低收入和中等收入国家缺乏关于吸烟对糖尿病患者影响的证据。在这里，我们报告了一大群墨西哥成年糖尿病患者中吸烟与死亡率的关系。 墨西哥招募时年龄为 35-74 岁的糖尿病参与者（自我报告诊断、使用抗糖尿病药物或 HbA1c   6.5%）城市前瞻性研究也包括在内。估计了与基线吸烟状况相关的 Cox 回归混杂因素调整死亡率比 (RR)。 在 15,975 名年龄在 35-74 岁之间、患有糖尿病但在招募时没有其他合并症的女性和 8225 名男性中，其中 2498 名女性 (16%) 和 2875 名男性 (35%) ) 男性报告曾吸烟，2753 名女性 (17%) 和 3796 名男性 (46%) 报告目前吸烟。在平均 17 年的随访期间，有 5087 人死亡，年龄在 35 岁至 74 岁之间。与从不吸烟相比，以前吸烟的全因死亡率RR为1.08（95%CI 1.01-1.17），当前吸烟的全因死亡率RR为1.11（95%CI 1.03-1.20），非日常吸烟的全因死亡率RR为1.09（95%CI 0.99-1.20）。吸烟，每天吸烟 < 10支香烟的值为1.06 (95% CI 0.96-1.16)（随访期间每天吸4支香烟的中位数），每天吸烟 ≥ 10支香烟的值为1.28 (95% CI 1.14-1.43)（随访期间的中位数）后续15支烟/天）。每天吸烟者的慢性阻塞性肺病、肺癌、心血管疾病和急性糖尿病并发症的死亡风险最大。在墨西哥糖尿病成人队列中，尽管观察到的吸烟模式与其他吸烟模式不同，但每天低强度吸烟与死亡率增加相关。人口中，超过 5% 的死亡与吸烟有关。© 2024。作者。

Evidence from low- and middle-income countries regarding the effect of smoking in people with diabetes is lacking. Here, we report the association of smoking with mortality in a large cohort of Mexican adults with diabetes.Participants with diabetes mellitus (self-reported diagnosis, use of antidiabetic medications or HbA1c ≥ 6.5%) aged 35-74 years when recruited into the Mexico City Prospective Study were included. Cox regression confounder-adjusted mortality rate ratios (RRs) associated with baseline smoking status were estimated.Among 15,975 women and 8225 men aged 35-74 years with diabetes but no other comorbidities at recruitment, 2498 (16%) women and 2875 (35%) men reported former smoking and 2753 (17%) women, and 3796 (46%) men reported current smoking. During a median of 17 years of follow-up there were 5087 deaths at ages 35-74 years. Compared with never smoking, all-cause mortality RR was 1.08 (95%CI 1.01-1.17) for former smoking, 1.11 (95%CI 1.03-1.20) for current smoking, 1.09 (95%CI 0.99-1.20) for non-daily smoking, 1.06 (95%CI 0.96-1.16) for smoking < 10 cigarettes/day (median during follow-up 4 cigarettes/day), and 1.28 (95% CI 1.14-1.43) for smoking ≥ 10 cigarettes/day (median during follow-up 15 cigarettes/day). Mortality risk among daily smokers was greatest for COPD, lung cancer, cardiovascular diseases, and acute diabetic complications.In this cohort of Mexican adults with diabetes, low-intensity daily smoking was associated with increased mortality, despite observing smoking patterns which are different from other populations, and over 5% of total deaths were associated with smoking.© 2024. The Author(s).