title: Post-discharge tobacco cessation rates among hospitalized US veterans with and without diabetes.
abstract: OBJECTIVE
  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.
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA. bump@umich.edu
authors.forename: S A
authors.initials: SA
authors.lastname: Duffy
authors.forename: A
authors.initials: A
authors.lastname: Munger
authors.forename: C A
authors.initials: CA
authors.lastname: Karvonen-Gutierrez
authors.forename: J D
authors.initials: JD
authors.lastname: Piette
authors.forename: T A
authors.initials: TA
authors.lastname: Kao
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007297:Inpatients; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D020340:Tobacco Use Cessation / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data