Most young people who decide to smoke cigarets or marijuana are only marginally influenced in their decision to do so by the knowledge of their harmful effects. Smoking, in particular, has been well established as being associated with an increased risk of macrovascular disease, in general (81), and diabetic nephropathy, in particular (82). The contributory role of smoking to diabetic retinopathy remains controversial (83-86). Diabetic youth need to know the additional risk factor smoking provides to the long- term complications of diabetes and should have the opportunity to freely discuss these issues.
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