Tobacco smoking is the leading cause of preventable disease and death in Australia today (AIHW 2021). While the exact mechanism for how smoking impacts diabetes risk is unclear, research has shown that smoking increases insulin resistance and is associated with an increased risk of type 2 diabetes in men and women (Chang 2012). Prenatal smoking is also associated with an increased risk of gestational diabetes (Bar-Zeev et al. 2020).   

People with diabetes who smoke also further increase their risk of cardiovascular disease, peripheral vascular disease and neuropathy (Chang 2012). There is also emerging evidence in relation to the health effects of second-hand smoke and the increased risk of developing type 2 diabetes (Campbell et al. 2017) and gestational diabetes (Morales-Suárez-Varela et al. 2022). Smoking cessation benefits people at any age with evidence that doing so reduces the relative risk for some diabetes-related complications (CDC 2020).

Though long-term data on the safety of e-cigarettes is scarce, recent research has found using e-cigarettes could influence glucose levels and the development of pre-diabetes (Gorna et al. 2020). The potential toxic effects of e-liquid and nicotine together with the risk of vaping as a driver to future tobacco smoking among youth is concerning (WHO 2020).   

In 2022–23, based on results from the National Drug Strategy Household Survey:

  • 8.3% of people aged 14 and over smoked daily (males 9.0%, females 7.7%)
  • men and women aged 50–59 had the highest proportion of current daily smokers (12.1% and 11.9%, respectively).

Between 2001 and 2022–23:

  • the proportion age 14 and over who smoked daily decreased by 57% for both males and females 
  • daily smoking rates among males and females aged 15–24 decreased by 74% and 82%, respectively (AIHW 2024).

Use of e-cigarettes

While the proportion of Australians who smoke tobacco may be declining, the use of e-cigarettes is becoming more common, particularly among young adults. Current use of e-cigarettes among people aged 14 and over nearly tripled between 2019 (2.5%) and 2022–23 (7.0%) while quadrupling among people aged 18–‍24 (from 5.3% to 21%) and increasing more than five-fold among people aged 14–‍17 (from 1.8% to 9.7%) (AIHW 2024).

See the National Drug Strategy Household Survey 2022–23 report for more information.