Nicotine readily transits from the maternal circulation to the placenta and much has been written around the neonatal outcomes of in-utero exposure during pregnancy, birth and early infancy [93], however longer-term outcomes are being demonstrated including that in-utero nicotine exposure permanently impacts the foetal pancreas and results in a loss of beta cell mass, leading to a life-long increased risk of impaired glucose and insulin homeostasis, childhood and adult obesegenesis [94–97], and childhood [98] and adult hypertension [99] and type 2 diabetes [100]. This evidence concerns the gene INS and type 2 diabetes mellitus.