There are many good reasons not to smoke. For people with diabetes there are more such reasons than for other people, whose main risk is lung cancer. For someone with diabetes who smokes, the risk of developing circulatory problems in the legs or in the heart (such as an infarct or heart attack) is about two or three times higher than for smokers who do not have diabetes.

Since the 1980s, we have known that smoking damages not only the major blood vessels but also the capillaries, particularly those in the kidneys. Trials involving thousands of participants have shown that smokers develop micro- and macroalbuminuria as signs of kidney failure more often than do non-smokers – even when they do not have diabetes.

For people with diabetes, this relationship is plainer still. In a study of 800 people with Type 2 diabetes, more than twice as many smokers as non-smokers developed macroalbuminuria within the four-year observation period. There was also a significant relationship with the number of cigarettes smoked.

The heaviest smokers were the most at risk of developing diabetic nephropathy. Smoking not only favored the appearance of kidney failure, but also aggravated its condition. The reasons why cigarette smoking is so bad for the kidneys are not known exactly.

We know that blood pressure increases during smoking. In addition, there are many detrimental effects on the walls of the blood vessels. Motivation for smokers to give up or at least to cut down the number of cigarettes comes from observations on ex-smokers.

When someone quits smoking, their risk of nephropathy falls. It is not only the risk of nephropathy that increases with smoking, but also the risk for other complications relating to blood vessels.

Numerous studies have shown that patients with hypertension – which includes nearly all diabetics with nephropathy – reduce their risk of a myocardial infarction or heart attack by nearly a half when they give up smoking.

Such success is very hard to achieve by medical therapy! We all know that it is very hard to break the smoking habit. But you should try, because the health benefit is huge.

Today there are many methods available to help you give up cigarettes, such as nicotine patches or nicotine chewing gum to provide support in the first few weeks; no-smoking programs, usually run in groups led by an expert; and relaxation exercises, which can help you continue to do without cigarettes.

A serious attempt is worth the effort, in any case. Succeed or fail, you should not despair straightaway. Most ex-smokers have on average taken three attempts to break the habit successfully.