Post-discharge tobacco cessation rates among hospitalized US veterans with and without diabetes.

Duffy SA, Munger A, Karvonen-Gutierrez CA, Piette JD, Kao TA, Veterans Integrated Service Network (VISN) 11 Tobacco Tactics Team. Post-discharge tobacco cessation rates among hospitalized US veterans with and without diabetes. Diabetic medicine : a journal of the British Diabetic Association. 2012 Jul 1; 29(7):e96-101.

Related HSR&D Project(s)

• RCS 03-155 – Research Career Scientist Award
• SDP 06-003 – Inpatient Smoking Cessation: Bringing the Program to the Smoker

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Abstract:

AIMS: Smoking is a major risk factor for cardiovascular complications among patients with diabetes. Hospitalization has been shown to enhance cessation rates. The purpose of this study was to compare 6-month post-hospitalization tobacco cessation rates among US veterans with and without diabetes. METHODS: This was a longitudinal study among inpatient veterans who used tobacco in the past month (n = 496). Patients were recruited and surveyed from three Midwestern Department of Veterans Affairs hospitals during an acute-care hospitalization. They were also asked to complete a follow-up survey 6 months post-discharge. Bivariate- and multivariable-adjusted analyses were conducted to determine differences in tobacco cessation rates between patients with and without a diagnosis of diabetes. RESULTS: The mean age of patients was 55.2 years and 62% were white. Twenty-nine per cent had co-morbid diabetes. A total of 18.8% of patients with diabetes reported tobacco cessation at 6 months compared with 10.9% of those without diabetes (P = 0.02). Cotinine-verified cessation rates were 12.5 vs. 7.4% in the groups with and without diabetes, respectively (P = 0.07). Controlling for psychiatric co-morbidities, depressive symptoms, age, self-rated health and nicotine dependence, the multivariable-adjusted logistic regression showed that patients with diabetes had three times higher odds of 6-month cotinine-verified tobacco cessation as compared with those without diabetes (odds ratio 3.17, P = 0.005). CONCLUSIONS: Post-hospitalization rates of smoking cessation are high among those with diabetes. Intensive tobacco cessation programmes may increase these cessation rates further.