Nicotine-based Interventions for Adult Smokers with Diabetes: A Systematic Review
Bibliographic record
Abstract
Abstract Purpose Continuing to smoke or starting to smoke after a diagnosis of diabetes is associated with increased health complications, decreased treatment efficacy, and worse survival outcomes. However, the extent and effectiveness of smoking cessation services among patients with diabetes are poorly understood. Nicotine replacement is one of the available interventions to aid smokers in achieving smoking cessation. This systematic review aimed to provide comprehensive evidence on the effects of nicotine-based interventions to support smoking cessation in diabetic patients. Methods Electronic searches were carried out on the following databases: Medline, Embase, and Cochrane Library up to November 2022. Searches were supplemented by trial registries, references from identified studies, and review articles. Studies were included if nicotine was used to deliver a smoking cessation intervention and if the impact of the interventions was reported for diabetic patients. All articles were independently screened, selected, extracted, and assessed for quality. Narrative data synthesis was conducted due to heterogeneity. Results Sixteen studies reporting 12 trials met the inclusion criteria, including randomized controlled trials (n = 12), one cluster randomized trial, one non-randomized intervention trial, and two before-after design studies. Of the sixteen studies selected, eight studies exclusively assessed diabetic patients, and eight assessed patients with multiple comorbidities, in which diabetic patients were a subgroup of the total sample. Four studies reported interventions with nicotine that increased cessation rates significantly among the intervention group patients compared to the control group at six-month or twelve-month follow-ups. One trial reported a significant reduction in the self-reported number of cigarettes smoked/day in the intervention group compared to the control. Additionally, there was a trend toward positive changes in levels of biomarkers of glucose control and metabolic outcomes with the use of nicotine-based interventions. Conclusion Nicotine, with/without behavioral support, appears to increase smoking abstinence in those diagnosed with diabetes without making a significant negative clinical impact. However, data is limited to identifying the optimal form of nicotine or effective intervention for this population. Additionally, there is no evidence of efficacy in smoking cessation interventions with next-generation tobacco harm-reduction products among people with diabetes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.007 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".