No one doubts that quitting smoking is one of the best ways to improve your health. But a new study by Johns Hopkins researchers suggests that, in the short term, tossing the cigarettes might actually increase the risk of developing diabetes.

People who quit smoking tend to gain weight, and those extra pounds can put a person at increased diabetes risk. In fact, the diabetes risk was higher for people who gave up cigarettes than for those who continued to smoke - but only within the first couple of years of quitting, according to the research appearing in today's Annals of Internal Medicine.

After that, the diabetes risk decreased and almost disappeared after 10 years, researchers found.

The study shouldn't deter people from quitting smoking, researchers urged. Rather, quitters should be conscientious about their weight, and doctors who counsel them should offer lifestyle coaching, intensive weight management and glucose level checks, said Hsin-Chieh Yeh, an assistant professor of internal medicine and epidemiology at the Johns Hopkins University School of Medicine and the report's lead author. In addition, some studies suggest nicotine-replacement therapy such as the patch could help patients keep off the pounds, she said.

Most importantly, "don't even start smoking," said Yeh. "Quitting is good, but you need to watch your weight."

In the study of nearly 10,900 middle-age adults who were followed for 17 years, those who quit smoking had a 70 percent increased risk of developing diabetes in their first six years smoke-free. But smoking is also a risk factor for developing diabetes, researchers said. Over the same period, smokers had a 30 percent increased risk. The more a person smoked and the more pounds they gained, the higher the risk, researchers found.

Dr. Kevin Ferentz, a smoking cessation expert and associate professor in the department of family and community medicine at the University of Maryland School of Medicine, said the study confirms what he sees in his practice - about a third of all smokers who quit gain an average of 5 to 8 pounds. It's not because of a slowed metabolism, he said. Quitters often substitute eating for smoking.

To stop successfully, smokers need nutritional advice and a plan to tackle the triggers that keep them vulnerable to relapse, he said. Ferentz reminds quitters to munch on low-calorie snacks like carrot sticks, celery and sugar-free gum when the cravings hit.

"The key to stopping smoking is preparation, it's not will power," he said. "The analogy that I use is stopping smoking is a test. You either study for the test and there's a good chance you will pass, or you don't study and there's a good chance you will fail."

Dr. Mansur Shomali, a diabetes specialist at Union Memorial Hospital, questioned the study's scope. Researchers don't know for sure if weight gain was the sole cause for a higher diabetes risk. Quitters might have been at higher risk for developing diabetes long before they tried to kick the habit, for example.

Shomali said patients who smoke and have diabetes are at greater risk for severe cardiovascular problems.

"We sometimes think of these patients like a time bomb waiting for a heart attack or stroke," he said. "Diabetes is bad, smoking is bad, doing both together is worse. If you stop smoking it will be better for you in the long run. There is some short-term weight gain, but you can control that."