domingo, 6 de octubre de 2013

Preventing Chronic Disease | Trends in Cigarette Smoking Rates and Quit Attempts Among Adults With and Without Diagnosed Diabetes, United States, 2001–2010 - CDC

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Preventing Chronic Disease | Trends in Cigarette Smoking Rates and Quit Attempts Among Adults With and Without Diagnosed Diabetes, United States, 2001–2010 - CDC

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CME ACTIVITY

Trends in Cigarette Smoking Rates and Quit Attempts Among Adults With and Without Diagnosed Diabetes, United States, 2001–2010

Amy Z. Fan, PhD; Valerie Rock, MPH; Xuanping Zhang, PhD; Yan Li, MPH; Laurie Elam-Evans, PhD; Lina Balluz, PhD

Suggested citation for this article: Fan AZ, Rock V, Zhang X, Li Y, Elam-Evans L, Balluz L. Trends in Cigarette Smoking Rates and Quit Attempts Among Adults With and Without Diagnosed Diabetes, United States, 2001–2010. Prev Chronic Dis 2013;10:120259. DOI: http://dx.doi.org/10.5888/pcd10.120259External Web Site Icon.

MEDSCAPE CME

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Preventing Chronic Disease. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.
Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at www.medscape.org/journal/pcdExternal Web Site Icon; (4) view/print certificate.
Release date: September 18, 2013; Expiration date: September 18, 2014

Learning Objectives

Upon completion of this activity, participants will be able to:
  • Compare the prevalence of cigarette smoking among adults with and without diabetes
  • Distinguish demographic factors associated with lower rates of cigarette smoking
  • Compare rates of smoking cessation attempts among adults with and without diabetes
  • Distinguish variables associated with higher rates of smoking cessation attempts among adults with diabetes


EDITORS

Caran Wilbanks, Editor, Preventing Chronic Disease. Disclosure: Caran Wilbanks has disclosed the following relevant financial relationship: Partner is employed by McKesson Corporation.
CME AUTHOR
Charles P. Vega, MD, Associate Professor and Residency Director, Department of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.
AUTHORS AND CREDENTIALS
Disclosures: Amy Z. Fan, PhD; Valerie Rock, MPH; Xuanping Zhang, PhD; Yan Li, MPH; Laurie Elam-Evans, PhD; Lina Balluz, PhD have disclosed no relevant financial relationships.

Affiliations: Valerie Rock, Xuanping Zhang, Laurie Elam-Evans, Lina Balluz, Centers for Disease Control and Prevention, Atlanta, Georgia; Yan Li, Georgia Department of Community Health, Atlanta, Georgia.

PEER REVIEWED

Abstract

Introduction
Quitting smoking is a critical step toward diabetes control. It is not known whether smoking rates in adults with diabetes are similar to rates among adults who do not have the disease or whether people with diabetes have increased motivation to quit. We examined prevalence trends of current smoking and quit attempts among US adults with and without diagnosed diabetes from 2001 through 2010.
Methods
We used data from the 2001 through 2010 Behavioral Risk Factor Surveillance System, a state-based telephone survey of noninstitutionalized US adults, and conducted linear trend analysis and log linear regression.
Results
The adjusted prevalence of cigarette smoking among adults with diagnosed diabetes was 9% less than adults without diagnosed diabetes (adjusted prevalence ratio [APR], 0.91; 99% confidence interval [CI], 0.89−0.93). Declines in smoking prevalence were greater among adults without diabetes than adults with diagnosed diabetes (P < .001). Among smokers, the adjusted prevalence of quit attempts among adults with diagnosed diabetes was 13% higher than among adults without diagnosed diabetes (APR, 1.13; 99% CI, 1.11−1.15). Among adult smokers with diagnosed diabetes, quit attempts were stable over time for those aged 18 to 44 years and those with a high school education or less. Quit attempts were also stable for older smokers, non-Hispanic African Americans, and Hispanic smokers, regardless of diagnosed diabetes status.
Conclusion
A large proportion of smokers with diagnosed diabetes seemed to have quit smoking, but more research is needed to confirm success and how difficult it was to achieve.

