An inhaled form of human insulin, Exubera, has been approved in Europe and the United States for the treatment of type 1 and 2 diabetes in adults. The drug, to be marketed jointly by Pfizer and Sanofi-Aventis, was hailed by the US Food and Drug Administration as the “first new insulin delivery option introduced since the discovery of insulin in the 1920s.”

Both the FDA and the European Agency for the Evaluation of Medicinal Products have specified that the drug, which will not be available for several months, is contraindicated in smokers and in patients who have smoked in the preceding six months. It is “not recommended” in patients with asthma, bronchitis, or emphysema.

The European agency has also specified that Exubera is indicated only for “adult patients with …