Complications - [b] Vascular Complications & Smoking Status

In 2004 with regard to Current Smokers versus Current Non-smokers, interestingly the respective percentages were similar, where 68.0% versus 66.3% had no complications reported, 27.4% versus 28.6% had 1-2 complications and 4.6% versus 5.1% had 3+ complications [Table 26].

Table 26 Vascular Complications and Smoking [Adult Forms Only]

Vascular Complications / Smoking Status	No Vasc Complications	1-2 Vasc Complications	3+ Vasc Complications
2000 Current	0.0%	0.0%	0.0%
2000 Non Smoker	0.0%	0.0%	0.0%
2000 Missing Smoking Status	70.1%	26.6%	3.2%
2002 Current	79.3%	18.9%	1.8%
2002 Non Smoker	65.8%	30.3%	3.9%
2002 Missing Smoking Status	57.5%	35.6%	6.9%
2004 Current	68.0%	27.4%	4.6%
2004 Non Smoker	66.3%	28.6%	5.1%
2004 Missing Smoking Status	62.1%	32.7%	5.2%
2006 Current	75.9%	23.1%	0.0%
2006 Past	65.4%	32.8%	1.8%
2006 Never	82.4%	16.1%	1.5%
2006 Current + Past	68.3%	30.3%	1.4%
2006 Past and Never	76.0%	22.4%	1.7%
2006 Missing Smoking Status	75.6%	23.2%	1.2%
2009 Current	64.5%	32.2%	3.3%
2009 Past	42.4%	49.0%	8.6%
2009 Never	73.7%	23.4%	2.9%
2009 Current + Past	48.2%	44.7%	7.2%
2009 Past and Never	60.4%	34.3%	5.3%
2009 Missing Smoking Status	51.4%	44.0%	4.6%
2011 Current	64.9%	30.9%	4.1%
2011 Past	52.4%	41.1%	6.6%
2011 Never	77.5%	19.5%	3.1%
2011 Current + Past	55.7%	38.4%	5.9%
2011 Past and Never	68.0%	27.6%	4.4%
2011 Missing Smoking Status	43.9%	49.2%	6.9%

Removing PVD [not collected in 2006], and recalculating the 2004 data showed [Current Smoker versus Non Smoker] 78.4% versus 75.3% had no complications reported, 21.2% versus 23.3% had 1-2 complications and 0.5% versus 1.5% had 3+ complications [Table 26a]

The respective data for 2006 involved the additional data on Past Smokers as well as Never Smoked. For comparison with the 2004 data we compared Current Smoker versus Past Smoker + Never Smoked combined as ‘Non Smokers’. The data were similar : [Current Smoker versus Non Smoker] 76.9% versus 76.0% had no complications reported, 23.1% versus 22.4% had 1-2 complications and 0.0% versus 1.7% had 3+ complications.

Further assessment revealed that, [as was the case in 2004 and 2006], Current Smokers were younger [mean age 50.9 + 14.4 versus 58.6 + 16.2 years] with a shorter mean duration of diabetes [10.2 + 8.7 versus 12.9 + 10.1 years].
Combining Current plus Past Smokers [ie those who have ‘Ever’ Smoked], and comparing them to those stated to have ‘Never’ Smoked revealed that in 2006 [and 2009] respectively, there were substantially less with no complications amongst those who had ‘Ever’ smoked being 68.3% [48.2% 2009] versus 82.4% [73.7% in 2009].

This substantial difference remained in 2009 after removing PVD [which was not collected in 2006] – (see Table 26[a]) being 55.5% [‘Ever’ Smoked] versus 78.9% [‘Never’ Smoked].

The full adjusted data for 2009 and 2011 [with comparison to 2004 and 2006 data] are shown in Table 26[a].

Table 26[a] Vascular Complications and Smoking Adjusted [Adult Forms Only]

Vascular Complications / Smoking Status	No Vasc Complications	1-2 Vasc Complications	3+ Vasc Complications
2004 Current	78.4	21.2	0.5
2004 Non Smoker	75.3	23.3	1.5
2006 Current	76.9	23.1	0.0
2006 Past	65.4	32.8	1.8
2006 Never	82.4	16.1	1.5
2006 Current + Past	68.3	30.3	1.4
2006 Past and Never	76.0	22.4	1.7
2009 Current	72.8	25.6	1.7
2009 Past	49.5	47.0	3.5
2009 Never	78.9	19.6	1.5
2009 Current + Past	55.5	41.5	3.1
2009 Past and Never	66.5	31.1	2.4
2009 Missing Smoking Status	57.4	30.9	1.7
2011 Current	74.2	25.5	0.3
2011 Past	61.3	36.6	2.1
2011 Never	81.8	16.7	1.5
2011 Current + Past	64.7	33.7	1.6
2011 Past and Never	74.0	24.2	1.7
2011 Missing Smoking Status	57.6	40.0	2.4

Thus, with the benefit of data on Past Smokers, the increased in vascular complications seen in these individuals is consistent with what would be expected. One interpretation of these data is that individuals cease smoking when a complication develops [and are thus no longer Current Smokers in ANDIAB surveys].

In 2011, this substantial difference also remained after removing PVD [which was not collected in 2006] – (see Table 26[a]) being 64.7% [‘Ever’ Smoked] versus 81.8% [‘Never’ Smoked].

The substantial difference remains when considering those with 1-2 Vascular Complications (excluding PVD) where the figures are 33.7% [‘Ever’ Smoked] versus 16.7% [‘Never’ Smoked] – the respective figures in 2009 were 41.5% [‘Ever’ Smoked] versus 19.6% [‘Never’ Smoked].