Cigarette smoking predicts incident type 2 diabetes, but smoking cessation leads to higher short-term risk. For smokers at risk for diabetes, smoking cessation should be coupled with strategies for diabetes prevention and early detection.

Evidence suggests that stressful experiences might affect diabetes, in terms of both its onset and its exacerbation. In this article, the authors review some of this evidence and consider ways in which stress might affect diabetes, both through physiological mechanisms and via behavior. They also discuss the implications of this for clinical practice and care.

Primary care clinicians counsel patients to quit smoking more often when they are prompted by an electronic health record, according to a new study supported by AHRQ and NIH's National Cancer Institute. Clinicians participating in the study were part of the Partners Primary Care Practice-Based Research Network, a group of 26 primary care practices that currently use a Web-based electronic health record and are affiliated with Boston's Brigham and Women's Hospital and Massachusetts General Hospital. Clinicians in an intervention group received tobacco treatment-related reminders and icons; more than 40 percent of them used a new "Tobacco Smart Form," an addition to the electronic health record that prompted them to provide a range of smoking cessation interventions. Among patients who were smokers at the start of the study, more than twice as many (5.3 percent), who went to practices with the prompts or the form quit smoking by the end of the study, largely due to followup with a tobacco counselor (3.9 percent). Select to access the free full article the April 27 issue of the Archives of Internal Medicine.