Nicotine dependence in patients with diabetes mellitus Jakir Hossain Bhuiyan Masud 1 , M H Faruquee 2 , Mainul Alam Chaklader 3 , Nawzia Yasmin 2 ABSTRACT Tobacco use is a major preventable cause of premature death and disease. Tobacco use is a major risk factor for various complications of diabetes. A cross sectional study was conducted among 217 diabetic patients attending outdoor of a specialized tertiary care hospital on diabetes in Dhaka. A structured questionnaire was used to identify the level of dependence to nicotine among the tobacco users. Among the total respondents 58.5% were in the age group of 25-44 years. Overall smoking tobacco user was 51.2% and smokeless tobacco user was 18.4%. Among the smoking tobacco user (39.6%) had high level of nicotine dependency and smokeless tobacco user (82.5%) had high level of nicotine dependency. Majority 49.0% respondents believe strong desire can be an effective method of quitting and 34.4% believe that they need physician encouragement. Strengthening of awareness and tobacco cessation program to control tobacco is recommended. Key words: diabetes mellitus, tobacco, nicotine dependence Introduction Tobacco is one of the leading causes of disability and death worldwide. Tobacco, especially smoking is a major cardiovascular risk factor and death. Recent evidence has suggested a positive association between smoking and diabetes mellitus (DM) in both male and female.(1,2) In a cohort study at USA positive association between cigarette smoking and DM was reported. (3) Cigarette smoking may be an independent, modifiable risk factor for insulin dependent diabetes mellitus. In another study it was found that, smoking is independently associated with increased risk of DM among both middle aged and elderly men and women. (4–6) Tobacco consumption is an important public health problem in Bangladesh. Tobacco is harmful to health and is of particular danger to people with diabetes. All late complications of diabetes such as cardiovascular disease, foot problems, kidney and eye diseases are worsened by smoking. Smoking cessation has immediate positive effects; however it is made difficult by tobacco dependence and by all forms of advertising and promotion used by the tobacco industry.