Chapter 19. What is the Evidence That Changing Tobacco Use Reduces the Incidence of Diabetic Complications?

  1. R. Williams3,
  2. W. Herman4,
  3. A.-L. Kinmonth6 and
  4. N. J. Wareham5
  1. Deborah L. Wingard1,
  2. Elizabeth Barrett-Connor2 and
  3. Nicole Wedick2

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch19

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Wingard, D. L., Barrett-Connor, E. and Wedick, N. (2002) What is the Evidence That Changing Tobacco Use Reduces the Incidence of Diabetic Complications?, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch19

Editor Information

  1. 3

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 4

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 5

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 6

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. 1

    Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0607, USA

  2. 2

    Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0607, USA

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582

SEARCH

Keywords:

  • smoking;
  • diabetes;
  • complications;
  • nephropathy;
  • neuropathy;
  • retinopathy;
  • heart disease;
  • morbidity;
  • mortality

Summary

In addition to the known benefits of smoking cessation for the general population, substantial evidence from patient series, case-control, and cohort studies of adults with diabetes indicates that smoking is associated with both the development and progression of heart disease and nephropathy, and with the development of neuropathy. Evidence of an association with retinopathy is inconsistent. Smoking also increases the risk of overall mortality in individuals with diabetes. There are no randomized controlled trials of smoking cessation among those with diabetes, but evidence from studies of nondiabetic individuals suggests that smoking cessation will be associated with a significant reduction in risk of cardiovascular disease and death. Individuals with diabetes appear to be smoking at the same rate as nondiabetic individuals (or even higher among black males). Development of group-specific approaches to smoking cessation and trials of the effectiveness of such programs among diabetic adults are critically needed.