HealthDay News — Despite expending more effort to quit, declines in smoking prevalence were smaller in the diabetic population than the general population, according to the CDC.

Adult with diabetes who smoked had a 13% higher number of quitting attempts than their nonsmoking peers (adjusted prevalence ratio 0.91; 99% CI: 0.89−0.93) during a nine-year period, yet significantly more adults without the disease were able to quit the habit (P<0.001), Amy Z. Fan, PhD, of the CDC and colleagues reported in Preventing Chronic Disease.

For patients with diabetes, smoking cigarettes increases the risk for cardiovascular disease and stroke, increased insulin resistance, and various complications, including diabetic nephropathy, retinopathy, neuropathy and lower extremity amputations.

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Although smokers with diabetes are urged to quit, data from 1990 to 2001 show that overall age-adjusted current smoking prevalence among those with the disease remained unchanged, despite significant reductions in cigarette smoking in the general population during the same time period.

To examine trends in current smoking and quit attempts among this population since then, Fan and colleagues analyzed data from the Behavioral Risk Factor Surveillance System from 2001 through 2010.

The prevalence of cigarette smoking declined from 2001 through 2010 for adults with and without diagnosed diabetes. Overall, adjusted cigarette smoking prevalence among adults with diagnosed diabetes was 9% less than adults without diagnosed diabetes (adjusted prevalence ratio [APR], 0.91; 99% CI: 0.89−0.93), the researchers found.

However, similar to studies from previous years, more remarkable declines in smoking prevalence occurred among adults without diabetes compared to adults with diabetes (0.67% vs. 0.25% average annual decline; P<0.001).

Overall, the estimated prevalence of adult smokers who reported quit attempts for one or more days increased an average of 0.5% per year, from 55.5% to 58.8% between 2001 to 2010, and was similar for those with and without diabetes (P=0.51).

Despite the overall higher number of quit attempts among those with diabetes versus those without, during the study period the average number of quit attempts did not change among smokers with diabetes who were aged 18 to 44 years, as well as those with a high school education or less, older smokers and African-Americans regardless of diabetes status.

“The diagnosis of a chronic disease may increase the odds of smoking cessation and produce a greater desire for smoking cessation,” Fan and colleagues wrote. “However, research also suggests that smokers with diabetes are less active in their diabetes self-care and less compliant with recommendations for diabetes management. Additionally, they may be more likely to report feelings of depression than nonsmokers with the disease and have a low readiness to quit smoking.”

They called for more research to examine the effectiveness of integrating smoking cessation interventions with diabetes self-management and education programs.


  1. Fan AZ et al. Prev Chronic Dis. 2013;10:120259.