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Research ArticleOriginal Article
Open Access

Determinants of tobacco cessation among patients with chronic diseases (diabetes/hypertension) enrolled in Ministry of Health Tobacco Cessation Clinics, Kingdom of Saudi Arabia from 2012-2017

A case control study

Nariman A. Alshakhis, Mahmoud A. Mahmoud and Ali M. Alwadey
Saudi Medical Journal April 2021, 42 (4) 433-440; DOI: https://doi.org/10.15537/smj.2021.42.4.20200354
Nariman A. Alshakhis
From the Ministry of Health (Alshakhis), Dammam; from the Department of Community and Family Medicine (Mahmoud), AL Immam Mohammad Ibn Saud Islamic University; and from the Anti-Tobacco Program (Alwadey), Ministry of Health, Riyadh; Kingdom of Saudi Arabia.
MBSS, SBCM
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  • For correspondence: [email protected]
Mahmoud A. Mahmoud
From the Ministry of Health (Alshakhis), Dammam; from the Department of Community and Family Medicine (Mahmoud), AL Immam Mohammad Ibn Saud Islamic University; and from the Anti-Tobacco Program (Alwadey), Ministry of Health, Riyadh; Kingdom of Saudi Arabia.
MD, ABCM
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Ali M. Alwadey
From the Ministry of Health (Alshakhis), Dammam; from the Department of Community and Family Medicine (Mahmoud), AL Immam Mohammad Ibn Saud Islamic University; and from the Anti-Tobacco Program (Alwadey), Ministry of Health, Riyadh; Kingdom of Saudi Arabia.
MBSS, FETP
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    Table 1

    - Socio-demographic characteristics of respondents with chronic diseases (diabetes/hypertension) attending Ministry of Health Tobacco Cessation Clinics, Riyadh, Saudi Arabia, 2012-2017.

    CharacteristicsResults
    Age, years (n=402)
    40-50 years140 (34.8)
    51-60 years170 (42.3)
    61-70 years75 (18.7)
    71-80 years17 (04.2)
    Gender (n=402)
    Male393 (97.8)
    Female09 (2.8)
    Marital status (n=395)
    Single1 (0.3)
    Married382 (96.7)
    Divorced6 (01.5)
    Widowed6 (01.5)
    Missing=7
    Educational level (n=390)
    Intermediate or less167 (42.8)
    Diploma or high school140 (35.9)
    Bachelor or higher83 (21.3)
    Missing values12 (3.0)
    Missing=12
    Occupation (n=392)
    Government employee108 (27.6)
    Private employee62 (15.8)
    Self employed31 (7.9)
    Retired168 (42.9)
    Unemployed23 (05.9)
    Missing =10
    Income level (SAR)(n=322)
    None15 (4.7)
    ≤5,00081 (25.2)
    5,001-10,000119 (37.0)
    10,001-20,00092 (28.5)
    >20,00015 (4.7)
    Missing=80
    Nationality (n=384)
    Saudi335 (87.2)
    Non-Saudi49 (12.8)
    Missing=18
    Region (n=387)
    Central region93 (23.1)
    Eastern region43 (11.1)
    Western region204 (52.7)
    Southern region37 (9.2)
    Northern region10 (2.6)
    Missing=15
    • Values are presented as mean ± standard deviation, number and percentage (%)

    • View popup
    Table 2

    - Chronic disease characteristic of respondents’ attending Ministry of Health (MOH) Tobacco Cessation Clinics, Riyadh, Saudi Arabia, 2012-2017.

    CharacteristicsResults
    Chronic diseases(n=402)
    Only diabetes mellitus (DM)384 (95.5)
    Only hypertension (HTN)193 (48.0)
    Both175 (43.5)
    Duration of DM (n=377)
    ≤10 years235 (62.7)
    >10 years140 (37.3)
    Missing=25
    Duration of HTN(n=192)
    ≤10 years135 (70.7)
    >10 years56 (29.3)
    Missing=210
    Type of clinic visited for medical care of DM or HTN (n=351)
    MOH-primary health care175 (45.7)
    MOH-hospital103 (26.9)
    Private hospital69 (18.0)
    Other government hospital74 (19.3)
    None19 (04.7)
    Missing=51
    Frequency of health care facility visit per year for DM follow up (n=351)
    ≤8 times per year199 (56.7)
    >8 times per year152 (43.3)
    Frequency of health care facility visit for HTN follow up (n=165)
    ≤8 times per year88 (53.3)
    >8 times per year77 (46.7)
    Reported level of DM control (n=402)
    Controlled60 (16.1)
    Uncontrolled126 (33.9)
    Don’t know216 (53.7)
    Missing=216
    Reported level of HTN control (n=402)
    Controlled28 (07.0)
    Uncontrolled48 (11.9)
    Don’t know326 (81.1)
    Last reported HbA1c (n=186) (mean+SD)07.7±01.7
    Missing=216
    Last known systolic blood pressure (n=81) (mean+SD)143.9±27.9
    Last known diastolic blood pressure (n=76) (mean+SD)87.4±21.6
    Previous Hospital Admission (n=392) 
    Yes65 (16.6)
    No327 (83.4)
    Missing=10 
    Reason for hospital admission (n=402)
    Thromboembolism13 (27.1)
    High blood sugar10 (20.8)
    High blood pressure04 (08.3)
    Heart disease10 (20.8)
    Other disease11 (22.9)
    Treating physician recommended tobacco cessation (n=381)
    Yes305 (80.1)
    No76 (19.9)
    Missing=21 
    Self-decision to quit tobacco due to DM or HTN (n=398)
    Yes179 (45.0)
    No219 (55.0)
    Missing=4 
    • Values are presented as mean ± standard deviation, number and percentage (%)

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    Table 3

    - Medical Services provided to respondents with chronic diseases (diabetes/hypertension) attending Ministry of Health Tobacco Cessation Clinics, Riyadh, Saudi Arabia, 2012-2017.

