Diasmoke Working Group in Warsaw: how to address the smoking issue among diabetes patients?

During the 2023 edition of the GFN, a pool of international diabetologists, coordinated by prof. Riccardo Polosa, addressed the issue of cigarette smoking among diabetes patients, setting new international treatment guidelines to be published soon.

Warsaw, June 2023 – Tackling the issue of smoking among patients with severe diseases means updating existing treatment guidelines to develop new solutions and options for those who can’t or won’t stop smoking. Growing evidence indicates that regular smokers are at risk of developing incident diabetes. Quitting smoking shows clear benefits in terms of reducing or slowing the risk of cardiovascular morbidity and mortality in people with diabetes. 

Quitting smoking is a top priority for diabetes patients who smoke, because it has a negative impact on body weight, glycemic control and subsequent increased risk of new-onset diabetes. Moreover, its role on microvascular complications of the disease is unclear. 

What are the current smoking cessation treatments, and which ones are better for patients with diabetes? 

Behavioural and pharma approaches are available for smoking cessation in diabetes patients who smoke. The emerging technologies that deliver nicotine via aerosol, such as electronic cigarettes, could also be a viable and much less harmful alternative for those diabetes smokers who cannot or don’t want to stop smoking.

A pool of international diabetologists met in Catania in April 2023, to analyze possible alternatives and future application, by evaluating the safety and efficacy profile of each method and the implementation in the healthcare sector.

The guidelines drafted during the Catania meeting were discussed by the same experts during the 2023 edition of the GFN in Warsaw. The draft of the document elaborated will be soon sent to scientific magazines and journals for publications, setting new standards in the treatment of tobacco addiction in diabetes patients.

As remarked by a 2023 GFN press release, “experts have called on the World Health Organization (WHO) to urgently reconsider its approach to the use of safer nicotine products for smoking cessation. At the event, 70 speakers, including people who have quit smoking through switching to safer nicotine products, are discussing the huge potential of this strategy – and the risks to public health if it is not integrated into the global response to tobacco- related death and disease”.

New guidelines are needed to treat a disease that affects more than 500 million people worldwide” explained prof. Riccardo Polosa, CoEHAR founder. “Current smoking cessation guidelines do not consider that quitting smoking is a real struggle for those who smoke. Even if patients are aware of the tremendous impact of smoking on their health, many of them keep smoking as part of an habit. We need to approach the problem from a different perspective: new electronic nicotine delivery systems are recognized to reduce the harm by more than 95% and can reduce the co-morbidities associated to severe diseases. We have developed a parallel path that can be a solution for those unable to quit on their own and with real-life results”.

Recently, the American Diabetes Association’s Professional Practice Committee (ADA-PPC) updated the ADA Standards of Care in Diabetes document/report addressing the problem of smoking. However, the ADA document suggest that “no individuals should be advised to use e-cigarettes, either as a way to stop smoking tobacco or as a recreational drug”. This statement does not reflect the emerging evidence in the field of the harm reduction research: a cross-sectional approach should carefully evaluate the use of electronic nicotine releasing systems and the need of a good quality research that can provide those answer that are needed to set new treatment guidelines.


Do you want to participate in the study?