Smoking and Death in Thai Diabetic Patients: The Thailand Diabetic Registry Cohort
Thongchai Pratipanawatr MD*, Petch Rawdaree MD*, Thanya Chetthakul MD*, Pongamorn Bunnag MD*, Chardpraorn Ngarmukos MD*, Yupin Benjasuratwong MD*, Rattana Leelawatana MD*, Natapong Kosachunhanun MD*, Nattachet Plengvidhya MD*, Chaicharn Deerochanawong MD*, Sompongse Suwanwalaikorn MD*, Sirinate Krittiyawong MD*, Sirima Mongkolsomlit BS*, Chulaluk Komoltri PhD*, TDR Working Group*
Affiliation : * Division of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol Universty, Bangkok, Thailand
Objective : To determine the impact of smoking and quit smoking on mortality rate.
Material and Method: This prospective cohort was a three-year follow-up of Thai Diabetes Registry project that registered
9,370 diabetic patients from 10 diabetic clinics in tertiary medical centers in Bangkok and major provinces between
April 2003 and February 2006.
Results : The groups of 7,487 (80%), 1,315 (14%), and 568 (6%) patients were classified as non-smokers, ex-smokers, and
current smokers. The crude death rate of ex-smokers (Hazard Ratio (HR) 1.52 (95% CI 1.19-1.95)) and current smokers
(HR 1.55 (1.10-2.19)) were higher than death rate of non-smokers. After control for covariates, the HR comparing
ex-smokers with non-smokers was not different (1.10 (0.81-1.50)), while the HR comparing current smokers with non-smokers
remained statistical significant (1.74 (1.17-2.61)).
Conclusion : Smoking increases mortality rate in diabetic patients by about 74%. Quitting smoking decreased mortality
rate to the same rate as of diabetic non-smokers.
Keywords : Diabetes, Smoking, Death rate, Cause of death
