How can we safely help patients with type 2 diabetes who smoke? Polish scientists are part of the international DiaSmokeFree team.
The world's first smoking cessation guidelines specifically designed for people with this condition have been developed.

A groundbreaking consensus among international experts provides physicians with a ready-made roadmap for integrating smoking cessation support into routine diabetes care. The document has been published in the prestigious journal „Diabetes Research and Clinical Practice.”

Scientists from the Mossakowski Medical Research Institute, Polish Academy of Sciences (PL: IMDiK PAN) participated in developing these recommendations. The guidelines are the result of work by the international DiaSmokeFree Working Group, comprising 35 experts from 13 countries specializing in diabetology, cardiometabolic medicine, tobacco dependence treatment, behavioral sciences, and clinical guideline methodology. The team was established at the initiative of CoEHAR, an interdisciplinary research center based at the University of Catania in Italy. This center conducts international research on the health effects of smoking and strategies for tobacco harm reduction.

Smoking significantly increases the risk of chronic complications associated with type 2 diabetes, particularly cardiovascular ones. Quitting smoking reduces this risk but can lead to short-term changes in glycemic control, body weight, blood pressure, and drug metabolism. Therefore, guidelines treat smoking cessation as a structured, individualized clinical process - rather than merely general lifestyle advice.

From advice to active treatment
The central message is clear: smoking cessation should be an essential component of type 2 diabetes care, supported by treatment, monitoring and continued follow-up.

Principal recommendations include: 

• Make smoking cessation a routine component of diabetes management for every patient who smokes, regardless of nicotine dependence or previous quit attempts.
• Combine pharmacotherapy with structured, intensive behavioural support and repeated contact within diabetes services.
• Review patients within two weeks and again at four weeks, assessing glycaemic control, body weight, blood pressure and relevant drug-smoke interactions.
• Embed cessation pathways in diabetes services through electronic prompts, automated referrals and multidisciplinary coordination.
• Developing research on smoking cessation strategies tailored to the needs of people with diabetes.

From publication to implementation
Publication marks the beginning of a broader DiaSmokeFree implementation programme coordinated by CoEHAR. The next phase will translate the recommendations into practical resources for professionals and patients, including clinical algorithms, pharmacotherapy guidance, drug–smoke interaction tools, follow-up templates and educational materials.

These resources are intended for use in diabetes clinics, primary care, professional education and health systems internationally. The Working Group will engage international and national diabetes organisations and professional societies to promote cessation assessment, treatment and follow-up as measurable components of diabetes care.

From Experts:
“We are immensely proud of this pioneering achievement. For the first time, clinicians have comprehensive, actionable guidance designed specifically for a high-risk population that has been overlooked for too long” said Professor Riccardo Polosa, who conceived and coordinated the initiative. “This turns a familiar instruction <<you should quit>> into a practical clinical pathway for helping patients with diabetes quit safely and successfully.”

“People with type 2 diabetes who smoke face an exceptionally high burden of preventable complications. Yet it is shocking to note that cessation support has rarely been tailored to their clinical needs,” said Professor Magdalena Walicka, lead author of the recommendations. “These recommendations close that gap by bringing treatment, metabolic monitoring and relapse prevention into one coordinated approach.”

“CoEHAR recognised this neglected need and convened an outstanding international group to address it,” said Professor Giovanni Li Volti, Director of CoEHAR. “The result is more than a consensus paper: it is a blueprint for making smoking cessation part of routine diabetes care worldwide. Our next task is to translate these recommendations into practical tools and care pathways that clinicians can use - and into measurable improvements for patients.”

Publication details

• Title: International consensus recommendations for smoking cessation in type 2 diabetes from the DiaSmokeFree Working Group
• Journal: Diabetes Research and Clinical Practice
• DOI:1016/j.diabres.2026.113528
• Authors: Magdalena Walicka, Cristina Russo, Antonio Ceriello, Jacob George, Davide Campagna, Anoop Misra, Giusy Rita Maria La Rosa, Roberta Sammut, Riccardo Polosa and the DiaSmokeFree Working Group.
• Funding: The study was supported by grants from the Italian Ministry of University and Research under the PNRR HEAL Italia and LEGO programmes.