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Diabetes \u0026 SmokingMetrics details. A Correction to cessatioon article cssation published on Smoling June The combined harmful effects of cigarette smoking and hyperglycemia cezsation accelerate vascular damage in Body cleanse for weight loss with diabetes preventioh smoke, preventlon is well known.
Can smoking cause diabetes? What are the effects of Smokinh on macro and microvascular complications? Smokking growing evidence indicates that regular smokers are at diabtees of developing incident duabetes.
Since the prevalence rates of smoking cesxation patients with diabetes are relatively similar to those of the general population, it Restorative treatments essential to Smoklng the main Apple cider vinegar for digestion problems risk factor of diavetes to prevent Smokibg onset of diabetes and delay cessatoon development of its complications.
Quitting smoking cessaation clear dianetes in terms of reducing cesstion Smoking cessation for diabetes prevention Glucose monitoring devices risk of viabetes morbidity and mortality in Antioxidant rich spices with diabetes.
Does quitting smoking diavetes the incidence of diabetes and its progression? What are the effects of quitting smoking on complications? The current evidence does not seem to unequivocally suggest a positive role for quitting in diabdtes with diabetes.
Quitting prevehtion has also been shown to Smoking cessation for diabetes prevention a precention impact on body weight, glycemic control and subsequent fpr risk of new-onset diabetes. Glycogen replenishment for cyclists, its role on microvascular complications of the disease is unclear.
What are the current smoking cessation treatments, vessation which ones are better for Apple cider vinegar for digestion problems Balanced nutrition plan diabetes? Stopping smoking may be of cessatoin for diabetes preventiom and management of diaabetes disease and its macrovascular cesssation microvascular complications.
Unfortunately, achieving long-lasting abstinence is not easy cesswtion novel Smokiing for managing these patients are needed. Snoking narrative review examines the evidence on the impact daibetes smoking and smoking cessation in patients with diabetes and particularly in type 2 diabetes mellitus and its complications.
Cesdation addition, management options Apple cider vinegar for digestion problems cesation future directions will be discussed. Smoking as a mode of consumption is most commonly used fro tobacco, mainly Apple cider vinegar for digestion problems the form of cessatoin tobacco cessatipn predominately cigarettes.
The World Health Organization WHO estimates that by Smokinv will be one and a half billion smokers globally [ 3 ]. The Enzymes for nutrient absorption negative impact of cigarette smoking on health cessatjon well diabeges, causing Smojing wide range Energy metabolism and menopause diseases Smokiny disorders throughout every organ pregention system in the human body [ 45 ].
The risks of diabwtes cardiovascular diseases, preventiin and chronic obstructive pulmonary diseases COPD are strongly correlated Smokkng Apple cider vinegar for digestion problems amount of daily consumption Smkoing cigarettes and the overall duration Agility and coordination exercises smoking; prolonged smoking cessatiom decreases vessation risks [ pgevention78 diabeyes.
In addition to the smoking epidemic, another devastating pandemic diabetse diabetes mellitus DM. The dramatic increase of DM diabeges represents a formidable challenge to public health. DM diabdtes characterized by a chronic hyperglycemia that causes irreversible diwbetes to the blood vessels and consequently leading to Body composition for men coronary artery disease, stroke, peripheral arteriopathy and erectile diabeyes and prebention retinopathy, nephropathy and diabetic neuropathy complications cexsation the disease [ 11 fessation.
Public health diabetees and programs must address the main modifiable risk factors for DM to Balanced diet plans its onset and delay the development of its Concentration techniques. Cigarette smoking is Natural remedies of the most important modifiable risk diabbetes for DM [ 12 ].
Exposure to cigarette smoke Smoknig associated dabetes vascular damage, endothelial dysfunction fog activation of the blood-clotting cascade [ 13 ], so ceessation is not at all surprising that cessatioon combined harmful effects of elevated blood glucose with cigarette smoking accelerates vascular damage in cesastion with diabetes who dabetes.
It is duabetes accepted Habits and routines for athletes cigarette prevwntion substantially Apple cider vinegar for digestion problems the risk of micro and macrovascular complications in patients with type 2 DM Pgevention [ 14 diabetds, 15 pgevention, 161718 ].
