Smoking Behavior in Hypertensive and Diabetic Patients

BACKGROUND: Previous research links low-income communities with smoking but little literature examines smoking behavior by ethnic group and chronic disease diagnosis. Smoking has serious health effects in patients with diabetes and hypertension.

OBJECTIVE: Describe findings on cigarette use among ethnically diverse patients at a community health center in a medically underserved area.

METHODS: In our four-year, multi-method study, epidemiological surveys were completed by 291 patients from four ethnic groups (Latino, Vietnamese, African-American, white) diagnosed with diabetes and/or hypertension. In-depth interviews (total N=18) and focus groups (total N=43) were conducted with a subset of survey participants.

FINDINGS: We found higher than national rates of smoking across diagnosis, gender and ethnicity. Of the 291 participants, 27.5% are current smokers (men: 33.1%, women: 21.7%). Thirty percent of whites and Latinos, 42.2% of African Americans, and 10.3% of Vietnamese participants currently smoke. Hypertensive participants smoke more than diabetic participants (30.6% to 22.9%), and 27.3% of dually-diagnosed individuals are smokers. Smoking is negatively associated with income: Of those with a monthly income between $400 and $799, 28.8% smoke, while 41.1% of those who make less than $400 smoke. Forty percent of the participants who are “not looking for work” smoke whereas 59.1% of those “looking for work” are current smokers. Qualitative data indicates patients are more apt to quit smoking when it is recommended by a health professional.

DISCUSSION: Health care professionals should recommend specific strategies for quitting to their diabetic and hypertensive patients and emphasize increased risks for these groups.