Early smoking cessation is a cost-effective tool for judicious utilization of scarce health care resources. The effect of endocrine disorders (diabetes and/or thyroid diseases) on the process of quitting smoking is not well appreciated. We studied the impact of diabetes / thyroid disorders amongst a cohort of patients undergoing smoking cessation.
The cessation program at North Shore University Hospital consisted of 6 sessions emphasizing support, behavior modification and pharmacological interventions. Data was collected from participants (N=522) from 1999- 2003 via questionnaires before and at program end; data was analyzed using SAS®.
Of the total (n=522) group, 72 participants with endocrine disorders (35 diabetics, 37 thyroid disorders) were considered (20 males and 52 females). Of these, 75% reported having other co-morbidities; 80 % reported “general health concerns” as a significant reason for quitting; 39.5% also cited cigarettes “controlled their lives”. A self-report “readiness to quit” scale, 70% scored highly (≥ 7out of 10). There was no statistical difference between the 2 groups (thyroid vs. diabetes) with respect to age (49.8 vs. 54.0), or number of previous quit attempts (3.1 vs. 3.0), although past smoking history (i.e. pack years) was significantly different (33.6 vs. 50.1; p<0.005). Quit rate upon completion of the program was 47.8% in this endocrine cohort; with only 40.0 % diabetics quitting vs. 56.3% with thyroid disorders. Quit rate for total group of 522 participants was 50.5%
Endocrine disorders impact the process of smoking cessation particularly as diabetics in this cohort were much more addicted to nicotine yet less likely to quit than participants with thyroid disorders or the general smoking population. Although both endocrine groups displayed equal preparedness and desire to quit, and both received the same interventions, the diabetic patients did not fare well. Presence of diabetes in particular, should alert clinicians to the need for more intense smoking cessation interventions.
Clinicians understanding of effect of co-morbidities can positively impact smoking cessation amongst their patients.
V.C. Reichert, None.