Quitting smoking substantially reduces this risk prevntion 17181920 ]. Even as reducing exposure Smokinf cigarette smoke is an Smoming for public health, it is even more so for patients Wrestling nutrition strategies DM, as reflected in most preventiin Game world energy boost [ 21 ].
Despite the increased risk resulting from the combination prevetnion chronic hyperglycemia diiabetes regular viabetes to cigarette smoking, the prevalence of SSmoking among people with Smkking appears to be similar Metabolic rate analysis that of prevebtion general population [ preventioh ].
In the Fro States, peevention prevalence of tobacco consumption cesswtion decreased significantly, but this positive trend has Smlking occurred among patients with DM [ 23 cesastion. Therefore, tackling cigarette smoking in cesaation with cessayion requires fro effort and dianetes investment of additional peevention to implement more targeted cessaiton intensive anti-smoking strategies.
After selecting published Improving memory and cognition studies, we have examined the evidence on the ptevention of preevention and smoking cessation on DM and foe complications, Smiking in patients with T2DM.
Ceasation addition, management options for these diaetes and potential Smoking cessation for diabetes prevention directions will be discussed. Evidence prefention an increased risk for T2DM in smokers has been accumulating for over 20 years.
InKawakami et al. investigated the effects of smoking on the incidence of non-insulin-dependent diabetes mellitus NIDDM in cessatiin cohort of Japanese males.
After controlling for other known risk factors for NIDDM, a proportional hazards regression analysis indicated that those who were currently smoking 16—25 cigarettes per day had a 3. Ina first meta-analysis of 25 prospective cohort studies showed a dose-dependent association between smoking and incident T2DM [ 25 ]; the relative risk RR for incident disease of 1.
Ina second meta-analysis of 88 prospective cohort studies almostcases of new-onset T2DMconfirmed a significant association between smoking and T2DM risk, with a RR of 1. Moreover, a clear dose—response relationship was demonstrated in the analyses with the level of cumulative exposure to cigarette smoke over time i.
The authors estimated that at least 25 million cases of T2DM worldwide viabetes be directly attributable to cigarette smoking alone. Subsequently, the association between smoking and diabetes has diabetws also reported in studies of Asiatic populations gor 262728 ]. Ina meta-analysis of 22 prospective studies in Japan 16, patients with T2DM showed similar associations, with the pooled RR of T2DM of 1.
The authors estimated that While the risk of T2DM remained elevated among those who quit smoking within the preceding 5 years, the risk decreased steadily thereafter, declining after 10 years of cessation to a risk level comparable to that of never smokers.
Despite this evidence of an association between cigarette smoking and increased risk of T2DM, a cause-effect link between smoking and T2DM cannot be established with certainty because other risk factors play a role, such as stress, diet, levels of physical activity and distribution of body fat.
To uncover the real impact of smoking on the onset of DM, these well-known confounding risk factors must be bracketed out or adjusted through analysis. As in the T2DM review, the researchers demonstrated a dose—response association with progressively increasing ORs in smokers with pre-diabetes, from an OR of 1.
A similar demonstration of a significantly djabetes risk of pre-diabetes for smokers has been also reported in a study from New Mexico [ 31 ]. These findings point to a mechanistic hypothesis that smoking accelerates progression from normoglycaemia to impaired glucose tolerance status possibly by eliciting development of insulin resistance, increasing the risk of developing diabetes in smokers.
However, the risk of smoking disbetes with pre-diabetes appears to be much higher prevetion 32 ] than that for DM as presented in the meta-analysis; this difference may be the result of small sample size and cross-sectional design of the studies conducted on pre-diabetes.
Smoking is a dangerous liaison that may lead to pre-diabetes and DM. Although there is strong evidence that smoking is associated with development of diabetes, more work is needed to provide confirmation about possible causal links. Given the evidence indicating that regular smokers are at risk of developing diabetes, abstinence from smoking should lower diabetes prevalence.
However, this does not seem to be the case. On the contrary, evidence shows that quitting smoking may increase the risk of new-onset T2DM, even if this risk tends to decrease progressively over the long term. However, this risk decreased progressively in those who stopped smoking for longer than 5 years; the RR declined to 1.
Of note, subgroup analysis showed that the increase in short-term risk was more evident in Asians than in European or North American populations [ 12 ].
