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Updated: Sep 13, 2025

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Alcohol, Smoking, and Their Synergy as Risk Factors for Incident Type 2 Diabetes.

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  • 1Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Reus, Spain; Nutritional Epidemiology Research Team (EREN), INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Université Sorbonne Paris Nord and Université Paris Cité, Bobigny, France; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.

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Summary

Smoking significantly increases Type 2 diabetes risk, while alcohol consumption shows no protective effect. Combined smoking and heavy alcohol use did not elevate risk, warranting further investigation into these relationships.

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Area of Science:

  • Endocrinology
  • Public Health
  • Epidemiology

Background:

  • Smoking is a known risk factor for Type 2 diabetes.
  • The association between alcohol consumption and Type 2 diabetes risk is debated.
  • The combined impact of smoking and alcohol on Type 2 diabetes risk requires further study.

Purpose of the Study:

  • To investigate the individual effects of smoking and alcohol consumption on Type 2 diabetes risk.
  • To examine the combined impact of smoking and alcohol on Type 2 diabetes risk.
  • To analyze data from a large cohort for robust statistical power.

Main Methods:

  • Analysis of data from 110,076 participants in the NutriNet-Santé cohort (2009-2023).
  • Utilized multivariable Cox regression models to assess associations.
  • Evaluated individual and combined effects of smoking and alcohol consumption, including heavy use categories.

Main Results:

  • Smoking, both former and current, was associated with a 36% increased risk of Type 2 diabetes.
  • Heavy smoking (≥20 cigarettes/day) more than doubled the risk compared to light/moderate smoking.
  • Alcohol consumption, even heavy intake, was not significantly linked to Type 2 diabetes risk.

Conclusions:

  • Smoking is confirmed as an independent risk factor for Type 2 diabetes.
  • Alcohol consumption does not appear to offer protection against Type 2 diabetes.
  • Further research is needed to understand the combined effects and mechanisms of alcohol and tobacco use on Type 2 diabetes risk.