Introduction:
In Turkey, the prevalence of diabetes is 14.6 percent, the highest in the European region. Smoking among diabetes patients increases the risk of premature death from cardiovascular diseases, progression of micro albuminuria and impairment of renal function and neuropathy. It also deteriorates the effectiveness of insulin and anti-diabetic drugs. The strong evidence of a dose-response association between cigarette smoking and diabetes morbidity and mortality makes smoking cessation a priority in diabetes patient management. However, in Turkey smoking cessation for diabetes patients is not part of routine patient care. As part of Project Quit Tobacco International, diabetes nurses in Istanbul hospitals were trained on the harms of tobacco use for diabetes patients and were provided skills for cessation counselling. This paper discusses this training as well as nurses’ experiences on the ward post training.

Material and Methods:
Interviews (n=10) were conducted in diabetes clinics in Istanbul to gain an understanding of the willingness and interest of nurses to be trained in cessation counseling. After determining a high level of interest, a group of diabetes nurses (n=15) were provided a two-day training focused on an overview of tobacco control in Turkey, the harms of tobacco and diabetes-specific information, and training in cessation counseling. Two months after the training, nurses were debriefed on their experiences conducting cessation counseling.

Results:
Results reveal that illness-specific information about the harms of smoking were well received by patients, and many were interested in quitting. Educational materials including posters, flipcharts and pamphlets that were prepared by the researchers were found to be important in patient understanding of the importance of quitting. Nurses expressed increased satisfaction in their job.

Conclusions:
Clinic-based smoking cessation is clearly warranted in Turkey and initial experiences of trained nurses will allow future trainings to better tailor cessation messages to this special population.

Funding:
Funding was provided by Global Bridges, Mayo Clinic, U.S.