According to the Surgeon General, active smokers have a 30% to 40% higher risk of developing type 2 diabetes compared with nonsmokers. This new data was just published in the Surgeon General’s 50-year anniversary report on smoking – The Health Consequences of Smoking — 50 Years of Progress.

While the 2010 Surgeon General’s report on smoking had discussed associations between smoking and impaired glycemic control, the development of diabetes, and diabetic complications, it was not clearly established at that time that any link was independent of other factors, such as physical inactivity and poor diet.

But newer studies have controlled for those and other confounders and have also demonstrated a dose-response relationship, as well as a reduction in diabetes risk following smoking cessation. So now, the Surgeon General report concludes: “The evidence is sufficient to infer that cigarette smoking is a cause of diabetes.”

“The link between smoking and diabetes is really interesting,” Serena Tonstad, MD, PhD, MPH, professor at the School of Public Health, Loma Linda University, California, told Medscape Medical News.

Dr. Tonstad stressed that the lack of attention paid to smoking cessation in clinical encounters with patients who have diabetes or prediabetes is “a major concern.”

“I believe that most of the consultation time goes to blood sugar regulation, medications, and diet. These findings from the report underscore the importance of giving attention to smoking cessation also. There are unfortunately very few data regarding smoking cessation in persons with diabetes,” she noted.

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