1.9.3.0 Smok­ing

Rec­om­men­da­tions

13.38 Elic­it a smok­ing his­to­ry at ini­tial and fol­low-‍up di­a­betes vis­its; dis­cour­age smok­ing in youth who do not smoke, and en­cour­age smok­ing ces­sa­tion in those who do smoke. A

13.39 e-‍Cigarette use should be dis­cour­aged. B

The ad­verse health ef­fects of smok­ing are well rec­og­nized with re­spect to fu­ture can­cer and CVD risk. De­spite this, smok­ing rates are significant­ly high­er among youth with di­a­betes than among youth with­out di­a­betes (108,109). In youth with di­a­betes, it is im­por­tant to avoid ad­di­tional CVD risk fac­tors. Smok­ing in­creas­es the risk of onset of al­bu­min­uria; there­fore, smok­ing avoid­ance is im­por­tant to pre­vent both mi­crovas­cu­lar and macrovas­cu­lar com­pli­ca­tions (98, 110). Dis­cour­ag­ing cigarette smok­ing, in­clud­ing e-‍cigarettes (111,112), is an im­por­tant part of rou­tine di­a­betes care. In younger chil­dren, it is im­por­tant to as­sess ex­po­sure to cigarette smoke in the home be­cause of the ad­verse ef­fects of se­cond­hand smoke and to dis­cour­age youth from ever smok­ing if ex­posed to smok­ers in child­hood.