Think about this from my personal experience with smoking patients:
Not everyone who smokes gets cancer. Certainly every type of cancer imaginable is more likely if you smoke, but some people get through an entire life of smoking without cancer... and vice versa.
However... every single smoker will get some degree of COPD (emphysema) and atherosclerosis (hardening of the arteries or "ASVD"). If you smoke, you will get this. The severity depends on the amount of time... but you will absolutely get both. Add either of these to chronic medical conditions such as diabetes, and you can't imagine the suffering you will endure. Don't believe me -- go hang out around a dialysis clinic for a few minutes.