title: Misconceptions about smoking in patients with type 2 diabetes mellitus: a qualitative analysis.
abstract: OBJECTIVE
  To investigate the smoking behaviours, perceptions about quitting smoking and factors associated with intention to quit in patients with type 2 diabetes mellitus.
  
  
  BACKGROUND
  Smoking causes type 2 diabetes mellitus. There has been limited research on the needs and concerns of smokers with type 2 diabetes mellitus about quitting smoking.
  
  
  METHODS
  The study used a qualitative design.
  
  
  METHODS
  Patients diagnosed with type 2 diabetes mellitus who had a history of smoking were recruited at the outpatient diabetic clinics of two major local hospitals in Hong Kong for a semi-structured interview (n = 42), guided by the theory of planned behaviour.
  
  
  RESULTS
  At data saturation, 22 current smokers and 20 ex-smokers with type 2 diabetes mellitus were recruited. The current smokers reported they had not quit smoking because of satisfaction with present health status, and misconceptions about the association between diabetes and smoking, and the perceived hazards of quitting. In contrast, ex-smokers had a positive opinion about quitting smoking, accepted advice about quitting from health professionals and received more family support than current smokers. Psychological addiction and weight gain after cessation made quitting challenging.
  
  
  CONCLUSIONS
  Satisfaction with health status, inadequate knowledge about the relationship between type 2 diabetes mellitus and smoking, and misconceptions about quitting smoking resulted in negative attitudes toward quitting by type 2 diabetes mellitus smokers. Smoking peers, psychological addiction and post-cessation weight gain hindered the quitting process.
  
  
  CONCLUSIONS
  Education on the causal link between smoking, type 2 diabetes mellitus and its complications is important to raise health awareness and counter misconceptions about quitting smoking. Behavioural counselling with weight control strategies should be part of a comprehensive smoking cessation intervention for type 2 diabetes mellitus smokers.
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Tin Kin
authors.initials: TK
authors.lastname: Chau
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Daniel Yee Tak
authors.initials: DY
authors.lastname: Fong
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Sophia Siu Chee
authors.initials: SS
authors.lastname: Chan
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Janet Yuen Ha
authors.initials: JY
authors.lastname: Wong
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: William Ho Cheung
authors.initials: WH
authors.lastname: Li
authors.affiliation: Department of Medicine, The University of Hong Kong, General Administration Office, Queen Mary Hospital, Pokfulam, Hong Kong.
authors.forename: Kathryn Choon Beng
authors.initials: KC
authors.lastname: Tan
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Angela Yee Man
authors.initials: AY
authors.lastname: Leung
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: David Chung Ngok
authors.initials: DC
authors.lastname: Wong
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
authors.forename: Doris Yin Ping
authors.initials: DY
authors.lastname: Leung
authors.affiliation: School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Tai Hing
authors.initials: TH
authors.lastname: Lam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling; D003924:Diabetes Mellitus, Type 2; D005260:Female; D006293:Health Promotion; D006723:Hong Kong; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods
keywords: diabetes; misconception; perception; qualitative; smoking cessation; theory of planned behaviour