Cigarette smoking harms nearly every system of the human body, thus causing a broad range of diseases, many of which are fatal. In particular, cardiovascular disease (CVD) is the most important cause of death in those who smoke (1). Both diabetes mellitus and cigarette smoking are well-known risk factors for the development of CVD and atherothrombosis (2,3). It is now acknowledged that endothelial cell dysfunction and clotting activation are not exclusive of diabetes. Cigarette smoking is also associated with functional changes of the endothelium and with an hypercoagulability state (4). It is likely that the combined injurious effects of high blood glucose together with cigarette smoke may be responsible for the observed accelerated course of vascular complications in diabetic patients who smoke.