Bringing smoking cessation to diabetes clinics in Indonesia

Objectives: To assess the feasibility of delivering brief and disease-centred smoking cessation interventions to patients with diabetes mellitus in clinical settings. Methods: We conducted a feasibility study involving two interactive smoking cessation interventions: doctor's advice and visual representation of how tobacco affects diabetes (DA) and DA plus direct referral to a cessation clinic (CC). Follow-up was at 3 and 6 months post intervention. Primary outcome was 7-day-point prevalence abstinence. The study involved male patients recruited from two referral diabetes clinics in Yogyakarta Province, Indonesia during January 2008 to May 2009. Of the 71 patients who smoked during the last month, 33 were randomized to the DA group and 38 to the CC group. Results: At 6 months follow-up, DA and CC groups had abstinence rates of 30% and 37%, respectively. Of those continuing to smoke, most reported an attempt to quit or reduce smoking (70% in DA and 88% in CC groups). Patients in both groups had increased understanding of smoking-related harm and increased motivation to quit smoking. Conclusions: This study demonstrates the feasibility of disease-centred doctors messages about smoking cessation for patients with diabetes, supported by the presence of a CC motivating clinicians to routinely give patients cessation messages.