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

Diabet Med. 2012 Jul;29(7):e96-101. doi: 10.1111/j.1464-5491.2012.03635.x.


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.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / prevention & control
  • Comorbidity
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetic Angiopathies / epidemiology*
  • Diabetic Angiopathies / prevention & control
  • Female
  • Health Services Needs and Demand
  • Humans
  • Inpatients
  • Longitudinal Studies
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Patient Discharge / statistics & numerical data
  • Prevalence
  • Risk Factors
  • Surveys and Questionnaires
  • Tobacco Use Cessation / statistics & numerical data*
  • United States / epidemiology
  • Veterans / statistics & numerical data