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

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.