Prospective, cluster-randomized trial to implement the Ottawa model for smoking cessation in diabetes education programs in Ontario, Canada
Abstract
OBJECTIVE To test whether a practice-level intervention to promote the systematic identification, treatment, and follow-up of smokers (the Ottawa Model for Smoking Cessation [OMSC]) would improve long-term abstinence rates among smoker-patients with type 2 diabetes or prediabetes receiving care from diabetes education programs in Ontario, Canada. RESEARCH DESIGN AND METHODS The Tobacco Intervention in Diabetes Education study was a matched-pair, cluster-randomized clinical trial. Within each pair, sites were randomly allocated to either an OMSC intervention (n = 7) or a wait-list control (WLC) condition (n = 7). Diabetes education programs in the OMSC group introduced standardized processes to identify smokers and routinely provided smoking cessation interventions and follow-up. Smokers in the OMSC group received counseling, a discount card to partially cover the cost of smoking cessation medication, and follow-up telephone calls over a 6-month period. Diabetes education programs in the WLC condition were offered the OMSC intervention after a 1-year waiting period. Smokers in the WLC group received usual care for smoking cessation from their diabetes educator. The primary end point was carbon monoxide (CO)–confirmed 7-day point prevalence abstinence from smoking at 6-month follow-up. RESULTS A total of 313 smokers (OMSC group n = 199, WLC group n = 114) with diabetes or prediabetes were enrolled. The CO-confirmed abstinence rate at 6 months was 11.1% in the OMSC group versus 2.6% in the WLC group (odds ratio 3.73 [95% CI 1.20, 11.58]; P = 0.02). CONCLUSIONS Implementation of the OMSC in diabetes education programs resulted in clinically and statistically significant improvements in long-term abstinence among smokers with diabetes or prediabetes.
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Smoking cessation interventions offered through diabetes education clinics increase quit rates and long-term abstinence rates (>6 months) regardless of motivation to quit at baseline.
“A cluster randomized trial found statistically significant increases in quit rates and long-term abstinence rates (>6 months) when smoking cessation interventions were offered through diabetes education clinics, regardless of motivation to quit at baseline (297).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [297]
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- Authors
- Reid, R. D., Malcolm, J., Wooding, E., Geertsma, A., Aitken, D., Arbeau, D., Blanchard, C., Gagnier, J.-A., Gupta, A., Mullen, K.-A., Oh, P., Papadakis, S., Tulloch, H., LeBlanc, A. G., Wells, G. A., & Pipe, A. L.
- Affiliations
- University of Ottawa (CA)
- Ottawa Hospital (CA)
- Ottawa Heart Institute (CA)
- Horizon Health Network (CA)
- Dalhousie University (CA)
- Trillium Health Centre (CA)
- Toronto Rehabilitation Institute (CA)
- Corresponding author
- Reid, Robert D.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2017-12-21
- Volume
- 41
- Issue
- 3
- Pages
- 406-412
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2780476783
- Cited by
- 30
- References
- 28
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 6 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 1 · 2019: 4
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer (Global Research Award for Nicotine Dependence)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- smoking cessation, type 2 diabetes, prediabetes, diabetes education program, smoking abstinence, tobacco intervention, smoking cessation medication, telephone follow-up
- MeSH terms
- Smoking Prevention, Adult, Aged, Counseling, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Ontario, Patient Education as Topic, Prospective Studies, Smoking, Smoking Cessation, Treatment Outcome
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