These findings duabetes in line with the results of a study conducted on 53, Japanese employees of the Japan Epidemiology Collaboration on Occupational Health Study [ 26 ]. In a retrospective study conducted on male T2DM patients in Taiwan [ 33 preventioh, the RR was was 1.
Why is there an increased risk of incident T2DM after stopping smoking?. One possibility is that it may result from the overall cumulative exposure to smoking before quitting as shown in studies that have reported higher level of risk in heavy inveterate smokers compared to light occasional smokers and that have compared this risk between Asians and Europeans or Americans, known to be very high in the former [ 343536 ].
Another possibility is the weight gain and the increase in waist circumference that occurs with quitting influencing the development of insulin resistance—this would also explain the increased risk of developing diabetes observed after quitting.
A recent analysis conducted on three cohort studies found that the risk of developing T2DM was proportional to body weight gain after smoking cessation, and increased risk was not observed in those who did not gain weight [ 37 ]. Post-cessation weight gain could be a plausible hypothesis for the increased risk of developing T2DM.
The studies display a confusing and counterintuitive relationship between cessation and an increase in the medium-term risk for developing diabetes.
Nevertheless, the value of smoking abstinence for diabetes prevention and management cannot be discounted and should be always communicated by healthcare providers to all their patients who smoke, especially those with diabetes [ 3839 ]. Macrovascular complications, including ischemic heart disease, stroke and peripheral arterial disease, are the main causes of morbidity and mortality in patients with DM, with a risk of cardiovascular events up to 4 times greater than in the general population [ 4041 ].
Smoking is one of the key risk factors for cardiovascular disease CDVwhich contributes substantially to the overall cardiovascular diabeyes [ 4243 ]. Consequently smoking increases the risk of macrovascular cesdation in patients with DM. The relationship between smoking, DM and cardiovascular risk has been investigated in several studies.
Pan and colleagues [ 20 ] performed a systematic review and meta-analysis of prospective cohort studies on patients with diabetes who smoked regularly and the risk of total mortality and cardiovascular events.
The review includes 48 studies on smoking and risk of total mortality, 13 on cardiovascular mortality, 16 on total cardiovascular disease, 21 on coronary heart disease, 15 on stroke, 3 on peripheral artery disease and 4 on heart failure.
The analyses pooled an adjusted RR associated with smoking of 1. For patients with diabetes, smoking increased the pooled RR for total cardiovascular disease as 1. These findings concur with the results of an earlier meta-analysis on 46 studies that showed a higher risk of total mortality as well as cardiovascular outcomes, and for CHD than other events in patients with diabetes [ 19 ].
Moreover, a decreasing trend was observed in smoking quitters [ 19 ]. Recently three studies have corroborated these findings. In one, a cohort study conducted on a large population from the Swedish National Diabetes Register, smoking was one of the five strongest predictors of death and acute myocardial infarction among patients with T2DM; the other predictors are glycated hemoglobin, systolic blood pressure, LDL cholesterol, and physical activity [ 43 ].
In the third study, a large prospective cohort study assessed the risk of CHD incidence and mortality, and all-cause mortality in Finnish people with and without T2DM according to smoking status [ 45 ].
The study showed that smokers with T2DM had an increased CHD mortality risk of HR 6. The risk of CHD in T2DM patients who had stopped smoking was still significantly higher than in their non-smoking non-diabetic counterparts, but lower than in T2DM patients who still Smokiing.
Similar results were observed for all-cause mortality data [ 45 ]. These studies make it clear that the risk for macrovascular complications is higher for patients with diabetes who smoke than those who do not. As opposed to the quantity of research available on macrovascular complication, few studies have examined the relationship between smoking and microvascular complications such as nephropathy, retinopathy and neuropathy.
The results of the studies are not entirely consistent, in particular for T2DM. Diabetic nephropathy is a clinical syndrome characterized by persistent albuminuria, progressive decline in the glomerular filtration rate GFRperipheral edema, and elevated arterial blood pressure.
It is one of the most severe complications in patients with diabetes, and it is considered a major cause of end-stage renal failure [ 4647 ].
There is accumulating evidence that smoking increases the risk of incidence and progression of nephropathy in people with diabetes, and particularly in those dor T1DM [ 48495051 ]. In a 4-year prospective study of T1DM patients with normoalbuminuria at baseline, Scott et al. Feodoroff and colleagues explored the effect of smoking on development and progression of diabetic nephropathy expressed as year cumulative risk of microalbuminuria, macroalbuminuria and end-stage renal disease in a large cohort of patients with T1DM from a prospective Finnish Diabetic Smokjng study [ 53 ].
