Management of type 2 diabetes: A handbook for general practice

Lifestyle interventions for management of type 2 diabetes

Smoking cessation

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Last revised: 17 Sep 2020

Grade: Strong recommendation; high certainty

All people who smoke should be offered brief advice to quit smoking

These recommendations are drawn from the most recent recommendations from organisations including the National Health and Medical Research Council (NHMRC), the Scottish Intercollegiate Guidelines Network (SIGN), Diabetes Canada, the American Diabetes Association (ADA) and other relevant sources. Refer to ‘Explanation and source of recommendations’ for explanations of the levels and grades of evidence.

Smoking is associated with an increased risk of type 2 diabetes in men and women,39 and smoking negatively affects glycaemic control (eg smokers with type 2 diabetes need larger doses of insulin to achieve control similar to that of those who do not smoke).40

People with diabetes who smoke also further increase their risk of CVD, peripheral vascular disease and neuropathy (and progression of neuropathy). Smoking also increases the risks associated with surgery.8

The importance of smoking cessation in those with, or at risk of, type 2 diabetes cannot be overstated.

In the absence of contraindications, smokers who have evidence of nicotine dependence should be offered pharmacotherapy, along with behavioural support, if they are motivated to stop smoking. The choice of pharmacotherapy is based on efficacy, clinical suitability and patient choice.8

Guidelines for smoking cessation and a pharmacotherapy treatment algorithm are available in the RACGP’s Supporting smoking cessation: A guide for health professionals.


Aboriginal and Torres Strait Islander point

The following organisations provide resources and strategies for smoking cessation for Aboriginal and Torres Strait Islander people:

Specific support for Aboriginal and Torres Strait Islander people is also provided by Quitline.

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