Recommendations: Smoking Cessation
Recommendations for smoking cessation1 are summarized on this slide Advise all patients not to smoke or use tobacco products (A) Include smoking cessation counseling and other forms of treatment as a routine component of diabetes care (B) Smoking may have a role in the development of type 2 diabetes and other studies of individuals with diabetes consistently demonstrate that smokers have a heightened risk of CVD, premature death, and increased rate of microvascular complications of diabetes One study in smokers with newly diagnosed type 2 diabetes found smoking cessation was associated with amelioration of metabolic parameters and reduced blood pressure and albuminuria at 1 year2 The routine and thorough assessment of tobacco use is important as a means of preventing smoking or encouraging cessation A number of large randomized clinical trials have demonstrated the efficacy and cost-effectiveness of brief counseling in smoking cessation, including the use of quit lines, in the reduction of tobacco use. For the patient motivated to quit, the addition of pharmacological therapy to counseling is more effective than either treatment alone Special considerations should include assessment of level of nicotine dependence, which is associated with difficulty in quitting and relapse383References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S34. Voulgari C, Katsilambros N, Tentolouris N. Smoking cessation predicts amelioration of microalbuminuria in newly diagnosed type 2 diabetes mellitus: a 1-year prospective study. Metabolism 2011;60:1456–1464. Ranney L, Melvin C, Lux L, McClain E, Lohr KN. Systematic review: smoking cessation intervention strategies for adults and adults in special populations. Ann Intern Med 2006;145:845-856.