Niaz Ahmed Shaikh, Shaheen Bhatty, Akhter Ali Baloch, Aneel Sham Vaswani, Aneel Kumar Sumbhuani, Syeda Sakina Alya Fatima.
Prevalence and pattern of tobacco use in diabetic patients at Civil Hospital Karachi.
Pak J Chest Med Jan ;14(4):15-20.

Tobacco use, a leading preventable cause of mortality throughout the world is still very prevalent in developing countries. Tobacco use in diabetic patients is associated with further increase of mortality and morbidity due to its effects on metabolic control as well as increase in the development of macrovascualr and microvascular complications. Objective: To determine the prevalence and pattern of tobacco use in diabetic patients. Study Design and Methods: A cross sectional study of patients visiting Medical and Diabetic clinics of Civil Hospital Karachi. Four hundred twenty five diabetic patients of either sex were interviewed according to the questionnaire which was developed considering the objectives of the study.The data was recorded and analyzed with SPSS 15. Results: Two hundred eighteen patients were females (52.2%) and two hundred seven (47.8%) were males. Mean age of study population was 50.9 ± 11.2 years with a range from 14 to 85 years. Two hundred seven patients (48.7%) were currently using tobacco (P <0.005) in various forms which was more common in males (P <0.005). Smoking (29.9%) was the most common form of tobacco use followed by Chewing of Pan (26%) and Niswar (18.8%). Hypertension (P value <0.027) and ischemic heart disease (P value <0.001) was more common in tobacco users, majority of whom required insulin therapy. One hundred thirty three patients (64.2%) of the current tobacco users had attempted quitting (only 33.8% of them at the advice of doctors) but failed. Eighty nine patients had quitted tobacco use successfully. Conclusion: Tobacco use in various forms is alarmingly and very common in diabetic patients. Tobacco cessation is difficult in diabetic patients. An intensive, structured and integrated approach for tobacco cessation is warranted to reduce the morbidity and mortality in diabetic smokers.

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