    CharacteristicsResults
    Type of treatment
    Behavioral186 (46.3)
    Medications371 (92.3)
    Both166 (41.3)
    Type of medication (n=352)
    Patch156 (38.8)
    Tablets262 (65.2)
    Gum11 (02.7)
    Lozenge68 (16.9)
    Type of tablet (n=262)
    Varenicline233 (58.0)
    BupropionMissing=2304 (01.0)
    Days used medication (mean±SD)
    Days for patch22.6 ± 30.9
    Days for lozenges31.9 ± 98.8
    Days for varenicline38.9 ± 48.9
    Days for bupropion15.0 ± 17.3
    Days for gum10.0 ± 0
    Treatment satisfaction(n=352)
    Very unsatisfied17 (04.8)
    Unsatisfied26 (07.4)
    Unsure45 (12.8)
    Satisfied121 (34.4)
    Very satisfied143 (40.6)
    Missing=50
    • Values are presented as mean ± standard deviation, number and percentage (%).

    • View popup
    Table 4

    - Bivariate analysis for the association between socio-demographics characteristics and groups of respondents attending Ministry of Health Tobacco Cessation Clinics, Riyadh, Saudi Arabia, 2012-2017.

    FactorGroup of patientsP-value*
    Case (quit) (n=85)Controls (not quit)(n=317)
    Age
    ≤60 years63 (74.1)247 (77.9)0.459
    >60 years22 (25.9)70 (22.1)
    Gender
    Male83 (97.6)310 (97.8)0.936
    Female2 (02.4)7 (02.2)
    Marital status
    Single1 (01.2)12 (03.9)0.224
    Married83 (98.8)299 (96.1)
    Educational level
    High school or below53 (65.4)206 (66.7)0.834
    Diploma or higher28 (34.6)103 (33.3)
    Occupation
    Employed42 (51.2)159 (51.3)0.991
    Unemployed40 (48.8)151 (48.7)
    Income level (SAR)
    ≤10,00035 (57.4)165 (67.1)0.155
    >10,00026 (42.6)81 (32.9)
    Nationality
    Saudi71 (85.5)264 (87.7)0.601
    Non-Saudi12 (14.5)37 (12.3)
    Reported level of DM
    Controlled14 (35.69)46 (31.3)0.584
    Uncontrolled25 (64.1)101 (68.7)
    Reported level of HTN
    Controlled08 (57.1)20 (32.3)0.081
    Uncontrolled06 (42.9)42 (67.7)
    • Results are expressed as number and percentage (%).

    • ↵* P-value has been calculated using Chi-square test. DM: diabetes mellitus, HTN: hypertension

    • View popup
    Table 5

    - Multivariate analysis predicting group of patients as case versus control from the socio-demographics characteristics, of respondents attending Ministry of Health Tobacco Cessation Clinics, Riyadh, Saudi Arabia, 2012-2017.

    FactorOR95% CIP-value*
    Age, years
    ≤60 vs. >600.5370.036-8.1230.654
    Educational level
    High school or below vs. diploma or higher17.0111.000-289.20.050†
    Occupation
    Employed vs. unemployed6.2580.446-87.7440.173
    Income level (Saudi Riyal)
    ≤10,000 vs. >10,0000.4900.047-5.1130.551
    Nationality
    Saudi vs. non-Saudi0.8290.411-1.6730.601
    Reported level of DM
    Controlled vs. uncontrolled1.4290.130-15.7390.771
    Reported level of HTN
    Controlled vs. uncontrolled17.8241.516-209.60.022†
    • OR: odds ratio, DM: diabetes mellitus, HTN: hypertension, vs: versus,

    • ↵† Indicates significant p-value.

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Determinants of tobacco cessation among patients with chronic diseases (diabetes/hypertension) enrolled in Ministry of Health Tobacco Cessation Clinics, Kingdom of Saudi Arabia from 2012-2017
Nariman A. Alshakhis, Mahmoud A. Mahmoud, Ali M. Alwadey
Saudi Medical Journal Apr 2021, 42 (4) 433-440; DOI: 10.15537/smj.2021.42.4.20200354

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Determinants of tobacco cessation among patients with chronic diseases (diabetes/hypertension) enrolled in Ministry of Health Tobacco Cessation Clinics, Kingdom of Saudi Arabia from 2012-2017
Nariman A. Alshakhis, Mahmoud A. Mahmoud, Ali M. Alwadey
Saudi Medical Journal Apr 2021, 42 (4) 433-440; DOI: 10.15537/smj.2021.42.4.20200354
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Keywords

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  • Saudi Arabia

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