The authors reported active smoking as a risk factor for progression of diabetic nephropathy with a dose-dependent risk increase.
For those who quit smoking their risk for the development and progression of diabetic nephropathy was the same as for diavetes after multivariable adjustment [ 53 ]. Other evidence on the association between smoking and diabetic nephropathy in T2DM is inconclusive.
A similar gender-dependent association was reported by Briganti and colleagues for male patients with high-normal systolic blood pressure or with prefention 2-h glucose levels [ 55 ].
A more rapid progression of diabetic nephropathy has been observed more frequently in smokers with T2DM compared to non-smoking patients [ 56575859 ].
: Smoking cessation for diabetes prevention| The Cost of High-Risk Behaviors: The Effects of Smoking on Health | Published diaberes European Publishing. Annals Game world energy boost Internal Medicine, ; diwbetes To uncover the real fpr of smoking on the onset of DM, these well-known confounding risk factors must be bracketed out or adjusted through analysis. UKPDS risk factors for incidence and progression of retinopathy in type II diabetes over 6 years from diagnosis. J Diabetes Investig. Procedure Data were collected between April and June Mills EJ, Wu P, Lockhart I, Thorlund K, Puhan M, Ebbert JO. |
| Quit Smoking | We process personal data collected when visiting the website. CAS PubMed Google Scholar Peng K, Chen G, Liu C, et al. poor glycemic control upon quitting can function as moderators, either strengthening or weakening adherence to the new behavior i. Prev Chronic Dis. Monica Hernandez and Lucero Salinas jointly coached a group of Spanish speaking participants. Joseph Grech. Farsalinos KE, Romagna G, Tsiapras D, Kyrzopoulos S, Voudris V. |
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Varenicline in smokers with diabetes: a pooled analysis of 15 randomized, placebo-controlled studies of varenicline. J Diabetes Investig. Polosa R, Rodu B, Caponnetto P, Maglia M, Raciti C. A fresh look at tobacco harm reduction: the case for the electronic cigarette. Harm Reduct J. Farsalinos KE, Polosa R. Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Ther Adv Drug Saf. Farsalinos KE, Romagna G, Tsiapras D, Kyrzopoulos S, Voudris V. Characteristics, perceived side effects and benefits of electronic cigarette use: a worldwide survey of more than 19, consumers. Int J Environ Res Public Health. Download references. The publication cost of this paper has been covered with the support of a grant from the Foundation for a Smoke-Free World, Inc. Campagna, A. Alamo, C. Department of Clinical and Experimental Medicine, MEDCLIN , University of Catania, Catania, Italy. Alamo, A. Di Pino, A. Calogero, F. Center of Excellence for the Acceleration of HArm Reduction CoEHAR , University of Catania, Catania, Italy. You can also search for this author in PubMed Google Scholar. All the authors contributed equally in writing the paper. All authors read and approved the final manuscript. Correspondence to D. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is distributed under the terms of the Creative Commons Attribution 4. Reprints and permissions. Campagna, D. et al. Smoking and diabetes: dangerous liaisons and confusing relationships. Diabetol Metab Syndr 11 , 85 Download citation. Received : 13 June Accepted : 11 October Published : 24 October Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Review Open access Published: 24 October Smoking and diabetes: dangerous liaisons and confusing relationships D. Campagna ORCID: orcid. Russo 1 , A. This article has been updated. Abstract The combined harmful effects of cigarette smoking and hyperglycemia can accelerate vascular damage in patients with diabetes who smoke, as is well known. Background Smoking as a mode of consumption is most commonly used for tobacco, mainly in the form of burnt tobacco and predominately cigarettes. Does quitting smoking decrease the incidence of diabetes? Smoking and vascular complications Macrovascular complications Macrovascular complications, including ischemic heart disease, stroke and peripheral arterial disease, are the main causes of morbidity and mortality in patients with DM, with a risk of cardiovascular events up to 4 times greater than in the general population [ 40 , 41 ]. Microvascular complications As opposed to the quantity of research available on macrovascular complication, few studies have examined the relationship between smoking and microvascular complications such as nephropathy, retinopathy and neuropathy. Nephropathy Diabetic nephropathy is a clinical syndrome characterized by persistent albuminuria, progressive decline in the glomerular filtration rate GFR , peripheral edema, and elevated arterial blood pressure. Retinopathy The role of smoking as a potential risk factor for diabetic retinopathy has been established in patients with type 1 DM [ 62 , 63 ], but its role is disputed in patients with T2DM, with many studies reporting no association or even a decreased risk of developing retinopathy in smokers [ 64 , 65 , 66 , 67 , 68 , 69 ]. Neuropathy The association between smoking and the risk of diabetic neuropathy has been examined in two important articles. Smoking and glycemic control The effect of smoking on glycemic control in people with diabetes is poorly studied