Type 2 Diabetes Risk Higher for People Exposed to Tobacco Early in Life

• A study has found a link between tobacco exposure early in life and increased type 2 diabetes risk.
• Having a high genetic risk for type 2 diabetes made the risk even greater.
• Experts say it could be that tobacco somehow alters cellular insulin response.
• Nicotine replacement therapy and medications can make it easier to quit smoking.
• Other resources include counseling, support groups, apps, and online programs.

According to preliminary research to be presented at the American Heart Association’s Epidemiology and Prevention│Lifestyle and Cardiometabolic Health Scientific Sessions 2024, March 18- 21, in Chicago, being exposed to tobacco while still in the mother’s womb was associated with the later development of type 2 diabetes as an adult.

Being exposed to tobacco during childhood or adolescence was also linked to greater risk.

Those people with a high genetic risk for type 2 diabetes were especially prone to developing the condition.

Smoking as an adult is a known risk factor for type 2 diabetes, according to the U.S. Centers for Disease Control and Prevention. In fact, people who smoke are 30% to 40% more likely to develop this condition than non-smokers.

However, senior study author Victor Wenze Zhong, PhD, stated in a press release that it is not known whether tobacco exposure prior to adulthood can impact whether a person goes on to develop type 2 diabetes.

It is also unclear how having a genetic predisposition to type 2 diabetes might interact with smoking.

Their goal was to help answer these questions.

Tobacco exposure before birth increased diabetes risk by 22%

To perform the study, Zhong and his team of researchers examined data from almost 476,000 adults from the UK Biobank.

The UK Biobank is a large database of medical data for around 500,000 adults living in the United Kingdom who have accessed health care via the National Health Service (NHS).

The collected data was used to estimate the association between prenatal tobacco exposure and beginning smoking during childhood (ages 5–14 years) or adolescence (ages 15–17 years) with subsequent development of type 2 diabetes as an adult.

Polygenic risk scores were used to determine any potential interactions between the study participants’ early tobacco exposure and their genetic vulnerability to develop type 2 diabetes.

The scientists also looked into whether the individuals engaged in healthy behaviors — such as eating well, exercising, getting enough sleep, and abstaining from smoking — that may have influenced the development of type 2 diabetes among those at high risk.

They found that people who were exposed to tobacco before birth had a 22% greater risk for type 2 diabetes when compared to those who had never smoked.

Additionally, those who started smoking as children had twice the risk, while those who started during adolescence had a 57% higher risk.

Also, those who didn’t start smoking until adulthood had a 33% greater risk.

In comparison to those with low genetic risk and no early exposure to tobacco, those individuals who had a high genetic risk score had a 330% higher risk of developing diabetes if they were exposed to tobacco prior to birth, a 639% higher risk if they started smoking in childhood, and a 427% higher risk if they started smoking during adolescence.

However, in those with early tobacco exposure and high genetic risk, following a healthy lifestyle as an adult appeared to mitigate the risk, reducing it by 67% to 81%.