BACKGROUND: Cigarette smoking is an established predictor of incident type 2 diabetes mellitus, but the effects of smoking cessation on diabetes risk are unknown. OBJECTIVE: To test the hypothesis that smoking cessation increases diabetes risk in the short term, possibly owing to cessation-related weight gain. DESIGN: Prospective cohort study. SETTING: The ARIC (Atherosclerosis Risk in Communities) Study. PATIENTS: 10,892 middle-aged adults who initially did not have diabetes in 1987 to 1989. MEASUREMENTS: Smoking was assessed by interview at baseline and at subsequent follow-up. Incident diabetes was ascertained by fasting glucose assays through 1998 and self-report of physician diagnosis or use of diabetes medications through 2004. RESULTS: During 9 years of follow-up, 1254 adults developed type 2 diabetes. Compared with adults who never smoked, the adjusted hazard ratio of incident diabetes in the highest tertile of pack-years was 1.42 (95% CI, 1.20 to 1.67). In the first 3 years of follow-up, 380 adults quit smoking. After adjustment for age, race, sex, education, adiposity, physical activity, lipid levels, blood pressure, and ARIC Study center, compared with adults who never smoked, the hazard ratios of diabetes among former smokers, new quitters, and continuing smokers were 1.22 (CI, 0.99 to 1.50), 1.73 (CI, 1.19 to 2.53), and 1.31 (CI, 1.04 to 1.65), respectively. Further adjustment for weight change and leukocyte count attenuated these risks substantially. In an analysis of long-term risk after quitting, the highest risk occurred in the first 3 years (hazard ratio, 1.91 [CI, 1.19 to 3.05]), then gradually decreased to 0 at 12 years. LIMITATION: Residual confounding is possible even with meticulous adjustment for established diabetes risk factors. CONCLUSION: Cigarette smoking predicts incident type 2 diabetes, but smoking cessation leads to higher short-term risk. For smokers at risk for diabetes, smoking cessation should be coupled with strategies for diabetes prevention and early detection.
BACKGROUND: Cigarette smoking is an established predictor of incident type 2 diabetes mellitus, but the effects of smoking cessation on diabetes risk are unknown. OBJECTIVE: To test the hypothesis that smoking cessation increases diabetes risk in the short term, possibly owing to cessation-related weight gain. DESIGN: Prospective cohort study. SETTING: The ARIC (Atherosclerosis Risk in Communities) Study. PATIENTS: 10,892 middle-aged adults who initially did not have diabetes in 1987 to 1989. MEASUREMENTS: Smoking was assessed by interview at baseline and at subsequent follow-up. Incident diabetes was ascertained by fasting glucose assays through 1998 and self-report of physician diagnosis or use of diabetes medications through 2004. RESULTS: During 9 years of follow-up, 1254 adults developed type 2 diabetes. Compared with adults who never smoked, the adjusted hazard ratio of incident diabetes in the highest tertile of pack-years was 1.42 (95% CI, 1.20 to 1.67). In the first 3 years of follow-up, 380 adults quit smoking. After adjustment for age, race, sex, education, adiposity, physical activity, lipid levels, blood pressure, and ARIC Study center, compared with adults who never smoked, the hazard ratios of diabetes among former smokers, new quitters, and continuing smokers were 1.22 (CI, 0.99 to 1.50), 1.73 (CI, 1.19 to 2.53), and 1.31 (CI, 1.04 to 1.65), respectively. Further adjustment for weight change and leukocyte count attenuated these risks substantially. In an analysis of long-term risk after quitting, the highest risk occurred in the first 3 years (hazard ratio, 1.91 [CI, 1.19 to 3.05]), then gradually decreased to 0 at 12 years. LIMITATION: Residual confounding is possible even with meticulous adjustment for established diabetes risk factors. CONCLUSION: Cigarette smoking predicts incident type 2 diabetes, but smoking cessation leads to higher short-term risk. For smokers at risk for diabetes, smoking cessation should be coupled with strategies for diabetes prevention and early detection.
Authors: Stephanie S O'Malley; Judith L Cooney; Suchitra Krishnan-Sarin; Joel A Dubin; Sherry A McKee; Ned L Cooney; Amy Blakeslee; Boris Meandzija; Denise Romano-Dahlgard; Ran Wu; Robert Makuch; Peter Jatlow Journal: Arch Intern Med Date: 2006-03-27
Authors: Hsin-Chieh Yeh; Naresh M Punjabi; Nae-Yuh Wang; James S Pankow; Bruce B Duncan; Frederick L Brancati Journal: Diabetes Care Date: 2005-06 Impact factor: 19.112
Authors: Katherine J Strissel; Zlatina Stancheva; Hideaki Miyoshi; James W Perfield; Jason DeFuria; Zoe Jick; Andrew S Greenberg; Martin S Obin Journal: Diabetes Date: 2007-09-11 Impact factor: 9.461
Authors: Marc De Hert; Dan Cohen; Julio Bobes; Marcelo Cetkovich-Bakmas; Stefan Leucht; David M Ndetei; John W Newcomer; Richard Uwakwe; Itsuo Asai; Hans-Jurgen Möller; Shiv Gautam; Johan Detraux; Christoph U Correll Journal: World Psychiatry Date: 2011-06 Impact factor: 49.548
Authors: Joseph T Ciccolo; David M Williams; Shira I Dunsiger; James W Whitworth; Aston K McCullough; Beth B Bock; Bess H Marcus; Merle Myerson Journal: Ment Health Phys Act Date: 2014-06-01
Authors: Xiaolin Zhang; Robert P Igo; Jeremy Fondran; V Vinod Mootha; Matt Oliva; Kristin Hammersmith; Alan Sugar; Jonathan H Lass; Sudha K Iyengar Journal: Invest Ophthalmol Vis Sci Date: 2013-08-27 Impact factor: 4.799
Authors: Joshua J Joseph; Justin B Echouffo-Tcheugui; Mercedes R Carnethon; Alain G Bertoni; Christina M Shay; Haitham M Ahmed; Roger S Blumenthal; Mary Cushman; Sherita H Golden Journal: Diabetologia Date: 2016-06-08 Impact factor: 10.122
Authors: Terry M Bush; Michele D Levine; Brooke Magnusson; Yu Cheng; Xiaotian Chen; Lisa Mahoney; Lyndsay Miles; Susan M Zbikowski Journal: Ann Behav Med Date: 2014-04