Intervention study for smoking cessation in diabetic patients - A randomized controlled trial in both clinical and primary care settings

OBJECTIVE - To evaluate the effectiveness of a nurse-managed smoking cessat ion intervention in diabetic patients. RESEARCH DESIGN AND METHODS - This randomized controlled clinical trial inv olved 280 diabetic smokers (age range 17-84 years) who were randomized eith er into control (n = 133) or intervention (n = 147) groups at 12 primary ca re centers and 2 hospitals located in Navarre, Spain. The intervention cons isted of a 40-min nurse visit that included counseling, education, and cont racting information (a negotiated cessation date). The follow up consisted of telephone calls, letters, and visits. The control group received the usu al care for diabetic smokers. Baseline and 6-month follow-up measurements i ncluded smoking status (self-reported cessation was verified by urine cotin ine concentrations), mean number of cigarettes smoked per day and stage of change. RESULTS - At the 6-month follow-up, the smoking cessation incidence was 17. 0% in the intervention group compared with 2.3% in the usual care group, wh ich was a 14.7% difference (95% CI 8.2-21.3%). Among participants who conti nued smoking, a significant reduction was evident in the average cigarette consumption at the 6-month follow-up. The mean number of cigarettes per day decreased from 20.0 at baseline to 15.5 at 6 months for the experimental g roup versus from 19.7 to 18.1 for the control group (P < 0.01). CONCLUSIONS - A structured intervention managed by a single nurse was shown to be effective in changing the smoking behavior of diabetic patients.