, increases the odds of joining the country’s growing diabetes epidemic.
The first step is personal choice. _If you smoke, quit. If you don’t, don’t start._
Your blood sugar, kidneys, heart and future depend on it.