Diabetic Smokers Are More Hardcore

Smokers with diabetes have a more difficult time giving up cigarettes than do other smokers, even when they have a strong desire to quit, a new study finds.

"They smoke more and are less likely to quit," says lead researcher Virginia C. Reichert, a nurse practitioner and director of the Center for Tobacco Control at the North Shore-Long Island Jewish Health System in Great Neck, N.Y. "I think they are going to need more intense interventions."

Reichert presented her findings Oct. 29 at a meeting of the American College of Chest Physicians in Orlando, Fla.

Reichert and her colleagues followed a group of 522 smokers, including 35 diabetics and 37 with thyroid disorders. Overall, 70 percent scored highly on a "readiness to quit" scale, she says, but the diabetics' success rate was lower than those with thyroid disorders or the others.

While more than 56 percent of those with thyroid disorders quit and overall the quit rate among all 522 smokers was 50.5 percent, only 40 percent of those with diabetes quit, she found.

When she looked more closely at those with thyroid disorders and those with diabetes, she found their ages were similar, 49 versus 54, and the number of previous quit attempts, 3.1 vs. 3, was also similar.

But they differed in past smoking history, with the diabetics smoking much more. While those with thyroid disorders had a smoking history of more than 33 "pack years," those with diabetes had a history of 50 pack years. A pack year is the number of packs smoked per day multiplied by the number of years. So 50 pack years might reflect smoking two packs a day for 25 years, or three packs for nearly 17 years.

All smokers got the same six-session cessation program that emphasizes support, behavior modification and pharmacologic interventions.

Having diabetes somehow impacts the process of quitting cigarettes, Reichert says, and the diabetics studied are more addicted to nicotine but less likely to quit than those with thyroid disorders or the general smoking population.

To encourage smokers to quit, Reichert says she tells them "the benefits of quitting are immediate." She recommends that physicians caring for diabetic patients who smoke should suggest more intense programs for quitting.

"It's an important study," says Dr. Robert Rizza, vice president of the American Diabetes Association (ADA) and professor of medicine at the Mayo Clinic in Rochester, Minn. "We should encourage our patients [with diabetes] to be involved in smoking cessation programs."

According to the ADA, about 17 million Americans have diabetes, although 6 million are unaware they have it.

More information

Get a primer on the disease from the American Diabetes Association. For five common myths about smoking, try the Office of the Surgeon General. Need online help to kick the habit? Try QuitNet.

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