The impact of smoking cessation on the control of diabetes mellitus and blood pressure in Saudi Arabia: A prospective randomized controlled clinical trial

Abstract

Diabetes mellitus is a major health problem that affects a wide range of populations worldwide. Recently, diabetes mellitus had become a growing public health concern in Saudi Arabia. The latest prevalence estimates indicate that there are about 4 million diabetic adults among Saudi population. The present study represents a prospective open labelled randomized controlled clinical trial with a two-group parallel design to detect the impact of smoking cessation on the control of diabetes mellitus and hypertension in Saudi populations. Assessment of smoking showed no difference in smoking duration between the two groups; whereas the intervention group had higher nicotine dependency level, greater amount of smoking and a higher level of expired carbon monoxide (CO). Indicators of diabetes control showed a minor, non-significant decrease in glycosylated hemoglobin (HbA1c) and a statistically significant increase in fasting blood glucose (FBG) (+18.34 ± 73.90 mg/dL versus -21.10 ± 46.20 mg/dL) in the intervention versus the control group respectively. In the present study, after one-year, smoking cessation intervention reduced systolic blood pressure (BP) by 7.8 mmHg and cigarette abstinence reduced it by 9.8 mmHg, by comparison to continued smoking where only a 2.8 mmHg decrease in systolic BP was observed. In conclusion, motivational smoking cessation interviews and telephone-calls follow-up along with the appropriate pharmacological interventions resulted in significant decline in the rate of smoking with significant reduction of systolic BP when compared versus those who continued smoking. However, smoking cessation, at least on the short-term run, didn't significantly affect the glycemic control.