Post-discharge tobacco cessation rates among hospitalized Veterans with and without diabetes

Background: Smoking is a major risk factor for cardiovascular complications among patients with diabetes. Hospitalization has been shown to enhance quit rates. The purpose of this study was to compare 6-month post-hospitalization tobacco cessation rates among 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 six-month post-discharge. Bivariate and multivariable-adjusted analyses were conducted to determine differences in tobacco cessation rates between patients with and without a diabetes diagnosis. Results: The mean age was 55.2 years and 62% were White. Twenty-nine percent had comorbid diabetes. A total of 18.8% of diabetes patients reported tobacco cessation at six months compared to 10.9% of those without diabetes (P = 0.02). Cotinine verified cessation rates were 12.5% versus 7.4% in the diabetes and non-diabetes groups, respectively (P = 0.07). Controlling for psychiatric comorbidities, 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 to those without diabetes (odds ratio = 3.17, P = 0.005). Conclusions: Diabetes patients may be sensitive to the ‘teachable moment' afforded by an inpatient hospitalization. Intensive tobacco cessation programs may increase these cessation rates further.