Smoking, smoking cessation behaviors and health-related quality of life among low income diabetic patients

Background: Smokers with diabetes have more problems with dental disease, bleeding gums and ulcers than their non-diabetic counterparts. Quitting smoking is an important and effective approach to improving diabetes management. Little is known about the influence of smoking status and cessation services on health-related quality of life (HRQoL) among low income diabetic patients. Thus, it is of particular interest to better understand smoking cessation behavior among these lower-income diabetic patients.

Method: The LSU Tobacco Control Initiative (TCI) patient survey was self-administered to individuals visiting primary care outpatient clinics in seven public hospitals in Louisiana. Data of 1209 patients were collected from January to February 2013. 370 of those surveyed were diabetic patients. This survey was developed to monitor cessation behaviors and perceptions of provider’s treatment of tobacco, quit attempts and utilization of cessation services within Louisiana’s safety-net public hospital system.

Results: Current smokers had significantly lower mean scores on the EQ5D-VAS (visual analogue scale) than former and non-smokers (61.69 vs. 67.18 and 69.45, p<0.001). Diabetic patients who were current smokers had significant lower mean scores on the EQ5D-VAS (56.06, p<0.016). 53.87% of diabetic patients who were current smokers tried to quit in the past twelve months. Among diabetic patients, current smokers were more likely to report difficulties in all five dimensions of the HRQOL EQ5D survey component, especially in pain or discomfort, anxiety/ depression and usual activity compared to former and non-smokers.

Conclusion: Smoking status is significantly and negatively associated with health-related quality of life among low income diabetic patients. Future study should consider how quality of life among diabetic patients may be affected by smoking status and past quitting behaviors.