Tobacco use raises the already elevated risk of complications in people with diabetes. Tobacco dependence cessation treatment can significantly increase quit rates. Effective intervention strategies include counseling, behavioral support, and medications.
- Screen people with diabetes at least once a year for non-ceremonial tobacco use (cigarettes, chewing tobacco) and exposure to secondhand smoke. Exit Disclaimer: You Are Leaving www.ihs.gov
- Advise tobacco users to quit and assess their willingness to quit, at every diabetes visit.
- Use evidence-based models such as the Five Major Steps to Intervention Exit Disclaimer: You Are Leaving www.ihs.gov (The “5 A’s”: Ask, Advise, Assess, Assist, and Arrange) for nicotine dependence cessation.
- Ask about tobacco use - Identify and document tobacco use.
- Advise to quit - Urge every tobacco user to quit.
- Assess - Is there a willingness to quit?
- Assist - For tobacco users willing to quit, offer cessation counseling and treatment including nicotine dependence medications or refer the patient to a tobacco cessation program (or outside referral services such as 1-800-QUIT-NOW or smokefree.gov). Exit Disclaimer: You Are Leaving www.ihs.gov
- Arrange - Schedule follow up, preferably within the first week after the quit date.
Tobacco cessation medications are available on the IHS National Core Formulary (for details see National Pharmacy and Therapeutics Committee Formulary Brief: Nicotine Dependence: [PDF – 234 KB]
- Nicotine replacement therapy (long-acting patch and rapid-acting products such as gum, lozenges, inhaler and nasal spray)
- Bupropion SR (Zyban)
- Varenicline (Chantix)
Note: E-cigarettes are not FDA-approved for smoking cessation, and the U.S. Preventive Services Task Force has concluded that evidence supporting their use for smoking cessation is insufficient.