Smoking Too Common Among Young Diabetes Patients

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Young People With Diabetes Not Consistently Counseled by Doctors to Stop Smoking, Study Finds

By Katrina Woznicki
WebMD Health News

Reviewed by Laura J. Martin, MD

Dec. 3, 2010 -- Smoking rates are high among young people with diabetes, and many teens and young adults with the condition report never being asked about their smoking habits or advised by their doctors to stop, according to a new federally supported study.

Diabetes and smoking are both risk factors for cardiovascular disease. The national study looked at the presence of risk factors for cardiovascular disease among young people who had either type 1 or type 2 diabetes and whether they smoked.

Smoking Habits Start Early

Researchers led by Kristi Reynolds, PhD, MPH, an investigator from Kaiser Permanente, found that teenagers who had type 1 diabetes and smoked were more likely to be physically inactive and have higher triglycerides for cardiovascular disease, both risk factors for cardiovascular disease. Among their other findings:

• Tobacco use increased with age. Among the study group with type 1 diabetes, smoking prevalence was 2.7% among those aged 10 to 14; 17.1% among those aged 15 to 19; and 34% of those aged 20 and older.
• Tobacco use also steadily increased with age among those with type 2 diabetes and prevalence was 5.5% among those aged 10 to 14; 16.4% among those aged 15 to 19; and 40.3% among those aged 20 and older.
• Ten percent of youths with type 1 diabetes and 15.7% of those with type 2 diabetes were using some form of tobacco at the time of the study.
• Among the group with type 1 diabetes, 30.4% of 10- to 14-year-olds, 68.3% of 15- to 19-year-olds, and 84.7% of young adults 20 and older reported being asked by their health care provider whether they smoked or used tobacco products.
• Among the group with type 2 diabetes, 47.2% of 10- to 14-year-olds, 51.8% of 15- to 19-year-olds, and 57.4% of young adults 20 and older reported being asked about tobacco use.
• Overall, smoking among young diabetes patients was more common among those living in households with family annual incomes of $50,000 or less.
• Smoking was more common among Native Americans and least common among Asian-Pacific Islanders.
• Past and current smokers who had type 1 diabetes had significantly poorer cardiometabolic profiles -- such as higher triglycerides and blood pressure -- than diabetes patients who were nonsmokers.

The results are published in the December issue of Journal of Pediatrics, and are based on 3,466 children and young adults aged 10 to 22 who had diabetes who participated in the SEARCH for Diabetes in Youth study. Participants provided blood samples and had their blood pressure, cholesterol, triglycerides, and blood sugar levels measured. They were also interviewed about their lifestyle habits, such as smoking or exercising. The research was funded by the CDC and the National Institute of Diabetes and Digestive Kidney Diseases.

The authors note that 90% of adult smokers say they started smoking before age 18, indicating that adolescence and early adulthood may be a prime time to intervene and instill healthier lifestyle habits.

Reynolds and her team state that their research included a large, racially, socioeconomically diverse study population.

"Smoking is an avoidable risk factor for the development of cardiovascular disease," Reynolds and her team write. "Youth with diabetes, regardless of type, should be targeted for aggressive smoking prevention and cessation programs."

SOURCE: Reynolds, K. Journal of Pediatrics, Dec. 3, 2010.

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