The habit of smoking is usually acquired at a young age and it is particularly undesirable in individuals with diabetes. A study was carried out to assess objectively the prevalence of smoking in young patients with diabetes and whether younger age at onset of diabetes (implying exposure to health education) reduced the incidence of smoking. Ninety nine young adults with diabetes attending the routine clinic were studied using a structured interview and assay of a urinary nicotine metabolite (cotinine). Forty eight percent of the cohort were smoking (raised urinary cotinine), although only 31% admitted to smoking. Thirty eight percent of the patients with childhood onset diabetes, 56% of the adolescent onset, and 47% of the young adult onset patients were smoking. Smoking was not related to glycaemic control or body mass index. In conclusion, smoking is common in young patients with diabetes and is often denied. Conventional health education does not appear to prevent children and adolescents with diabetes from starting to smoke. Anti-smoking policies and health education must therefore be reinforced and improved.
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