OBJECTIVE To test whether a practice-level intervention to promote the systematic identification, treatment, and follow-up of smokers (the Ottawa Model for Smoking Cessation [OMSC]) would improve long-term abstinence rates among smoker-patients with type 2 diabetes or prediabetes receiving care from diabetes education programs in Ontario, Canada.

RESEARCH DESIGN AND METHODS The Tobacco Intervention in Diabetes Education study was a matched-pair, cluster-randomized clinical trial. Within each pair, sites were randomly allocated to either an OMSC intervention (n = 7) or a wait-list control (WLC) condition (n = 7). Diabetes education programs in the OMSC group introduced standardized processes to identify smokers and routinely provided smoking cessation interventions and follow-up. Smokers in the OMSC group received counseling, a discount card to partially cover the cost of smoking cessation medication, and follow-up telephone calls over a 6-month period. Diabetes education programs in the WLC condition were offered the OMSC intervention after a 1-year waiting period. Smokers in the WLC group received usual care for smoking cessation from their diabetes educator. The primary end point was carbon monoxide (CO)–confirmed 7-day point prevalence abstinence from smoking at 6-month follow-up.

RESULTS A total of 313 smokers (OMSC group n = 199, WLC group n = 114) with diabetes or prediabetes were enrolled. The CO-confirmed abstinence rate at 6 months was 11.1% in the OMSC group versus 2.6% in the WLC group (odds ratio 3.73 [95% CI 1.20, 11.58]; P = 0.02).

CONCLUSIONS Implementation of the OMSC in diabetes education programs resulted in clinically and statistically significant improvements in long-term abstinence among smokers with diabetes or prediabetes.

目的测试实践水平的干预措施是否可以促进吸烟者的系统性识别，治疗和随访（渥太华戒烟模型[OMSC]）是否可以改善2型糖尿病吸烟者或长期吸烟者的长期戒断率在加拿大安大略省的糖尿病教育计划中接受糖尿病前期护理的人。

研究设计和方法糖尿病教育中的烟草干预研究是配对，集群随机临床试验。在每对中，将站点随机分配给OMSC干预（n = 7）或等待列表控制（WLC）条件（n= 7）。OMSC组的糖尿病教育计划引入了标准化程序来识别吸烟者，并定期提供戒烟干预措施和随访。OMSC组的吸烟者获得了咨询，一张打折卡（部分用于支付戒烟药物的费用）以及为期6个月的跟进电话。经过1年的等待期后，在OLC干预下为WLC条件下的糖尿病教育计划提供了服务。WLC组的吸烟者从其糖尿病教育者那里获得了戒烟的常规护理。主要终点是一氧化碳（CO）–在6个月的随访中确认了7天戒烟的患病率。

结果共纳入313名患有糖尿病或糖尿病前期的吸烟者（OMSC组n = 199，WLC组n = 114）。OMSC组在6个月时经CO确认的戒断率为11.1％，而WLC组为2.6％（赔率为3.73 [95％CI 1.20，11.58]；P = 0.02）。

结论在糖尿病教育计划中实施OMSC可以使患有糖尿病或前驱糖尿病的吸烟者的长期禁欲在临床和统计学上得到显着改善。