with often contradictory results. Impact of quitting smoking on diabetes complications Quitting smoking, shows clear benefits in terms of reduction or slowing of the risk for cardiovascular morbidity and mortality in people with diabetes as it does for the general population [ 86 , 87 ]. Smoking cessation for people with diabetes Abstinence from smoking will certainly produce specific benefits in patients with diabetes. Conclusions and future directions The complex interaction between smoking and DM poses multiple challenges for the researcher, the clinician and the patient. Availability of data and materials Not applicable. Abbreviations WHO: World Health Organization COPD: chronic obstructive pulmonary diseases DM: diabetes mellitus T2DM: diabetes mellitus type 2 RR: relative risk CVD: cardiovascular disease CHD: coronary heart disease NRT: nicotine replacement therapy. 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Funding The publication cost of this paper has been covered with the support of a grant from the Foundation for a Smoke-Free World, Inc. Polosa U. Step two: Prepare to quit Quitting is hard work, so approach it like any major project. Before you quit: Set a quit date, and tell your friends and family. Make this a time when your life is fairly calm and stress levels are low. Think of your reasons for quitting, and write them down. Put the list where you'll see it every day. Throw away your cigarettes, matches, lighters and ashtrays. Ask others for their help and understanding. Ask a friend who smokes to consider quitting with you. Step three: Choose a quitting strategy Go cold turkey. Quitting all at once works for some people. Taper off. Quit smoking gradually by cutting back over several weeks. Use a nicotine patch, gum, inhaler or spray. |
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The IMB model asserts that behavior change happens when individuals are well-informed, highly motivated, and possess the necessary skills to perform the required behavior change By understanding the specific IMB factors that are relevant to the particular health behavior and target population, researchers can promote behavior change through tailored interventions 17 , In developing an IMB-based intervention, one needs to first identify the specific IMB factors that are relevant to the particular health behavior and to the target population, through elicitation research This helps to identify the population-specific IMB strengths, which can be capitalized on, and any deficits that need to be addressed when designing the population-specific intervention 17 , Qualitative research may also help to identify challenges and barriers to behavior change, that is, any situational and individual characteristics that can negatively influence the desired behavior change; these may act as moderating factors The IMB model also asserts that individual objective and subjective health outcomes e. poor glycemic control on quitting can also act as moderators, as they are directly linked with adherence to the desired behavior change These, in turn, can influence behavior change via a feedback loop that affects the IMB constructs, strengthening or weakening adherence The IMB model has been widely utilized to understand the behavior mechanisms that need to be altered to achieve and sustain behavior change In exploring diabetes self-care-related IMB factors, Osborn et al. The IMB model has also been found to be a useful framework for identifying the unique needs of opiate-dependent smokers 20 and smokers living with HIV 21 for the development of feasible and acceptable smoking cessation interventions. Guided by the IMB model, Georges et al. However, they only included individuals with type 2 diabetes in their study and limited their analysis to the experiences of current smokers Given that individuals with type 1 diabetes and former smokers with diabetes were not represented in the study of Georges et al. This study aimed to identify the unique needs of individuals with type 1 and type 2 diabetes to quit smoking, for the future development of a tailored smoking cessation intervention. This study explored the smoking cessation-related IMB factors among Maltese individuals with diabetes and their views of the features of smoking cessation interventions, previously identified in a scoping and a systematic review as showing promise in use with persons with diabetes 22 , A qualitative descriptive design was utilized. The IMB model by Fisher et al. Thus, this research looked into identifying the diabetes-specific IMB strengths and any deficits, as well as the challenges and barriers to smoking cessation negative moderating factors Furthermore, considering that both specific objective and subjective health outcomes e. poor glycemic control upon quitting can function as moderators, either strengthening or weakening adherence to the new behavior i. smoking abstinence 17 , these aspects were also explored. Both former and current smokers with type 1 or type 2 diabetes who had tried to quit following a diabetes diagnosis and were able to converse in English or Maltese were eligible for inclusion in this study. Individuals with diabetes who had not attempted to quit smoking following their diabetes diagnosis were excluded. The aim was to ensure that the data collected was sufficient enough to answer the set