VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA.
Diabet Med. 2012 Jul;29(7):e96-101. doi: 10.1111/j.1464-5491.2012.03635.x.
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.
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.
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).
Post-hospitalization rates of smoking cessation are high among those with diabetes. Intensive tobacco cessation programmes may increase these cessation rates further.
吸烟是糖尿病患者心血管并发症的主要危险因素。住院治疗已被证明可以提高戒烟率。本研究的目的是比较有和没有糖尿病的美国退伍军人在住院后 6 个月的戒烟率。
这是一项对过去一个月内使用烟草的住院退伍军人进行的纵向研究（n=496）。在中西部三家退伍军人事务部医院的急性住院治疗期间招募并调查了这些患者。他们还被要求在出院后 6 个月完成随访调查。进行了单变量和多变量调整分析，以确定有和没有糖尿病诊断的患者之间戒烟率的差异。
患者的平均年龄为 55.2 岁，62%为白人。29%患有合并糖尿病。有糖尿病的患者中有 18.8%在 6 个月时报告戒烟，而没有糖尿病的患者中有 10.9%（P=0.02）。有和没有糖尿病的患者中，分别有 12.5%和 7.4%的患者通过尿酮证实戒烟（P=0.07）。控制精神病合并症、抑郁症状、年龄、自我评估健康和尼古丁依赖后，多变量调整后的逻辑回归显示，与没有糖尿病的患者相比，有糖尿病的患者在 6 个月时通过尿酮证实戒烟的可能性高三倍（比值比 3.17，P=0.005）。
有糖尿病的患者在住院后戒烟率较高。强化戒烟计划可能会进一步提高这些戒烟率。
