Diabetes Status and Smoking Cessation Activities In Texas Using Three Different Data Sources

BACKGROUND:  The study’s objective was to explore patterns of current smoking and tobacco cessation activities among persons with diabetes in Texas using three distinct data sources.

METHODS:  The first data source used was the Texas Behavioral Risk Factor Surveillance System (2007-2010). BRFSS data are used to reflect the prevalence of chronic conditions and major lifestyle risk factors among the general, non-institutionalized Texas adult population.  Respondents self-report doctor-diagnosed diabetes. Respondents were asked “Have you ever been told by a doctor that you have diabetes?” “Do you now smoke cigarettes every day, some days, or not at all?” “During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?” Questions were analyzed by demographics. The second data source was the Project Management Tracking System (PMATS) (2011-2012) for state-funded diabetes education classes in Texas.  Class participants self-report lifestyle behaviors and clinical outcomes are also collected through medical records. The third data source was the Texas Quitline 2011 call database. The Texas Quitline is a free telephone-based tobacco cessation program that provides information and counseling services.

RESULTS:  The prevalence of smoking among adults with diabetes in Texas was 14.4% based on BRFSS.  Females with diabetes were more likely to report smoking than males with diabetes, 8.4% versus 7.5% (p<.05).  More African Americans with diabetes reported smoking than non-Hispanic Whites with diabetes, 17.0% versus 14.3% (p<.05). Persons with diabetes with lower levels of education and income were more likely to report current smoking.  More African Americans with diabetes who reported current smoking also reported more frequent cessation efforts compared to non-Hispanic Whites and Hispanics, 80.0% versus 55.5% and  66.5% (p<.05). PMATS data showed 8.1% of persons attending state-funded diabetes education classes reported tobacco use, the majority of which (92.3%) reported smoking cigarettes specifically. Tobacco users in the PMATS population were more likely to be male and African American.  PMATS data indicated 39.6% of persons using tobacco reported not receiving recommendations for tobacco cessation. Approximately 10% of Texas Quitline callers reported having diabetes, compared to 9.7% of Texas adults reporting doctor-diagnosed diabetes in BRFSS 2007-2010.

CONCLUSIONS:  Current smoking is common among persons with diabetes in Texas. Current smokers with diabetes may not be receiving adequate tobacco cessation recommendations, however. African-American populations with diabetes may be an important audience for tobacco-free activities in Texas given the higher prevalence of smoking and potential greater interest in cessation.