Nicotine: cigarettes and vapes

Nicotine is the slow one. It rarely causes an emergency on the night, so it's easy to file away as a problem for much later. This page explains why it matters more with type 1, why it changes your numbers this month and not just in forty years, and why it's so hard to stop — whether you haven't started, or you've smoked for decades and assume it's too late.

Cigarettes and your blood vessels

Diabetes slowly affects small blood vessels. Smoking does exactly the same thing. Put them together and you're not simply doubling the risk — you're bringing that damage forward, potentially by decades.

The places this shows up are the same ones diabetes already puts under strain:

• Eyes. A higher risk of retina damage — the leading cause of blindness in young adults.
• Kidneys. A faster decline toward dialysis or a transplant.
• Nerves and feet. A higher risk of numbness, wounds that are slow to heal, and amputation.
• Heart. A higher risk of heart attack and stroke, far earlier than they should happen.

The part that changes your numbers now

It's natural to discount something that might happen in forty years. So here is the part that matters this month: nicotine also makes your body resist insulin, so the same dose does less work. That shows up in your readings now, not decades from now.

Why nicotine is so hard to put down

It grabs early and holds on

In young people, around 5 mg of nicotine a day — about a quarter of one vape pod — is enough to establish dependence. That happens on a brain that is still wiring attention and self-control, a process that runs into the mid-twenties.

That's why most adults who smoke today started before they were twenty, and have been trying to stop ever since. The dependence outlasts the age you picked it up at. Thirty years in, it is not weak willpower keeping you there.

Quitting works at every age

Blood vessel function starts improving within weeks of stopping. Insulin sensitivity improves too — the same dose starts doing more work again.

The damage is cumulative, so it is always the remaining years you are protecting. Stopping at fifty still changes what your sixties look like.

And about vapes

Vaping feels like the harmless version. But the nicotine is the same drug — often at a higher dose than a cigarette — and it does the same things to your blood vessels and your insulin sensitivity.

It's worth being honest about what we don't know. What's missing from vapes isn't the risk. It's the forty years of evidence that would let anyone tell you exactly how large that risk is. The nicotine effects themselves are well established; the long-term picture for vaping specifically is still unknown.

The earlier you stop, the more your body repairs.

Free help to quit

Both of these lines are free, and they cover vaping as well as cigarettes:

• Ligne J'ARRÊTE (Québec): 1-866-527-7383
• Canada-wide quit services: 1-866-366-3667

Your diabetes team can help too, including with how quitting might change your insulin needs.