Nurse practitioners and other healthcare providers are challenged to reduce unnecessary inhaler prescribing among patients with VCD without asthma and to seek specialty consultation to confirm or refute the diagnosis of asthma when needed.

The deidentified electronic medical records of 1,452 veterans with a history of smoking and assigned to an outpatient Department of Veteran Affairs Medical Center were examined. Descriptive statistics and two repeated measures ANCOVA were performed to determine the demographic characteristics of the sample and the relationships between the independent variable of tobacco use group on the dependent variables of LDL cholesterol and HbA1c levels, during the years 2003 through 2007. There was no statistically significant relationship between tobacco use and LDL levels when controlling for weight. There was a statistically significant difference in the tobacco use groups and HbA1c levels. Current smokers had higher HbA1c levels than did former smokers throughout the observational period, but the difference was statistically significant only for the years 2003 and 2007. Thus health care providers are challenged to monitor for cardiovascular risk factors, assist patients with smoking cessation, and prevent tobacco use.