The 13th World Conference on Tobacco OR Health

Objective: Smoking complicates the management of Type 2 diabetes, is positively related to complications, and may cause diabetes. In non-AI/AN (American Indian/Alaska Native) groups, current smoking prevalence is similar for those with or without diabetes (25%). We describe here AI/AN current smoking prevalence by diabetes status and in those whose glucose was not well-controlled.

Methods: Over 250 clinical variables were extracted from RPMS data (1998 to 2003) at eight Indian Health Service (IHS) sites (total=5,257,086 visits). After consolidation into unique patient records the final sample was 179,485 patients over age 14 with both diabetes and current smoking information.

Results: Cross-sectional results indicated diabetics were significantly more likely to be current smokers (24.4%) than non-diabetics (10.1%) (p < 0.001). Current smoking rates were two to three times higher among diabetics for each age category (p < 0.001). A higher proportion of diabetics who currently smoked had HbA1c values equal to or greater than 8.0%, 46% versus 42.7% of non-smokers (p < 0.05). At seven sites, those with HbA1c values equal to or greater than 8.0% were more likely to be current smokers (p < 0.05 in New Mexico, North Carolina, Oklahoma, and Minnesota). These results partially reflect non-standardized clinical practices in eight IHS Service Units. Nevertheless, they indicate high rates of smoking among diabetics and those with high HbA1c levels. It is clear these results argue for an examination of the effect of this modifiable risk factor on the prevention and management of diabetes in AI/AN populations.