Background:
Smoking cessation is an integral aspect of diabetes management. Given the diabetes-specific challenges faced by individuals with diabetes in attempting to quit smoking, the provision of tailored smoking cessation support has been recommended. However, there has been limited research on the development of tailored smoking cessation interventions for this cohort.

Objectives:
Develop a diabetes-specific smoking cessation intervention, based on evidence and the needs of individuals with diabetes.

Methods:
A scoping review of the literature on smoking cessation interventions for individuals with diabetes, and on the challenges and barriers to quitting was carried out to identify the most promising smoking cessation methods for this cohort. This was followed by a systematic review and intervention component analysis of the identified smoking cessation methods, for identifying the most effective smoking cessation elements. Additionally, a qualitative descriptive study was held amongst 20 Maltese former and current smokers with diabetes to explore their needs to quit smoking and views on the identified intervention components.

Results:
Based on the reviews and the qualitative descriptive study’s findings, a multi-component smoking cessation was developed. This consists of three to four behavioural support sessions (about 30 minutes each) and a six-week provision of Nicotine Replacement Therapy. To address the documented need for more impactful communication about tobacco-related harm, the intervention includes three brief video clips featuring a person with diabetes who experienced tobacco-associated diabetic complications. Participants from the qualitative descriptive study also expressed the need for smoking cessation support in local diabetes practice, presenting an opportunity to integrate the smoking cessation intervention into local diabetes education initiatives.

Conclusions:
This study reports on the development of a unique multi-component smoking cessation intervention based on evidence and the needs of individuals with diabetes. The intervention will now be piloted as part of local diabetes education efforts.