The adjusted odds ratios (AORs) for education and body mass index category were as follows: some college versus less than high school (AOR=1.76, 95% CI=1.16�C2.69), high school versus less than high school (AOR=1.80, more 95% CI=1.22�C2.66), and overweight versus normal weight (AOR=1.55, 95% CI=1.11�C2.16). Several bivariate associations were not detected after controlling for the other factors: single versus married/cohabitating, prior diagnosis of high blood pressure versus no diagnosis, one chronic disease versus no chronic diseases, multiple chronic diseases versus no chronic diseases, underweight versus normal weight, and student versus employed. Discussion Of the diseases we examined, diabetes was the only one that had a significant association with former smoking status after adjusting for several demographic factors.

Participants who reported that they had never been diagnosed with diabetes were approximately half as likely (OR=0.46; AOR=0.50) to be former smokers, compared with those who reported that they had diabetes. The diagnoses of hypertension and high cholesterol did not have significant associations with quitting smoking. Also, the likelihood of being a former smoker did not increase with an increase in the number of diagnosed chronic diseases. These findings were contrary to preliminary research in this area that has suggested that being diagnosed with a chronic illness or experiencing a medical event such as a heart attack increases the odds of smoking cessation (Gulliford, 2001; Wilkes & Evans, 1999). The finding of a relationship between diabetes and smoking status may have clinical significance.

Newly diagnosed patients with diabetes may represent a ��teachable moment�� for smoking cessation. Teachable moments have been described frequently as any naturally occurring life or health events that increase the motivation of a person to either adopt a new protective health behavior or reduce the frequency of risky behaviors (McBride, Emmons, & Lipkus, 2003). When smokers are newly diagnosed with diabetes or receive diabetes care, they are confronted with the seriousness of their health condition. A serious chronic illness such as diabetes may prompt an emotional reaction that could increase motivation to change behavior.

During these teachable moments, physicians or nurses may be able to influence the patient’s likelihood of quitting smoking by providing encouragement, education on the health benefits of smoking cessation, and concrete strategies and resources for quitting. The results regarding hypertension and high cholesterol are somewhat surprising Cilengitide in the context of health behavior models that indicate that adoption of preventive health behaviors should be greater when an event such as being diagnosed with a chronic disease heightens a person’s perception of vulnerability regarding health (Bandura, 1977; Fishbein & Ajzen, 1975; Weinstein, 1998).