Current smoking and type 2 diabetes among patients in selected Indian health service clinics, 1998-2003

Objectives. In non-American Indian/Alaska Native groups, current smoking prevalence is similar for those with or without diabetes (26%) We analyzed current smoking prevalence in American Indian/Alaska Natives by diabetes status. Methods. Data were extracted from Indian Health Service clinic visit information from 1998 to 2003. After consolidation into unique patient records, the sample comprised 71221 patients aged 14 years or older with both diabetes and current smoking information. Results. Cross-sectional results indicated that diabetic American Indian/Alaska Natives were significantly more likely than those without diabetes to be current smokers (29.8% vs 18.8%; P < .01). Smoking rates were 2 to 3 times higher among diabetic American Indians and Alaska Natives for each age category (P < .001), and current smokers with diabetes were more likely than nonsmokers to have glycosylated hemoglobin A 1c levels at 8.0% or higher (P < .05). Conclusions. American Indian/Alaska Natives with diabetes at all sites and age categories were found to smoke at significantly higher rates than those without diabetes. Smoking cessation programs should target diabetic patients to more effectively prevent complications and promote successful management of diabetes in American Indians/Alaska Natives.