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Smoking may pose an even greater threat to people living with diabetes than previously recognized. A new international consensus highlights that smoking is associated with a 55% higher risk of death from any cause among people with diabetes, prompting experts to call for smoking cessation to become a more active and structured part of diabetes care.
Rather than relying only on routine advice to quit, experts are urging healthcare professionals to provide practical support, including behavioral counseling, medication when appropriate and continued follow-up.
The recommendations mark a shift toward treating smoking cessation as an integral part of managing diabetes rather than as a separate lifestyle issue.
Smoking Creates Additional Risks for People With Diabetes
Diabetes already increases the risk of cardiovascular disease, kidney complications, nerve damage and other serious health problems. Smoking can further compound these risks.
Tobacco exposure can affect blood vessels, increase cardiovascular stress and make it more difficult to manage several of the complications associated with diabetes.
The World Health Organization has previously highlighted the relationship between smoking and diabetes, noting that quitting can reduce the risk of developing type 2 diabetes by 30% to 40%. Smoking is also associated with complications including cardiovascular disease, kidney failure, impaired wound healing and lower-limb amputations.
For people who already have diabetes, therefore, stopping smoking can represent an important part of reducing their overall health risk.
55% Higher Risk of Death Raises Concern
The latest international consensus draws particular attention to mortality.
According to the report highlighted in recent coverage, people with diabetes who smoke face a 55% higher risk of death from any cause compared with those who do not smoke.
The figure should not be interpreted as an individual’s personal probability of dying. Instead, it represents a population-level association showing how substantially smoking can add to the health burden already associated with diabetes.
Experts say the finding strengthens the argument for making smoking cessation a routine clinical priority for people with diabetes.
Experts Want More Than a Simple “Quit Smoking” Message
One of the central messages of the new recommendations is that simply telling a patient to stop smoking may not be enough.
Nicotine dependence can make quitting difficult, and many smokers require repeated attempts before they successfully stop.
The international recommendations therefore emphasize active quit treatment, including structured behavioral support, appropriate pharmacological treatment and ongoing follow-up.
This approach treats smoking cessation as a clinical intervention rather than simply a matter of willpower.
Healthcare providers can assess tobacco use, discuss a patient’s readiness to quit, establish a cessation plan and monitor progress over time.
Why Smoking Cessation Should Be Part of Diabetes Care
Smoking cessation is often discussed alongside general lifestyle measures such as improving diet, increasing physical activity and maintaining healthy blood glucose levels.
However, experts argue that quitting tobacco deserves the same level of attention as other major diabetes-management priorities.
Evidence summarized in recent research indicates that former smokers with diabetes have meaningfully lower risks of mortality and cardiovascular events than people who continue to smoke.
This means that helping a patient quit may potentially deliver benefits beyond lung health.
It can also contribute to reducing cardiovascular and other complications that are particularly important in people with diabetes.
Quitting Can Bring Short-Term Changes
Experts also recognize that quitting smoking can involve temporary changes that require medical attention.
Recent recommendations note that smoking cessation may lead to short-term changes in blood glucose control, body weight, blood pressure and medication metabolism.
These changes do not mean that people with diabetes should avoid quitting. Instead, they highlight why smoking cessation should be supported and monitored by healthcare professionals when necessary.
For example, changes in smoking habits can affect how the body responds to certain medications, making follow-up particularly useful for some patients.
Behavioral Counseling Can Improve the Chances of Success
Behavioral counseling is another important component of active smoking cessation treatment.
Counseling can help people identify situations that trigger smoking, develop strategies for dealing with cravings and build routines that reduce the likelihood of relapse.
For people with diabetes, counseling can also connect smoking cessation with broader health goals, including better cardiovascular health and diabetes management.
The new international consensus emphasizes a comprehensive approach rather than depending on a single intervention.
Medication May Be Part of a Quit Plan
For some smokers, behavioral support alone may not be sufficient.
Evidence-based smoking cessation medications can be considered by healthcare professionals depending on an individual’s circumstances, medical history and preferences.
The international recommendations specifically call for active treatment that can include medication alongside intensive behavioral counseling and follow-up.
The appropriate treatment should be determined with a healthcare professional rather than through self-medication.
Diabetes and Smoking Create a Dangerous Combination
The combination of diabetes and smoking is particularly concerning because both can contribute to vascular damage.
Diabetes can affect blood vessels and increase the likelihood of cardiovascular complications. Smoking adds additional harmful effects on the cardiovascular system.
This combination can therefore increase the overall burden of disease and premature mortality.
The consensus recommendations reinforce the idea that tobacco use should be routinely identified and addressed whenever people with diabetes receive medical care.
A Shift in How Doctors Approach Smoking Cessation
The latest recommendations could encourage a broader change in clinical practice.
Instead of treating smoking cessation as a brief conversation during a medical appointment, healthcare teams could integrate tobacco-use assessment and cessation support into routine diabetes management.
That could include regularly asking patients about tobacco use, documenting smoking status, offering evidence-based treatment and arranging follow-up.
Such an approach may be particularly important for people who have struggled to quit in the past.
Quitting Smoking Is an Important Health Investment
The benefits of stopping smoking extend beyond diabetes.
The WHO has emphasized that quitting smoking can reduce the risk of developing type 2 diabetes and can also improve diabetes management and reduce the risk of complications.
For people who already have diabetes, quitting can therefore become an important component of a broader strategy to protect cardiovascular health and reduce premature mortality.
The message from global experts is increasingly clear: smoking cessation should not be treated as an optional add-on to diabetes care.
Smoking is associated with a 55% higher risk of death from any cause among people with diabetes, according to a new international consensus highlighted in recent reports. The findings have prompted experts to call for more active smoking cessation treatment for people living with diabetes.
Experts recommend moving beyond simple advice to quit and providing structured support that may include behavioral counseling, appropriate medication and regular follow-up.
For people with diabetes who smoke, quitting can be an important step toward reducing cardiovascular and other health risks. Healthcare professionals can play a key role by making smoking cessation a routine and supported part of diabetes management.
