title: Factors associated with tobacco use among patients with multiple chronic conditions.
abstract: BACKGROUND
  Cigarette smoking is an important risk factor for disease onset and progression among the major chronic diseases accounting for most morbidity and mortality in the world. Our objective was to identify characteristics associated with tobacco use among patients with multiple chronic conditions (MCC).
  
  
  METHODS
  This cross-sectional study was implemented at the Center HIPERDIA Minas Juiz de Fora, Brazil, which manages patients with high cardiovascular risk, hypertension, diabetes mellitus and chronic kidney disease.
  
  
  RESULTS
  Of 1558 participants, 12% were current smokers; 41% former smokers and 47%, never smokers. In univariate analyses, current smoking was associated with gender, age, physical activity, alcohol use, depressive symptoms, overweight, and atherosclerosis. In multinomial analyses, multiple chronic conditions were associated with the current or previous use of tobacco; COPD and atherosclerotic disease were more prevalent among patients who were current smokers.
  
  
  CONCLUSIONS
  Cigarette smoking was as prevalent in this high population as in the general population. Smokers had worse clinical profiles compared to former smokers or never smokers. Aggressive smoking cessation support should yield considerable health benefits and health care cost savings within patients with MCC, especially, those with high cardiovascular risk.
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Electronic address: galilarise@gmail.com.
authors.forename: Arise Garcia
authors.initials: AG
authors.lastname: de Siqueira Galil
authors.affiliation: Kansas University, Kansas City, MO, USA.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Cupertino
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Eliane F C
authors.initials: EF
authors.lastname: Banhato
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Tatiane S
authors.initials: TS
authors.lastname: Campos
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Fernando A B
authors.initials: FA
authors.lastname: Colugnati
authors.affiliation: Kansas University, Kansas City, MO, USA.
authors.forename: Kimber P
authors.initials: KP
authors.lastname: Richter
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Marcus G
authors.initials: MG
authors.lastname: Bastos
mesh_terms: D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D008297:Male; D008875:Middle Aged; D000071069:Multiple Chronic Conditions / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology / Q000503:physiopathology; D016540:Smoking Cessation
keywords: Cardiovascular disease; Chronic kidney disease; Diabetes mellitus; Hypertension; Multiple chronic conditions; Tobacco use