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Smoking, Smoking Cessation, and Diabetes: Narrative Review on the Effects of Smoking and Smoking Cessation on Diabetes
Journal of the Korean Society for Research on Nicotine and Tobacco 2011; 2(1): 1-7
Published online January 15, 2011
© 2011 The Korean Society for Research on Nicotine and Tobacco.

Hong-Jun Cho*

Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
 Abstract
Cigarette smoking is the most important risk factor for public health. Smoking increases the incidence of diabetes. One meta-analysis showed that incident diabetes in smokers was 1.44 times that of non-smokers and there was a dose-response relationship between cigarette consumption and the risk of diabetes. Smoking increased rates of macrovascular complications of diabetes (e.g. ischemic heart disease and stroke). However, there was no consistent relationship between smoking and rates of microvascular complications. Generally, smoking increased the risk of nephropathy, but it did not always increase the risk of neuropathy and retinopathy. Quitting smoking also increased the incidence of diabetes, mainly through weight gain. The risk of diabetes was highest during the 3 years after smoking cessation and decreased to the level of a current smoker at 12 years. Quitting smoking could deteriorate the glucose control of an individual immediately after smoking cessation, but it contributed to reduce the risk of cardiovascular disease in the long run. Smoking cessation for diabetic patients is not different from the general population. The 5 A's model (Ask, Advise, Assess, Assist and Arrange) can be applied to diabetics. Screening for smoking status, counseling of various intensities, telephone counseling, and drug therapy including nicotine replacement, bupropion, and varenicline are all effective for achieving smoking cessation. Clinicians should use every encounter with diabetic patients as a moment to teach about smoking cessation.
Keywords : Smoking; Smoking cessation; Diabetes
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