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The review synthesizes diabetes-tailored approaches, emphasizing clear personalized quit advice within routine care. Evidence supports varenicline as the strongest medication option, while nicotine replacement therapy and bupropion may help but require caution due to limited diabetes-specific data. Harm reduction, GLP-1 receptor agonists, and digital tools may support cessation, alongside urgent monitoring and structured follow-up.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/addressing-the-dual-challenge-managing-smoking-cessation-in-patients-with-diabetes/406274/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/addressing-the-dual-challenge-managing-smoking-cessation-in-patients-with-diabetes/406274.png","ImageObject",300,407,{"name":92,"@type":93},"Melati","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is smoking cessation particularly challenging for people with diabetes?","Question",{"text":113,"@type":114},"Smoking increases complications and mortality, but cessation is harder due to physiological barriers such as weight gain and insulin sensitivity changes, along with psychological barriers.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which medication has the strongest evidence for smoking cessation in diabetes?",{"text":118,"@type":114},"Varenicline has the strongest evidence in this population. Nicotine replacement therapy and bupropion may help but have limited diabetes-specific data, so they should be used with caution.",{"name":120,"@type":111,"acceptedAnswer":121},"How can harm reduction and digital tools support quitting?",{"text":122,"@type":114},"Tobacco harm reduction options such as e-cigarettes and heated tobacco products may facilitate switching away from combustible cigarettes and reduce exposure, though long-term safety and efficacy in diabetes remain uncertain. Digital tools (apps, wearables, remote monitoring) can provide real-time support and adherence tracking while diabetes-specific effectiveness is still being established.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},406274,1790816441,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},962085570644,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","| W | J | D | World Journal of\u003Cbr>Diabetes |\n| --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Diabetes 2025 December 15; 16(12): 105241  \nDOI: 10.4239/wjd.v16.i12.105241 ISSN 1948-9358 (online)  \nMINIREVIEWS  \nAddressing the dual challenge: Managing smoking cessation inpatients with diabetes  \nCristina Russo, Magdalena Walicka, Gal Cohen, Carlo Maria Bellanca, Giulio Geraci, Pasquale Caponnetto, Dario Elvio Noviello, Roberta Chianetta, Jacob George, Roberta Sammut, Eward Franek, Riccardo Polosa  \nSpecialty type: Endocrinology and metabolism  \nProvenance and peer review:  \nUnsolicited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade B, Grade C  \nNovelty: Grade B, Grade C  \nCreativity or Innovation: Grade B, Grade C  \nScientific Significance: Grade B, Grade B  \nP-Reviewer: Huang ZW, PhD, Associate Professor, China; Shah SIA, PhD, Professor, Pakistan  \nReceived: January 18, 2025  \nRevised: April 2, 2025  \nAccepted: November 12, 2025  \nPublished online: December 15, 2025  \nProcessing time: 332 Days and 18.6 Hours  \nCristina Russo, Ashford and Saint Peter’s Hospitals NHS Foundation Trust, Chertsey KT16 0PZ, United Kingdom  \nMagdalena Walicka, Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw 02-106, Poland  \nMagdalena Walicka, Eward Franek, Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw 02-507, Poland  \nGal Cohen, Rose Research Center, Raleigh, NC 27617, United States  \nCarlo Maria Bellanca, Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania 95123, Sicilia, Italy  \nCarlo Maria Bellanca, Clinical Toxicology Unit, University Hospital of Catania, Catania 95123, Sicilia, Italy  \nCarlo Maria Bellanca, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari 09121, Sardegna, Italy  \nGiulio Geraci, Riccardo Polosa, Faculty of Medicine and Surgery, Kore University of Enna, Enna 94100, Sicilia, Italy  \nPasquale Caponnetto, Riccardo Polosa, Center of Excellence for the Acceleration of Harm Reduction, Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Sicilia, Italy  \nPasquale Caponnetto, Department of Science of Education, Section of Psychology, University of Catania, Catania 95123, Sicilia, Italy  \nDario Elvio Noviello, Clinica Medica “A. Murri”, Azienda Ospedaliero Universitaria Policlinico, Catania 95123, Sicilia, Italy  \nDario Elvio Noviello, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro Medical School, Bari 70100, Italy  \nRoberta Chianetta, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo 90127, Sicilia, Italy  \nJacob George, Molecular and Clinical Medicine, University of Dundee Medical School,  \n WJD  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 15, 2025  Volume 16  Issue 12   \nRusso C et al. Smoking cessation in people with diabetes  \nDundee DD1 9SY, United Kingdom  \nRoberta Sammut, Faculty of Health Sciences, University of Malta, Valletta 2080, Malta  \nEward Franek, Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw 02-668, Poland  \nCorresponding author: Riccardo Polosa, MD, PhD, Faculty of Medicine and Surgery, Kore University of Enna, Viale delle Olimpiadi 1, Enna 94100, Sicilia, [Italy.](Italy. polosa@unict.it)[ polosa@unict.it](Italy. polosa@unict.it)  \nAbstract  \nSmoking increases complications and mortality in people with diabetes. Quitting delivers major benefits, but physiological (weight gain, insulin sensitivity shifts) and psychological barriers mak","cbCaibT0HJtgKNpf","https://ap.wps.com/l/cbCaibT0HJtgKNpf","pdf",776345,14,"English","# Abstract\n# Key Words\n# Core Tip","[{\"question\":\"Why is smoking cessation particularly challenging for people with diabetes?\",\"answer\":\"Smoking increases complications and mortality, but cessation is harder due to physiological barriers such as weight gain and insulin sensitivity changes, along with psychological barriers.\"},{\"question\":\"Which medication has the strongest evidence for smoking cessation in diabetes?\",\"answer\":\"Varenicline has the strongest evidence in this population. Nicotine replacement therapy and bupropion may help but have limited diabetes-specific data, so they should be used with caution.\"},{\"question\":\"How can harm reduction and digital tools support quitting?\",\"answer\":\"Tobacco harm reduction options such as e-cigarettes and heated tobacco products may facilitate switching away from combustible cigarettes and reduce exposure, though long-term safety and efficacy in diabetes remain uncertain. Digital tools (apps, wearables, remote monitoring) can provide real-time support and adherence tracking while diabetes-specific effectiveness is still being established.\"}]","Addressing the dual challenge - Managing smoking cessation in patients with diabetes | PDF",1790564561,35]