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Ein vollst\u00e4ndiger Rauch- und Nikotinstopp kann zwar zu Gewichtszunahme und erh\u00f6htem Diabetesrisiko f\u00fchren, senkt jedoch die kardiovaskul\u00e4re und Gesamtmortalit\u00e4t. Die Basisdiagnostik (Fagerstr\u00f6m-Test, exhalatorisches CO) ist essenziell f\u00fcr eine erfolgreiche Raucherentw\u00f6hnung. Evidenzbasierte medikament\u00f6se Optionen umfassen Vareniclin, Nikotinersatztherapie, Bupropion und Cytisin; GLP-1-Rezeptoragonisten k\u00f6nnen adjuvant zur Gewichtskontrolle eingesetzt werden. Weder erhitzte Tabakprodukte, E\u2011Zigaretten noch rauchfreie Nikotinprodukte (Nikotinbeutel) sind harmlose Alternativen\u00a0\u2013 sie sind ebenfalls mit erh\u00f6htem Diabetesrisiko, Morbidit\u00e4t und Mortalit\u00e4t assoziiert. Sozio\u00f6konomische und psychische Faktoren beeinflussen Suchtverhalten (Rauchen, Nikotin, Alkohol) ma\u00dfgeblich. Moderater Alkoholkonsum scheint das Diabetes- und kardiovaskul\u00e4re Risiko zu senken, doch Selektionsbias und Untererfassung relativieren diesen Effekt. Dosisabh\u00e4ngig \u00fcberwiegen jedoch die Risiken durch Krebs, Lebererkrankungen und Infektionen. Infektionen treten bei Diabetes h\u00e4ufiger auf, verlaufen oft schwerer und atypisch. Bei unklarer Hyperglyk\u00e4mie ist immer an eine Infektion zu denken. Impfungen sind f\u00fcr Diabetespatient:innen von besonders hoher gesundheitlicher Relevanz.<\/jats:p>","DOI":"10.1007\/s00508-025-02680-x","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:15:36Z","timestamp":1779315336000},"page":"148-160","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rauchen und Nikotinkonsum, erhitzte Tabakprodukte, psychische und sozio\u00f6konomische Aspekte von Dependenz, Alkohol, Infektionen, Impfen und Diabetes mellitus (Update 2026)","Smoking and nicotine use, heated tobacco products, psychological and socioeconomic aspects of dependence, alcohol, infections, vaccination and diabetes mellitus (Update 2026)"],"prefix":"10.1007","volume":"138","author":[{"given":"Helmut","family":"Brath","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Huber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Verena","family":"Parzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Riesenhuber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Tatschl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Fasching","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Clodi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"2680_CR1","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1016\/S0140-6736(17)30819-X","volume":"389","author":"GBD 2015 Tobacco Collaborators","year":"2017","unstructured":"GBD 2015 Tobacco Collaborators. 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