First global recommendations issued on quitting smoking with type 2 diabetes

An international panel of 35 experts from 13 countries has issued the first dedicated global recommendations for helping people with type 2 diabetes quit smoking. The recommendations, published in *Diabetes Research and Clinical Practice*, were coordinated by the Center of Excellence for the Acceleration of Harm Reduction at the University of Catania and developed through an international consensus process.

The guidance matters because smoking substantially raises the risk of cardiovascular, cerebrovascular, kidney, blood-pressure and other complications in people with type 2 diabetes. While major organizations already advise people with diabetes not to smoke, clinicians have lacked diabetes-specific guidance on how to choose treatments, provide behavioral support, prevent relapse, monitor metabolic changes after quitting, and manage interactions between smoking and medications.

The recommendations call for smoking cessation to become a routine part of diabetes care for every patient who smokes, regardless of prior quit attempts or nicotine dependence level. They recommend varenicline as first-line drug therapy where available, with nicotine replacement therapy or bupropion as alternatives, combined with structured behavioral support and follow-up at two and four weeks. The broader message is that quitting smoking should be treated as a structured clinical intervention, not just general lifestyle advice.