BACKGROUND AND OBJECTIVE: This study aimed to determine whether cigarette dependence is an independent risk factor for new-onset proliferative diabetic retinopathy (PDR) and related neovascular complications in patients with type 2 diabetes mellitus (DM) and to assess the impact of smoking cessation.

PATIENTS AND METHODS: A retrospective cohort analysis using a clinical database was conducted with adult type 2 DM patients, excluding those with conditions affecting PDR progression. Propensity score matching was used to balance demographic and clinical factors between cigarette-dependent patients and controls.

RESULTS: After matching, cigarette dependence was seen to significantly increase the risk of first-instance PDR (hazard ratio [HR] 1.195), vitreous hemorrhage (HR 1.450), neovascular glaucoma (HR 1.469), and tractional retinal detachment (HR 1.670). Smoking cessation attempts reduced these risks (HR 0.716 for PDR, 0.722 for complications).

CONCLUSIONS: Cigarette dependence increases the risk of PDR and its complications in type 2 DM, and smoking cessation reduces these risks.