Smoking, Alcohol, Addictive Substance Use and Metabolic Health

by Russell Dinney  MScPT
updated Oct 16, 2024

Smoking and Metabolic Health

Cigarette smoking contains many harmful chemicals that impair metabolism. Smoking leads to:

• Increased insulin resistance (hyperinsulinemia)
• Increased blood glucose levels (hyperglycemia)
• Increased circulating triglyceride levels (hyperlipidemia)
• Reduced beneficial high-density lipoproteins (HDL).₁

Individuals who smoke have up to a 61% increased risk of developing Metabolic Syndrome compared to non-smokers, regardless of their age, BMI, or other lifestyle factors.₂ Smoking cessation is the single most effective strategy to improve metabolic health for individuals who smoke.₁ Some individuals are concerned about weight gain once they stop smoking. An average weight gain between 4-5 kg after stopping is common, but it’s important to recognize that the health benefits of smoking cessation far outweigh any negative effects of minor weight gain.1 Smoking provides an illusion of healthy weight control, while leading to dangerous visceral fat accumulation and Metabolic Syndrome.₁

Alcohol and Metabolic Health

Alcohol consumption is a common habit among the general population. The detrimental effects of alcohol can begin with even Light to Moderate alcohol consumption (LMAC). It is defined as <2 standard drinks (28g of alcohol) for females and <3 standard drinks (42g of alcohol) for males per day:

• Increased plasma triglyceride levels
• Increased caloric intake contributed by alcohol₃

More problematic issues arise with elevated levels of alcohol intake, like binge drinking and heavy use:

• Increased insulin resistance (hyperinsulinemia)
• Increased blood glucose levels (hyperglycemia)
• Increased risk for metabolic-associated fatty liver disease (MAFLD)₃

For the most up to date recommendations, see Canadian Centre on Substance Use and Addiction’s “Alcohol and Health”: https://www.ccsa.ca/canadas-guidance-alcohol-and-health.

Smoking Cessation and Substance Use/Addiction Resources

CAMH Smoking Treatment for Ontario Patients (STOP) Program – Free Nicotine Replacement Therapy and counseling services for eligible Ontario residents that can enroll online or for in person healthcare services. https://intrepidlab.ca/en/stop/

CAMH Self-help Resources – Free online resources on smoking and alcohol abuse, and strategies to increase success of quitting. https://intrepidlab.ca/en/Pages/Patients-Caregivers-alternate.aspx

CAMH Addiction Services – Patient self-referral For Addiction Services, patients may self-refer by calling Access CAMH at 416 535-8501, press 2, then press 4

CAMH Substance Use Program – Physician referral required through online form https://www.camh.ca/en/your-care/access-camh/referral-form

References:

1. Cena, H., Fonte, M. L., & Turconi, G. (2011). Relationship between smoking and metabolic syndrome. Nutrition reviews, 69(12), 745–753. https://doi.org/10.1111/j.1753-4887.2011.00446.x
2. Kawada, T., Otsuka, T., Inagaki, H., Wakayama, Y., Li, Q., Li, Y. J., & Katsumata, M. (2010). Association of smoking status, insulin resistance, body mass index, and metabolic syndrome in workers: A 1-year follow-up study. Obesity research & clinical practice, 4(3), e163–e246. https://doi.org/10.1016/j.orcp.2009.12.004
3. Sun, F. R., & Wang, B. Y. (2021). Alcohol and Metabolic-associated Fatty Liver Disease. Journal of clinical and translational hepatology, 9(5), 719–730. https://doi.org/10.14218/JCTH.2021.00173

About the author

Russell Dinney

Physiotherapist Learn More about Russell Dinney