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Prevalence and Associated Factors of Cigarette Smoking among Type 2 Diabetes Patients in Pakistan

Background: Pakistan ranks six in top ten countries with highest number of diabetics. Contributing factors are age, positive family history and obesity. Factors, such as smoking, increase the risk of cardiovascular events among diabetic patients. The study was planned to document the prevalence and associated factors of cigarette smoking among type-2 diabetes mellitus patients being seen at tertiary care hospitals in Rawalpindi Pakistan.

Methodology: A both qualitative and quantitative, cross sectional study was conducted, in order to determine the prevalence and associated factors of cigarette smoking among type 2 diabetics. Our study population was type 2 diabetic patients of 25 or more years of age. For qualitative part, we conducted two Focus Group Discussions (FGDs) with 6-8 participants, followed by semi-structured questionnaire as the qualitative part of the study.

Results: Prevalence of cigarette smoking among type 2 diabetes mellitus patients was 27%. There was significant association of male sex (p=0.00), number cigarettes smoked in a day (p=0.000, CI=1.92-2.135), duration of disease (p=0.000, CI=1.500-1.685), duration of cigarette smoking (p=0.000, CI=1.500-1.685), and at least one episode of Cardio Vascular Disease (CVD) (p=0.026). Smoking was initiated at early age and mainly influenced by peers and elderly in the family. Patients, who had diabetes for less than 20 years, were 1.41 times more likely to be smokers than the one who were diabetics for more than 20 years.

Study Limitation: The study has limitation of being a small cross-sectional study, the results of which cannot be generalized. However, it provides basis for larger studies on the subject in Pakistan.

Conclusion: The study concluded that smoking is prevalent among type 2 diabetic male patients and is associated with the initiation of smoking at younger age and the duration of the disease.

Author(s): Naila Khalid, Ejaz Ahmad Khan , Shifa Saleem , Adeel Tahir , Hassan Mahmood , Sarah Saleem

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