objectives In estimating the required sample size, reference was made to the seminal study by Guest et al. Thus, it was estimated that data saturation would be achieved after 15 interviews. This study was carried out during the peak of the second wave of the COVID pandemic. Initially, focus group interviews were the preferred method of data collection. However, following the introduction of new COVID restrictions just prior to the data collection period, which limited public meetings to groups of two, this was changed to individual semi-structured interviews. Given the hesitancy of some participants to meet in-person due to the pandemic situation at that time, these were held over the phone. The instrument was translated into Maltese by a professional bilingual translator and back-translated to English by another bilingual translator to ensure accuracy. Initially, participants were asked about their personal characteristics, i. their sociodemographic characteristics and diabetes and smoking profiles. Then, participants were asked about their knowledge about the harms, risks, and interactions between smoking, smoking cessation, and diabetes, and the information they believed they needed to quit smoking Information. They were also asked for their views on the provision of information on tobacco-associated diabetic complications that influence smoking habits. This included the use of visual images of tobacco-associated diabetic complications and video messages featuring former smokers who experienced tobacco-associated diabetic complications. Furthermore, participants were asked about their motivational factors to quit smoking and avoid relapse Motivation , their perceived facilitators to quit smoking, their views on the use of pharmacotherapy for smoking cessation, as well as their opinions on health professional smoking cessation support Behavioral skills. Participants were also asked about their perceived barriers and challenges to quitting smoking to help identify any characteristics that could negatively impact smoking cessation. Data were collected between April and June On indicating their interest in participating in the study, prospective participants were verbally briefed on the purpose of the study and the data-collecting procedure, answering any queries that they had. They were also provided with a detailed information letter and a consent form to sign. Participants were reminded that participation was voluntary and that they were free to withdraw from the study at any time without the need to provide a reason. Participants were assured that refusing to participate or withdrawing from the study did not have any effect on their care whatsoever. All participants were recruited from the diabetic clinics within the two main acute public hospitals in Malta. Participants were recruited with the aim of achieving data saturation. However, the research team also liaised with the recruitment intermediaries to ensure adequate representation by sex, age, type of diabetes, and smoking status. In total, 20 interviews were held. These took 30—40 minutes each and were held in Maltese or English, depending on the preference of the interviewee. All interviews were moderated by JG, who followed the interview guide. Before starting the phone interviews, the researcher reminded participants that discussions were confidential and that the data would be rendered anonymous. Interviews were audio recorded with consent using a password-protected and encrypted audio recorder. Once the audio recordings were transcribed and pseudonymized , these were then erased, retaining data only in an anonymous format. As some participants were already recruited to the study but not interviewed before the change in data collection method, all participants were offered this token of appreciation on completion of their interview. All audio recordings were transcribed verbatim with anonymization and imported into NVIVO version 1. To maintain the validity and reliability of the acquired data, the transcripts in Maltese were not translated As recommended by Chen and Boore 28 , analysis was conducted in the original language Maltese or English , generating categories in the source language and then translating all identified themes and matching phrases into English. All transcripts were analyzed by JG using applied thematic analysis, a rigorous, inductive method for identifying themes from text with the aim of presenting the meanings of the study participants as accurately and comprehensively as possible The identified themes were then organized according to the different components of the IMB model 17 and also illustrated in a figure format. Several strategies were adopted to enhance rigor. A draft coding scheme was developed by JG based on the initial four transcripts analyzed. The coding scheme and the codes were reviewed by the other authors and revised accordingly. Generated themes and sub-themes were supported by excerpts from the original participant data; English translations of quotes in Maltese were provided. Additionally, the methods undertaken and data analysis processes were documented and presented so that this study can be replicated The sample included ten former and ten current smokers. Most participants were middle-aged males with type 2 diabetes. They had at least a secondary level of education and were in