Elsevier

Addictive Behaviors

Volume 24, Issue 4, July–August 1999, Pages 573-578
Addictive Behaviors

Short communications
Smoking and diabetes: Readiness for change and provider advice

https://doi.org/10.1016/S0306-4603(98)00086-0Get rights and content

Abstract

Smoking is a serious health risk, particularly for people with diabetes. This study was designed to examine important aspects of smoking in a large group of individuals with diabetes. A survey was mailed to 2,056 individuals with diabetes. The variables examined were the stages of change for smoking, prevalence of quitting advice given by health care providers, and the patterns of readiness for change. The majority (57.8%) of current smokers were in the precontemplation stage. Comparisons on the stage of change indicated that more individuals with Type 2 diabetes have quit while there are more current smokers among those with Type 1 diabetes. Comparisons on current smokers indicated no differences on stage of change across the Type 1 and Type 2 groups, across three subgroups of individuals with Type 2 diabetes, or across duration of diabetes. Those who reported that they were given cessation advice were further along in the stages of change. These results suggest that the majority of individuals with diabetes who smoke are in the precontemplation stage of change and provider advice is important in moving smokers toward change. The current findings underscore the importance of assessing stage of change and providing stage-matched interventions when working with smokers with diabetes.

Section snippets

Participants

A thorough description of the total recruitment sample characteristics can be found in Ruggiero et al. (1997). The current sample includes all subjects who completed the survey items related to smoking. Therefore, there may be some differences in sample size compared with the total recruitment sample. The sample for the current study included, 1,875 individuals, including 258 with Type 1 and 1,617 with Type 2 diabetes. The average age was 62.6 years for the Type 2 group and 39.7 years for the

Results

Examination of the stages of change distribution indicated that 15.8% were in the precontemplation stage, 9.6% in the contemplation stage, 2.0% in the preparation stage, 3.2% in the action stage, and 69.4% in the maintenance stage. Comparison of the Type 1 and Type 2 groups across all stages revealed that 27.3% versus 14.2% were in the precontemplation stage, 20.0% versus 8.3% in the contemplation stage, 2.7% versus 1.9% in the preparation stage, 5.5% versus 3.1% in the action stage, and 44.5%

Discussion

Consistent with patterns seen in the general population (Cohen et al., 1989), the current findings for the entire sample of ever-smokers indicate that the majority of smokers with diabetes have already quit. In fact, the proportion of ever-smokers who are former smokers appears to be substantially greater in our sample of people with diabetes (73%) than in the general population (about 50%; Cigarette Smoking Among Adults—United States, 1994, 1994). Among the remaining current smokers, however,

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This study was conducted from a database developed by Lifescan, Inc., and Johnson & Johnson Health Care Systems Inc. as part of a diabetes management initiative.

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