Introduction:
Smoking cessation is a crucial intervention for reducing progressive lung deterioration in patients with Chronic Obstructive Pulmonary Disease (COPD) and for reducing mortality from cardiovascular disease. Smoking among diabetic patients amplifies the risk of cardiovascular morbidity as well as the total mortality.

Aim:
To examine the real-world effectiveness of the 2017 Specialized Tobacco Cessation Guidelines for High-risk Groups (TOB-G) recommendations among patients with: COPD, cardiovascular (CVD) disease and Type II diabetes or pre-diabetes.

Methods:
A pre-post pilot study was conducted among patients with COPD, cardiovascular disease and diabetes or pre-diabetes with current tobacco use, willing to quit smoking. Participants received a face-to-face counselling session at baseline and three telephone counselling sessions at 1, 2, and 6 months, from a trained healthcare professional. The primary outcome measure was point prevalence smoking abstinence measured at 1, 2, and 6 months, with biochemical validation at baseline and six months.

Results:
Among the 50 COPD patients (74% male; mean age 60.2±7.8 years), self-reported smoking abstinence was 30.6%, 44.9% and 64.6% at the 1, 2, and 6 months follow-up, respectively, with 33.3% confirmed by carbon monoxide (CO) validation. In CVD smokers, self-reported smoking abstinence ranged from 25.5%, 29.4% and 36.0% abstinent at the 1, 2, and 6 months follow-up, respectively, all verified by exhaled CO. The 50 diabetes/pre-diabetes (49%/51%) smokers had a self-reported and validated abstinence of 32.7% at both 1 and 2 months, and 63.3% at 6 months (p<0.001). Higher quit rates were documented among pre-diabetics versus diabetics (72% vs 54.2%; p=0.196), without statistical significance.

Conclusions:
Employing the TOB-G evidence-based tobacco treatment recommendations among samples COPD, CVD and diabetes/pre-diabetes patients determined important changes to smoking status.