近年来糖尿病的患病率快速上升，2013年全球糖尿病患病率达8.3%，我国糖尿病患病人数目前已居世界首位，约1.4亿。与此同时，全球吸烟人数约10亿，我国超过半数的男性为吸烟者。尽管多数人群研究观察到吸烟增加糖尿病的发生风险，但是也有部分研究显示吸烟与糖尿病发生无关或降低糖尿病的发生风险。机制方面，有研究观察到吸烟可以减轻体质量，从而降低糖尿病的发生风险;而吸烟对升糖激素、胰岛素抵抗的作用尚不明确。该文分别从人群研究和病理生理机制方面探讨了吸烟对糖尿病发生的影响。

The incidence of diabetes is increasing rapidly in recent years. The global incidence of diabetes was 8.3% in 2013 and the number of Chinese patients with diabetes is the largest in the world, about 140 millions. At the same time, there are about 1 billion smokers worldwide and more than half of Chinese males are smokers. Although most population-based studies show that smoking increases the risk of diabetes, some studies indicate that smoking is irrelevant to the incidence of diabetes or decreases the risk of diabetes. The mechanism may be that smoking can reduce the body mass, so as to decrease the risk of diabetes. The effects of smoking on sugar elevating hormones and insulin resistance are not clear yet. This paper discusses the effects of smoking on the incidence of diabetes from the perspectives of population-based studies and pathophysiological mechanisms.