Introduction

Cigarette smoking among people with diabetes is associated with an elevated risk of cardiovascular disease and stroke, increased insulin resistance, and various complications such as diabetic nephropathy, retinopathy, neuropathy, and lower extremity amputations (1–3). Previous studies have reported that people with diabetes are as likely to smoke as those without the disease (4,5). Trend analyses indicate that the overall age-adjusted current smoking prevalence among people with diabetes remained unchanged from 1990 to 2001, despite significant reductions in cigarette smoking in the general population during the same time period (4,6). From 1990 to 2001, significant decreases in smoking prevalence among people with diabetes were observed among African Americans and those aged 65 years or older, 2 populations that are disproportionately burdened by the disease and its related complications (4).
Because of the increased risk for comorbidity and mortality among people with diabetes, smoking cessation — not just a reduction in cigarette consumption — is recommended (7). Although there is limited research on the efficacy of smoking cessation interventions for smokers with diabetes, the US Public Health Service and the American Diabetes Association suggest that integration of tobacco use dependence interventions with diabetes management and educational programs may be an effective strategy to increase quit attempts and reduce smoking prevalence among people with diabetes (7,8).
This study seeks to update and build on the existing literature related to cigarette smoking among people with diabetes. We used data from the Behavioral Risk Factor Surveillance System (BRFSS) for 2001 through 2010 to examine the trend in prevalence of current cigarette smoking and quit attempts among the US adults aged 18 years or older by diagnosed diabetes status.

Author Information

Corresponding Author: Amy Fan, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E97, Atlanta, GA 30333. Telephone: 404-498-0513. E-mail: afan@cdc.gov.
Author Affiliations: Valerie Rock, Xuanping Zhang, Laurie Elam-Evans, Lina Balluz, Centers for Disease Control and Prevention, Atlanta, Georgia; Yan Li, Georgia Department of Community Health, Atlanta, Georgia.

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ACTIVIDAD DE EMC

Tendencias en las tasas de consumo de cigarrillos e intentos de cesación entre adultos con y sin un diagnóstico de diabetes, Estados Unidos, 2001–2010

Amy Z. Fan, PhD; Valerie Rock, MPH; Xuanping Zhang, PhD; Yan Li, MPH; Laurie Elam-Evans, PhD; Lina Balluz, PhD

Citación sugerida para este artículo: Fan AZ, Rock V, Zhang X, Li Y, Elam-Evans L, Balluz L. Trends in Cigarette Smoking Rates and Quit Attempts Among Adults With and Without Diagnosed Diabetes, United States, 2001–2010. Prev Chronic Dis 2013;10:120259. DOI: http://dx.doi.org/10.5888/pcd10.120259Aclaraci?n sobre los enlaces a sitios web externos.
REVISADO POR EXPERTOS

Resumen

Introducción
Dejar de fumar es un paso crucial para el control de la diabetes. Se desconoce si las tasas de tabaquismo en los adultos con diabetes son similares a aquellas entre los adultos que no tienen la enfermedad, o si las personas con diabetes tienen mayores motivaciones para dejar de fumar. Estudiamos las tendencias en la prevalencia del tabaquismo al momento de la encuesta y los intentos de cesación entre adultos con y sin un diagnóstico de diabetes en los Estados Unidos, desde el 2001 hasta el 2010.
Métodos
Utilizamos datos desde el 2001 hasta el 2010 del Sistema de Vigilancia de Factores de Riesgo del Comportamiento, una encuesta telefónica realizada a nivel estatal a adultos no internados en instituciones de los Estados Unidos, y realizamos un análisis de tendencia lineal y regresión lineal logarítmica.
Resultados
La prevalencia ajustada del consumo de cigarrillos entre los adultos a los que se les diagnosticó diabetes fue 9 % menor que la de los adultos sin un diagnóstico de dicha enfermedad (razón de prevalencia ajustada [APR, por sus siglas en inglés], 0.91; intervalo de confianza [IC] del 99 %, 0.89−0.93). Las disminuciones en la prevalencia del tabaquismo fueron mayores entre los adultos sin diabetes que entre los adultos a los que se les diagnosticó la enfermedad (P < .001). Entre los fumadores, la prevalencia ajustada de intentos de cesación entre los adultos a los que se les diagnosticó diabetes fue 13 % más alta que entre los adultos sin un diagnóstico de dicha enfermedad (APR, 1.13; IC del 99 %, 1.11−1.15). Entre los adultos fumadores a los que se les diagnosticó diabetes, los intentos de cesación fueron estables a través del tiempo en aquellos de 18 a 44 años y en aquellos con un nivel de educación secundaria o menor. Los intentos de cesación también fueron estables en los fumadores de edad avanzada, los afroamericanos no hispanos y los fumadores hispanos, independientemente de si se les había diagnosticado diabetes o no.
Conclusión
Una gran proporción de fumadores a los que se les diagnosticó diabetes pareció haber dejado de fumar, pero se necesitan más investigaciones para confirmar el éxito y cuán difícil fue conseguirlo.

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