Annemieke M W Spijkerman1, Daphne L van der A2, Peter M Nilsson3, Eva Ardanaz4, Diana Gavrila5, Antonio Agudo6, Larraitz Arriola7, Beverley Balkau8, Joline W Beulens9, Heiner Boeing10, Blandine de Lauzon-Guillain8, Guy Fagherazzi8, Edith J M Feskens11, Paul W Franks12, Sara Grioni13, José María Huerta14, Rudolf Kaaks15, Timothy J Key16, Kim Overvad17, Domenico Palli18, Salvatore Panico19, M Luisa Redondo20, Olov Rolandsson21, Nina Roswall22, Carlotta Sacerdote23, María-José Sánchez24, Matthias B Schulze10, Nadia Slimani25, Birgit Teucher15, Anne Tjonneland26, Rosario Tumino27, Yvonne T van der Schouw9, Claudia Langenberg28, Stephen J Sharp28, Nita G Forouhi28, Elio Riboli29, Nicholas J Wareham28. 1. National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands annemieke.spijkerman@rivm.nl. 2. National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. 3. Lund University, Malmö, Sweden. 4. Navarre Public Health Institute (ISPN), Pamplona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. 5. Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. 6. Catalan Institute of Oncology, Barcelona, Spain. 7. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Public Health Division of Gipuzkoa, San Sebastian, Spain Instituto BIO-Donostia, Basque Government, Donostia, Spain. 8. INSERM, CESP, U1018, Villejuif, France UMRS 1018, University Paris Sud 11, Villejuif, France. 9. University Medical Center Utrecht, Utrecht, the Netherlands. 10. German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany. 11. University of Wageningen, Wageningen, the Netherlands. 12. Lund University, Malmö, Sweden Umeå University, Umeå, Sweden. 13. Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 14. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. 15. German Cancer Research Centre (DKFZ), Heidelberg, Germany. 16. University of Oxford, Oxford, U.K. 17. Department of Public Health, Aarhus University, Aarhus, Denmark Aalborg Hospital, Aalborg University, Aalborg, Denmark. 18. Cancer Research and Prevention Institute (ISPO), Florence, Italy. 19. Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. 20. Public Health Directorate, Asturias, Spain. 21. Umeå University, Umeå, Sweden. 22. Department of Diet, Genes and Environment, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark. 23. Center for Cancer Prevention, Torino, Italy Human Genetics Foundation (HuGeF), Torino, Italy. 24. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Andalusian School of Public Health, Granada, Spain. 25. International Agency for Research on Cancer, Lyon, France. 26. Danish Cancer Society Research Center, Copenhagen, Denmark. 27. Cancer Registry and Histopathology Unit, ASP 7, Ragusa, Italy AIRE-ONLUS - Ragusa, Ragusa, Italy. 28. MRC Epidemiology Unit, Cambridge, U.K. 29. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K.
Abstract
OBJECTIVE: The aims of this study were to investigate the association between smoking and incident type 2 diabetes, accounting for a large number of potential confounding factors, and to explore potential effect modifiers and intermediate factors. RESEARCH DESIGN AND METHODS: The European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct is a prospective case-cohort study within eight European countries, including 12,403 cases of incident type 2 diabetes and a random subcohort of 16,835 individuals. After exclusion of individuals with missing data, the analyses included 10,327 cases and 13,863 subcohort individuals. Smoking status was used (never, former, current), with never smokers as the reference. Country-specific Prentice-weighted Cox regression models and random-effects meta-analysis were used to estimate hazard ratios (HRs) for type 2 diabetes. RESULTS: In men, the HRs (95% CI) of type 2 diabetes were 1.40 (1.26, 1.55) for former smokers and 1.43 (1.27, 1.61) for current smokers, independent of age, education, center, physical activity, and alcohol, coffee, and meat consumption. In women, associations were weaker, with HRs (95% CI) of 1.18 (1.07, 1.30) and 1.13 (1.03, 1.25) for former and current smokers, respectively. There was some evidence of effect modification by BMI. The association tended to be slightly stronger in normal weight men compared with those with overall adiposity. CONCLUSIONS: Former and current smoking was associated with a higher risk of incident type 2 diabetes compared with never smoking in men and women, independent of educational level, physical activity, alcohol consumption, and diet. Smoking may be regarded as a modifiable risk factor for type 2 diabetes, and smoking cessation should be encouraged for diabetes prevention.
OBJECTIVE: The aims of this study were to investigate the association between smoking and incident type 2 diabetes, accounting for a large number of potential confounding factors, and to explore potential effect modifiers and intermediate factors. RESEARCH DESIGN AND METHODS: The European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct is a prospective case-cohort study within eight European countries, including 12,403 cases of incident type 2 diabetes and a random subcohort of 16,835 individuals. After exclusion of individuals with missing data, the analyses included 10,327 cases and 13,863 subcohort individuals. Smoking status was used (never, former, current), with never smokers as the reference. Country-specific Prentice-weighted Cox regression models and random-effects meta-analysis were used to estimate hazard ratios (HRs) for type 2 diabetes. RESULTS: In men, the HRs (95% CI) of type 2 diabetes were 1.40 (1.26, 1.55) for former smokers and 1.43 (1.27, 1.61) for current smokers, independent of age, education, center, physical activity, and alcohol, coffee, and meat consumption. In women, associations were weaker, with HRs (95% CI) of 1.18 (1.07, 1.30) and 1.13 (1.03, 1.25) for former and current smokers, respectively. There was some evidence of effect modification by BMI. The association tended to be slightly stronger in normal weight men compared with those with overall adiposity. CONCLUSIONS: Former and current smoking was associated with a higher risk of incident type 2 diabetes compared with never smoking in men and women, independent of educational level, physical activity, alcohol consumption, and diet. Smoking may be regarded as a modifiable risk factor for type 2 diabetes, and smoking cessation should be encouraged for diabetes prevention.
Authors: Xianyong Yin; Chris Bizon; Jeffrey Tilson; Yuan Lin; Ian R Gizer; Cindy L Ehlers; Kirk C Wilhelmsen Journal: Am J Med Genet B Neuropsychiatr Genet Date: 2017-04-25 Impact factor: 3.568
Authors: Ashley L Merianos; Md Monir Hossain; Jane C Khoury; Georg E Matt; E Melinda Mahabee-Gittens Journal: Nicotine Tob Res Date: 2018-03-06 Impact factor: 4.244