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Smoking cessation is part of holistic management of type 2 diabetes but prevalence of smoking and smoking cessation in diabetes population is not well known. We aimed to determine prevalence of smokers and ex-smokers and associated factors in older diabetes population in Europe. A sample of European population ≥50 years of age (46,327 participants, 14.90 %/6,903 with diabetes: 57.36 % female, average age 70.85+-9.31, BMI 27.16+-4.76) from 27 countries from a wave 8 (2019/2020) of the Survey of Health, Ageing and Retirement in Europe was used. The data was collected from computer-assisted personal interviews using one common questionnaire, translated into national languages. Diagnosis of diabetes and smoking status were based on self-report of participants. X2 test and multinomial logistic regression models were used for statistical analyses. Prevalence of smokers in Europe was 13.93/12.15/14.24 % (whole/diabetes/nondiabetes group). Prevalence of ex-smokers was 27.06/29.87/26.57 % and prevalence of never smokers 59.01/57.97/59.19 %. Among countries diabetes populations, highest prevalence of ex-smokers (57.62 %) with low prevalence of smokers (9.52 %) was seen in the Netherlands. Highest prevalence of never smokers (84.21 %) was in Latvia, with lowest ex-smoker and low smoker prevalence (7.89 % for each). Highest prevalence of current smokers (17.94 %) with below average ex-smoker prevalence (26.46 %) was seen in Austria. Obesity was associated with higher ex-smoker prevalence, whilst normal weight, overweight, lower education, age 50-74, living without a partner and being male were associated with higher smoking prevalence. Lower ex-smoker prevalence was associated with ≥ 80 years of age and being female. Higher prevalence of ex-smokers in diabetes group might reflect diabetes diagnosis being an impulse for smoking cessation, nevertheless smoking prevalence remains high among older diabetes population in Europe. Smoking cessation interventions should be addressed repeatedly over the course of diabetes. Disclosure J. Malinovska: Employee; Boehringer Ingelheim s.r.o. M. Lustigova: None. J. Urbanova: None. P. Krollová: Advisory Panel; Boehringer-Ingelheim. Other Relationship; Sanofi. J. Michalec: None. J. Broz: None. Funding European Commission, DG RTD through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N°211909, SHARE-LEAP: GA N°227822, SHARE M4: GA N°261982, DASISH: GA N°283646); Horizon 2020 (SHARE-DEV3: GA N°676536, SHARE-COHESION: GA N°870628, SERISS: GA N°654221, SSHOC: GA N°823782, SHARE-COVID19: GA N°101015924); DG Employment, Social Affairs & Inclusion (VS 2015/0195, VS 2016/0135, VS 2018/0285, VS 2019/0332, VS 2020/0313); German Ministry of Education and Research; Max Planck Society for the Advancement of Science; National Institute on Aging (U01AG09740-13S2, P01AG005842, P01AG08291, P30AG12815, R21AG025169, Y1AG455301, IAGBSR0611, OGHA04064, HHSN271201300071C, RAG052527A)

Riziko rozvoje diabetes mellitus 2. typu (DM2) je vyšší u kuřáků cigaret v porovnání s nekuřáky. Po zanechání kouření toto riziko klesá, avšak u bývalých kuřáků je zároveň po zanechání kouření častěji pozorován metabolický syndrom. Nabízí se proto otázka, zda u kuřáků po zanechání kouření nedochází na přechodnou dobu ke zvýšení rizika rozvoje DM2 nad úroveň současných kuřáků. Z dostupných studií zabývajících se touto otázkou není možno vyvodit jednoznačný závěr i s ohledem na to, že většina studií neporovnává primárně bývalé kuřáky se současnými kuřáky, ale s nekuřáky. Výsledky studií spíše ukazují na přechodné zvýšení rizika DM2 po zanechání kouření. Vyšší riziko rozvoje DM2 je zřejmě potencováno přírůstkem váhy, který typicky v prvních letech po zanechání kouření bez intervence nastává. Proto by u pacientů -kuřáků, u kterých předpokládáme vyšší riziko rozvoje DM2, měla být léčba závislosti na tabáku spojena s prevencí rozvoje DM2 (úprava životního stylu, monitorování tělesné hmotnosti a doporučení farmakologické terapie závislosti na tabáku pro snížení rizika nárůstu váhy) a častějšími kontrolami glykemie pro zajištění časné detekce DM2.Klíčová slova: diabetes mellitus 2. typu, kouření, rizikové faktory, zanechání kouření. Smoking cessation and risk of type 2 diabetesRisk of type 2 diabetes mellitus (T2DM) is higher in tobacco smokers compared to non-smokers. The risk declines after smoking cessation. However, ex-smokers are also more prone to the metabolic syndrome. The question thus is, whether ex-smokers could temporarily have a higher risk of T2DM than current smokers. The available studies on this topic are not in agreement in their conclusions, as most of them also primarily do not compare ex-smokers to current smokers, but to non-smokers. However, based on the available studies, it rather seems the risk of T2DM is temporarily higher after smoking cessation. The higher risk of T2DM seems to be enhanced by weight gain that typically occurs first years after smoking cessation without intervention. Therefore, smoking cessation in patients who are in an increased risk of T2DM should be accompanied by T2DM preventative measures (lifestyle modification, weight monitoring and recommendation of pharmacotherapy of tobacco addiction to lower the risk of weight gain) and more frequent checks of blood glucose level to ensure early T2DM detection.