Health professional advice for smoking and weight in adults with and without diabetes: findings from BRFSS

Health risk behaviors including smoking and weight-gain can cause and exacerbate chronic diseases like diabetes. Brief provider
advice is an effective intervention to reduce risk from these behaviors. However, behavioral advice is provided more often
to those who already have a chronic illness when compared with those who are at risk. The purpose of this study is to determine
whether the frequency of provider advice for smoking cessation and weight loss varies between overweight or obese smokers
with and without diabetes. BRFSS data from a subset of overweight and obese smokers with (n = 848) and without (n = 6,279) diabetes were analyzed to determine differences in reported provider advice. Overweight and obese smokers with diabetes
reported receiving more advice for both weight (46.4% vs. 23.4%, P < 0.001) and smoking (84.5% vs. 72.8%, P < 0.001) compared to those without diabetes. Advice for smoking cessation was reported two to three times more often than
advice for weight. Nearly a quarter of those with diabetes and almost half of those without reported no receipt of advice
about weight. Results indicate that providers are not adequately addressing overweight and obesity in patients with and at
risk for diabetes.