SAN ANTONIO, Texas - It takes a lot to quit smoking. But a new study finds that even diehard puffers can kick the habit when faced with the life-changing news that they have diabetes, and the realization that, because of the disease, every cigarette they smoke puts them at increased risk for major health problems.
That's the finding of a new University of Michigan study that looked back at the smoking habits, diabetes status, and other health and socioeconomic characteristics of more than 1,600 middle-aged men and women whose health was monitored between 1992 and 1996 as part of a larger study. The results will be presented Sunday evening, June 12 during the prestigious Presidents' Poster Session at the American Diabetes Association's annual meeting in San Antonio.
Though only a small percentage of the smokers were diagnosed with diabetes during that period, those that did learn they had the disease between 1992 and 1994 were more than twice as likely to quit smoking by 1996 as the others. But not all of them did quit, despite the fact that smoking is known to worsen the already severe effects of diabetes and lead to increased rates of heart attacks, amputations, blindness, kidney failure, cancer and early death.
The finding supports the results of another recent study by the same researchers, which showed that another kind of life-threatening health event - a heart attack -also was enough to prompt many middle-aged smokers to quit.
"It seems that a big medical shock is what it takes to scare some Americans out of their tobacco habits, and some keep smoking despite the increased risk that the combination of their disease and smoking poses," says Linda Wray, Ph.D., U-M assistant professor of medical education. "We need to educate patients better about how smoking can worsen other health problems."
Wray's study looked for patterns among the smokers' ethnicity, education, financial worth and habits that might affect their likelihood to be diagnosed with diabetes, to stop smoking, and to have both occur. It confirmed past findings that being African American or obese put smokers at greater risk of diabetes, and that more educated people were more likely to quit. But the picture is more complicated, suggesting complex relationships among socioeconomic status, health habits affected by that status, and smoking and diabetes.
Those with the heaviest smoking habits had a lower tendency to stop smoking, even after diabetes diagnosis, while diabetics who were also obese were slightly more inclined to quit. This latter group, Wray says, may have let their weight rise to unhealthy levels but chose to move away from another unhealthy habit when faced with the threat of diabetes complications. "They seem to be picking the behavior that gives them the most bang for the buck," she explains.
Wray's study used data from the Health and Retirement Study, an ongoing nationally representative study of health and economic behavior that is being conducted by the Survey Research Center of the U-M's Institute for Social Research. The study tracks middle-aged adults representing all segments of society and documented their health status, socioeconomic characteristics and lifestyle habits.
Wray and her colleagues examined data from a diverse group of middle-aged adults in the 1992-1994 period and then looked at those same subjects' data from 1996. Those who had smoked in the earlier period and were not smoking in 1996 were defined as having stopped smoking.