Brief intervention to promote smoking cessation and improve glycemic control in smokers with type 2 diabetes: a randomized controlled trial

Abstract

BACKGROUND AND OBJECTIVES: Providing brief advice on smoking cessation is a part of standard care for smokers with diabetes mellitus (DM) but the effectiveness of such interventions need to be vigorously tested. Preventing multiple highrisk behaviors is an important focus in diabetes treatment. We aimed to examine the effects of a brief stage-matched smoking cessation intervention in promoting smoking abstinence and improving glycemic control for smokers with type 2 DM in Hong Kong. METHODS: A large randomized controlled trial was conducted on 557 type 2 DM smokers randomized into an intervention group (n=283) who received brief individualized face-to-face stage-matched smoking cessation counseling (20-minute) by trained nurses and a diabetes-specific smoking cessation leaflet, or a control group (n=274) who had only usual care. All patients were followed up at 1week, 1month, 3months, 6months and 12months via telephone to assess their smoking status. FINDINGS: More than 70% of the subjects were in the pre-contemplation stage of quitting. On average, they smoked 14 cigarettes daily for more than 37 years. The average age of the patients was 55 and more than 80% of them were male. Similar 7-day point-prevalence smoking abstinence (9.2% versus 13.9%; p = 0.08) and HbA1c levels (7.95% [63 mmol/mol] versus 8.05% [64 mmol/ mol], p = 0.49) at 12 months were observed in both groups. There was no significant difference found for the self- reported reduction rate at 12 months between intervention and control group (14.8% vs 14.6%, p=0.94). CONCLUSION: This brief stage-matched smoking cessation intervention was not effective for quitting and glycemic control in type 2 DM smokers. However, these patients are the vulnerable group to receive assistance for smoking cessation from healthcare professionals. There are not many smoking cessation programs target type 2 DM patients so further trials are necessary to investigate an effective smoking cessation intervention to help this group.