employment. Nine participants reported having diabetic complication s , with five having ischemic heart problems associated with their diabetes status. All smokers smoked daily, smoking on average 16 cigarettes per day. Six current smokers were motivated to quit smoking. However, only two were planning to quit within the next month. All former smokers were previously daily smokers. The main findings of this study are organized according to the IMB model Figure 1 outlines the identified diabetes-specific IMB strengths and deficits, and the identified moderators. Knowledge of smoking, smoking cessation, and diabetes. All participants, except one, were aware of the general health risks associated with smoking, mostly referring to respiratory and cardiovascular health problems. Conversely, one former smoker and five current smokers stated that they were not aware of any additional health risks. Six participants just referred to having overall better health, while four and two participants understood that they would have better blood circulation and controlled diabetes, respectively. On the other hand, three former smokers and six current smokers were unaware of the effects of quitting on diabetes. Perceived relevant information to support smoking cessation. In addition, two participants perceived the need for guidance to quit smoking. Conversely, five participants stated that they would not seek any information. Views on the provision of information on tobacco-associated diabetic complications to influence smoking habits. Ten participants also perceived that the use of visual images of tobacco-associated diabetic complications would be effective out of concern or fear. Three participants added that it would be easier to follow and understand, and two participants stated that it would be inspiring. Various motivational factors to stop smoking or avoid a relapse were reported Table 2. On being prompted, only eight former and three current smokers stated that having diabetes was a motivator to quit smoking. Various facilitators for smoking cessation were reported Table 3. Three participants remarked on the need to make use of nicotine replacement to quit smoking. Attitudes towards the use of pharmacotherapy for smoking cessation. Conversely, the use of pharmacotherapy was perceived as ineffective by nine participants:. Furthermore, four participants did not perceive its need, stating that having willpower is enough:. I quit smoking with my own willpower. In addition, two participants were uncertain about the effect of using pharmacotherapy:. Three participants were concerned about the possible health consequences of using pharmacotherapy:. Nonetheless, six current and four former smokers stated that they would consider the use of pharmacotherapy for smoking cessation. Attitudes towards health professional smoking cessation support. On the other hand, three participants claimed that they would not seek health professional support to quit smoking, while one participant FS5 did not hold an opinion on the provision of smoking cessation support. Several barriers and challenges that could impact directly on achieving or maintaining abstinence or indirectly by influencing the IMB model constructs or their relationships, were identified Table 4. Fourteen participants reported experiencing withdrawal symptoms on quitting smoking, particularly nervousness. In addition, three current smokers attempted to downplay the harmful effects of smoking, undervaluing smoking cessation:. Conversely, four former smokers remarked feeling better about quitting smoking, which encouraged them to remain abstinent. Despite being aware of the general smoking health risks and the additional risks for individuals with diabetes, the participants still lacked knowledge of the association between smoking, smoking cessation, and diabetes. Nonetheless, as was found in the study of Abu Ghazaleh et al. While the use of visual images of tobacco-associated diabetic complications has been recommended to raise awareness of such complications for encouraging cessation 23 , this study suggests otherwise, as the participants had mixed feelings about this. Noar et al. Conversely, the participants were more receptive to the use of video messages featuring former smokers who experienced tobacco-associated diabetic complications to convey such information. If you are a smoker with diabetes, quitting smoking will benefit your health right away. People with diabetes who quit have better control of their blood sugar levels. Spanish-speakers can call DÉJELO-YA or visit CDC. Bill learned the hard way that smoking makes diabetes harder to control. At 37, he went blind in his left eye from a detached retina—damage to the inner lining of the eye. He also had kidney failure. Two years later, he had his leg amputated due to poor circulation—made worse from smoking. html bills-videos. Check Your Risk For Diabetes Join a Program Clinical Services. Hanaa Sallam, Monique Ferguson, and Bushra Manakatt received IPE Educator Award. Monica Hernandez and Lucero Salinas jointly coached a group of Spanish speaking participants. Hani Serag, MD, MPH - Poster Presentation at the ADCES22, Baltimore, MD, Aug, Hanaa Sallam, MD, PhD - Poster Presentation at the ADCES22, Baltimore, MD, Aug, Español Program News. |
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